New Delhi: The word ‘Cancer’ has become associated with death. These days we often come across many stories of people battling with different types of cancers, and while some survive, others don’t. However, Thyroid cancer which is not much talked about, is now emerging as one of the fastest growing cancers in the world.
Dr C S Bal, Professor and Head, Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), Delhi who exclusively works in this field for last two-and-half decades and considered an authority in thyroid cancer treatment says that “Thyroid cancer patients, if treated early and on time, can reach a stage when they are disease free.” There was a case in his department of a patient, who was detected with Thyroid Cancer with lymphnode and lungs metastases when he was 16 years old. He was treated with radioactive iodine and on regular follow- ups, and today, at the age of 48, he is disease free and now may not need any further follow-up. According to the doctor, out of 7500 thyroid cancer patients, there are many such cases like him, where people come for treatment and are able to lead normal disease free lives after the treatment process.
Thyroid cancer is the most common cancer of the endocrine system and occurs in all age groups, including children. In India the number of new cases of thyroid cancer is 1-2 per 100,000 men and women per year.
According to Dr Bal, “I am sure that India has one of the highest burdens of thyroid cancer, and, on an average, we see at least 700 cancer cases a year in our hospital alone, it is a cancer with the second burden in the US and there are reports that say that by 2030 it will be the most prominent cancer in the world.”
Amongst men as well as women, the number of new cases of thyroid cancer is increasing at a faster rate than any other type of cancer. Papillary and follicular cancers often referred to as “Well-Differentiated” thyroid cancers (WDTC), and are the most common. Together, they account for about 90% of thyroid cancers. Generally, the prognosis, or long-term outlook, for patients diagnosed with WDTC is very good.
“It is important to note that there is no real information on the burden of this disease in India, and this is because we don’t have an official registry of the same.” Dr Deepak Sarin (Associate Director, Head and Neck Oncology Surgery, Medanta – The Medicity). He further goes on to state that “The reason that there is an increase in the burden is two- fold – one is due to an increase of patients with this disease and the otheris the fact that now more people are being tested for the disease. “
Thyroid cancer symptoms may include a lump in the neck, pain in the lower front part of the neck, swollen lymph nodes in the neck, hoarseness of voice, and trouble in breathing and swallowing. Physical examination, blood tests, thyroid and other scans, thyroid ultrasound, fine-needle aspiration biopsy and surgical biopsy can be done to detect thyroid cancer in a patient.
“Thyroid cancer is highly curable and not a death sentence, whether detected early or late with the right treatment all patients live a normal healthy life.” Says Dr Sarin.
For most thyroid cancer cases, the entire thyroid is removed via surgery followed by radioactive iodine therapy (in a majority of cases). In most of the advanced WDTC surgeries, as part of the post-surgical procedure, patients are required to go for radioactive iodine scans or ablation procedure. To have a successful outcome of this procedure, patients are required to have high levels of thyroid-stimulating hormone (TSH or thyrotropin) in the blood which can be given either by withdrawing thyroid hormone therapy or through the use of recombinant thyroid stimulating hormone injections. A successful treatment plan involves adopting a collaborative approach and combining the expertise of head and neck surgeon, general surgeon and a nuclear physician.
According to Dr Sarin,“India has advanced treatment facilities available for patients suffering from thyroid cancer. There are also new innovations to look forward to for the cure of the cancer. Molecular markers will be used to identify and differentiate between each cancer. All cancers will be individually identified and treated individually. This will help in expeditingthe treatment process.”
On World Thyroid Day, Dr Bal says that the one message that he would like people to know is that “Thyroid cancer is a straight forward cancer with a straightforward treatment and excellent outcome.”