View source for Medullary thyroid cancer (patient information)

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{{Medullary thyroid cancer (patient information)}}
{{CMG}}; {{AE}} {{Ammu}}

'''For the WikiDoc page for this topic, click [[Medullary thyroid cancer|here]]'''
==Overview==
[[Thyroid]] is a butterfly-shaped [[gland]] in the [[neck]] which makes [[hormone]]s to help the bodywork normally. Medullary thyroid cancer is [[cancer]] that starts in the [[thyroid gland]]. Medullary thyroid cancer doesn't have any early [[symptoms]]. With the development of the [[cancer]], usual [[symptoms]] include a [[lump]] that can be felt through the [[skin]] on your [[neck]], [[hoarseness]], [[Dysphagia|difficulty swallowing]], [[pain]] in the [[neck]] and [[throat]] and swollen [[lymph node]]s in the [[neck]]. Treatments include [[surgery]], [[radiation therapy]], [[chemotherapy]], [[Thyroxine|thyroid hormone therapy]] or a combination of them.

==What are the symptoms of Medullary thyroid cancer?==
* Early medullary thyroid cancer does not have any [[symptoms]]. As the [[tumor]] grows larger, people may notice one or more of the following [[Symptom|symptoms]]:

:*A nodule, [[lump]], or swelling in the [[neck]]
:*[[Pain]] in the front of the [[neck]]
:*[[Hoarseness]] or other voice changes
:*Trouble [[swallowing]]
:*Breathing problems
:*Continuous [[cough]]
* Other health problems may also cause these [[symptoms]]. Only a doctor can tell for sure. A person with any of these [[symptoms]] should tell the doctor so that the problems can be diagnosed and treated as early as possible.

==What causes Medullary thyroid cancer?==
*[[Medullary thyroid cancer]] can occur in older age groups.
* Other [[risk factors]] are a family history of [[medullary thyroid cancer]] and chronic [[goiter]].
* There are several types of [[medullary thyroid cancer]]:
:* Familial medullary thyroid cancer
:* Sporadic medullary thyroid cancer
==Who is at highest risk?==
Clinical data have suggested that the development of medullary thyroid cancer is related to several factors.

:*A diet low in [[iodine]]: Clinical survey show [[medullary thyroid cancer]] are more common in areas where people's diets are low in [[iodine]].
:*[[Radiation]]: Scientists has proven that [[radiation]] exposure is a [[risk factor]] for follicular thyroid cancer. Such [[radiation]] includes medical treatments and [[radiation]] fallout from power plant accidents or nuclear weapons.
:*[[Hereditary]] [[conditions]]: Studies show people with certain [[inherited]] medical [[conditions]] such as [[Gardner syndrome]], [[Cowden disease]], and [[familial adenomatous polyposis]] ([[FAP]]) are at higher risk of developing [[medullary thyroid cancer]]
:*Gender: Contrary to other cancers, follicular thyroid cancers occur more often in women than in men.
:*Age: Clinical data show that [[Papillary thyroid cancer|papillary]] and [[follicular thyroid cancer]] is usually found in people between the ages of 20 and 60 years.
==Diagnosis==
Your doctor will perform a [[physical exam]]. This may reveal a lump in the [[thyroid]], or swollen [[lymph node]]s in the [[neck]].

The following tests may be done:

*[[Calcitonin]] [[blood]] test to check for medullary cancer
*[[Thyroglobulin]] [[blood]] test to check for [[Papillary thyroid cancer|papillary]] or [[Follicular cancer of the thyroid|follicular cancer]]
*[[Laryngoscopy]]
*[[Biopsy|Thyroid biopsy]]
* Thyroid scan
*[[Ultrasound|Ultrasound of the thyroid]]
* This [[disease]] may also affect the results of the following [[thyroid function tests]]:
*[[T3]]
*[[T4]]
*[[TSH]]

==When to seek urgent medical care?==
Call your health care provider if [[symptoms]] of [[thyroid cancer]] develop.

==Treatment options==
In order to [[diagnose]] medullary thyroid cancer, your doctor may suggest the following tests:

:*[[Thyroid hormones]] tests: [[Thyroid hormones]] including [[T3]], [[T4]], FT3, FT4 and [[TSH]] ([[thyroid-stimulating hormone]]) are needed to assess [[thyroid gland]] function.
:*[[Fine needle aspiration]] [[biopsy]]: The doctor places a thin, hollow needle directly into the [[nodule]] to take out [[cells]] and repeats twice or three times to receive samples from several areas of the [[nodule]]. Then these [[cells]] can be checked under a microscope to see whether [[cancerous]] or [[benign]].
:*Thyroid gland radio-iodine scan: During this test, the doctors put substances with small amounts of [[radiation]] into your body and detect the location of the substances. The test can help locate abnormal [[cells]] in the body.
:*[[Computed tomography]] ([[CT scan]]) and [[biopsy]]: [[CT scans]] are often used to [[diagnose]] medullary thyroid cancer. It can help determine the location and size of medullary thyroid cancer and whether they have spread to nearby or distant areas. These are helpful for identifying the stage of [[cancer]] and in determining whether [[surgery]] is a good treatment option. [[CT scans]] can also be used to guide [[biopsy]] and a biopsy sample is usually removed and looked at under a microscope. 
:*[[Magnetic resonance imaging]] ([[MRI]]): An [[MRI]] uses magnetic fields but it is a different type of image than what is produced by [[computed tomography]] ([[CT]]) and produces very detailed images of [[Soft tissue|soft tissues]] such as the [[thyroid gland]]. Like [[computed tomography]] ([[CT]]), a [[contrast]] agent may be injected into a patient’s vein to create a better picture.
:*[[Positron emission tomography]] ([[PET]]) scan: When doing this test, a small amount of a [[radioactive]] medium is injected into your body and absorbed by the organs or [[tissues]]. This [[radioactive]] substance gives off energy which in turn is used to produce the images. [[PET]] can provide more helpful information than either [[CT]] or [[MRI]] scans. It is useful to see if [[cancer]] has spread to the [[lymph nodes]] and it is also useful for your doctor to locate where [[cancer]] has spread.
* [[Patients]] with medullary thyroid cancer have many treatment options. The selection depends on the stage of the [[tumor]]. The options are [[surgery]], [[radiation]] therapy, [[chemotherapy]], [[thyroid hormone]] treatment, or a combination of these methods. Before treatment starts, ask your health care team about possible [[side effects]] and how treatment may change your normal activities. Because [[cancer]] treatments often damage healthy [[cells]] and [[tissues]], [[side effects]] are common. [[Side effects]] may not be the same for each person, and they may change from one treatment session to the next.

:*[[Surgery]]: [[Surgery]] is the main treatment for medullary thyroid cancer. Usually, [[Thyroidectomy|surgery of removing the tumor]] and all or part of the remaining [[thyroid gland]] is recommended.
:*[[Radiation therapy]]: It includes [[radioactive]] [[Iodine]] ([[Radioiodine]]) therapy and [[external beam radiation therapy]]. [[Radioactive iodine]] (RAI) known as I-131 can be taken into the body to destroy the [[thyroid gland]] and any other thyroid cells including cancer cells. During [[external beam radiation therapy]], the doctors use high-energy rays to destroy [[cancer]] cells or slow their rate of growth.
:*[[Chemotherapy]]: [[Chemotherapy]] is seldom helpful for most types of medullary thyroid cancer.
:*[[Thyroid hormone]] therapy: This treatment is to take daily pills of [[thyroid hormone]]. The aim is to help maintain the body's normal [[metabolism]] (by replacing missing [[thyroid hormone]]) and prevent some [[thyroid cancers]] from returning.
==Where to find medical care for Medullary Thyroid Cancer?==
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|thyroid cancer}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating thyroid cancer]
==Prevention of Medullary Thyroid Cancer==
The reasons for the development of medullary thyroid cancer are not clear. [[Epidemiological]] data show the following may be helpful:
:*Avoidance of diets low in [[iodine]]
:*Avoidance of [[radiation]] exposure
==What to expect (Outlook/Prognosis)?==
The [[prognosis]] of medullary thyroid cancer depends on the following:

:*The stage of [[cancer]]: the size of the [[tumor]], whether the [[cancer]] has spread outside the [[thyroid gland]]
:*Whether or not the [[tumor]] can be removed by [[surgery]]
:*The [[patient]]’s general health
==Possible complications==
*Injury to the voice box and [[hoarseness]] after [[thyroid]] [[surgery]]
*Low [[calcium]] levels from accidental removal of the [[parathyroid glands]] during [[surgery]]
*Spread of the [[cancer]] to the [[lungs]], [[bones]], or other parts of the body
==Sources==
http://www.nlm.nih.gov/medlineplus/ency/article/001213.htm
http://www.nlm.nih.gov/medlineplus/thyroidcancer.html
==References==
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[[Category:Patient information]]
[[Category:Disease]]
[[Category:Thyroid disease]]
[[Category:Endocrinology]]
[[Category:Mature chapter]]
[[Category:Otolaryngology]]
[[Category:Types of cancer]]