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THYROID CANCER: EARLY SCREENING & EFFECTIVE TREATMENT
In Vietnam, according to Globocan in 2022, thyroid cancer ranked sixth with 6,122 new cases and 858 deaths, with an incidence rate of 3.4 per 100,000 people.
Women are three times more likely to develop thyroid cancer than men. However, thyroid cancer is one of the cancers with the best prognosis. Most cases, especially differentiated thyroid cancers (including papillary and follicular types), have a high likelihood of successful treatment if detected early and treated appropriately.
► What is thyroid cancer?
The thyroid gland is an endocrine gland located in the neck area, in front of the trachea, consisting of two lobes and a connecting isthmus between them, giving it a shape resembling a butterfly. Thyroid cancer is a condition that occurs when cells in the thyroid gland grow abnormally and proliferate uncontrollably. This is a common condition, with the trend increasing with age and more commonly found in women than in men.
► Types of Thyroid Cancer:
Papillary Thyroid Carcinoma (PTC)
It is the most common type of cancer, accounting for about 80% of thyroid cancer cases, with a female-to-male ratio of 3:1. The disease may have a familial nature in 3% to 9% of patients.
Papillary thyroid carcinoma can metastasize to regional lymph nodes in 1/3 of patients and may metastasize to the lungs. Patients under 55 years old with small tumors confined to the thyroid have a good prognosis.
It typically grows slowly and has a good prognosis if detected early, rarely causing death.
Follicular Thyroid Carcinoma (FTC)
Follicular carcinoma accounts for 4% - 10% of thyroid cancers, more common in older patients and in areas with iodine deficiency.
It can metastasize to other organs such as the lungs and bones. Metastatic cancer may be more difficult to treat.
Medullary Thyroid Cancer (MTC)
Accounts for about 4% - 5% of thyroid cancer cases. 25% of cases have a familial nature.
Often associated with genetic disorders such as MEN2 syndrome.
Anaplastic Thyroid Carcinoma (ATC)
It is a rare but highly malignant type, accounting for about 2% and developing rapidly. This is one of the most dangerous types of thyroid cancer.
The prognosis is very poor, with a very high mortality rate and extremely low treatment outcomes. The 1-year survival rate is approximately 20%.
► Factors related to thyroid cancer ?
Women have a disease incidence rate 2 to 3 times higher than men, due to the influence of estrogen hormones.
A history of goiter (enlarged thyroid).
A family history of thyroid disease or thyroid cancer.
Medullary thyroid cancer can sometimes be caused by changes in a gene inherited from parents to children
Researchers have discovered genetic causes of familial medullary thyroid cancer (FMTC). As a result, it is now possible to identify family members carrying the mutated RET gene that causes this type of cancer and perform thyroidectomy before the cancer can develop.
Individuals exposed to radiation, especially from radiation therapy in the neck area, have a higher risk of developing the disease.
Overweight or obesity: People who are overweight or obese have a higher risk of thyroid cancer compared to those with normal weight.
► Risk factors:
Exposure to radiation from childhood to late adolescence is a well-known risk factor for thyroid cancer. Radiation exposure such as from the Chernobyl nuclear disaster; health check-ups involving CT scans, X-rays; radiotherapy for head and neck cancers; and treatment for hyperthyroidism with radioactive iodine (RAI) I-131.
► Signs and symptoms of thyroid cancer
Lump or swelling in the neck: This is the most common symptom.
Hoarseness or voice changes: A thyroid tumor pressing on the vocal cords causes persistent hoarseness.
Difficulty swallowing or breathing: A growing tumor can compress the esophagus or trachea, making it hard to swallow or breathe.
Swollen lymph nodes in the neck: Thyroid cancer can metastasize to nearby lymph nodes.
Pain in the front of the neck: Some people with thyroid cancer experience pain in the front of the neck, which may radiate to the ear.
► Symptoms:
Persistent cough: A cough that does not go away, especially if it is not related to a cold or infection.
Feeling of a lump in the throat: A sensation of something stuck in the throat.
Fatigue: Fatigue can be a symptom of many conditions, but if it is persistent and unexplained, it should be noted.
Rapidly growing mass in the neck: If a mass in the neck grows quickly, you need to see a doctor.
Important note: Early-stage thyroid cancer often has no symptoms:
Many people with thyroid cancer are diagnosed incidentally during examinations or imaging to detect other health conditions. Many benign thyroid nodules: If you feel a lump in your neck, you need to see a doctor for evaluation, but most thyroid nodules are not cancerous.
Do not delay seeking medical attention: If you have any of the above symptoms, especially if they are persistent or worsening, consult a doctor to rule out thyroid cancer or other health conditions.
► How is thyroid cancer treated?
Most thyroid cancers can be successfully treated with surgery, along with radioactive iodine therapy (RAI) if necessary.
Surgery: This is the primary treatment method, involving the removal of the thyroid gland or part of it. It is a common treatment for thyroid cancer and is often very effective. However, this method can lead to long-term side effects, especially when the entire thyroid gland is removed. Total thyroidectomy or lobectomy.
Lobectomy for differentiated thyroid cancer of low risk and for low-risk papillary microcarcinoma confined to one lobe of the thyroid.
Total thyroidectomy after initial lobectomy for patients whose final pathology results are malignant and who were unaware of this diagnosis prior to surgery. Lymph node dissection for metastasis.
Preoperative ultrasound of the cervical lymph nodes and FNA of suspicious nodes confirm the necessity for lymph node dissection. The ATA recommends considering prophylactic lymph node dissection for progressive papillary thyroid cancer.
Serious permanent surgical complications from thyroidectomy, with or without lymph node dissection, include hypoparathyroidism (hypocalcemia) and recurrent laryngeal nerve paralysis (vocal cord paralysis).
Radioactive Iodine Therapy (RAI): It is an effective and widely used treatment for thyroid cancer, particularly for patients with papillary thyroid cancer and follicular thyroid cancer. This therapy uses radioactive iodine (I-131) to destroy cancerous thyroid cells or any remaining thyroid cells after surgery.
RAI is taken orally and absorbed by the thyroid gland. RAI post-surgery is used to eliminate residual thyroid tissue or tiny cancerous foci that remain after surgery.
RAI can be administered in high doses as adjuvant therapy to treat remaining localized cancer or metastases beyond the neck to improve disease-free survival rates or recurrence rates in high-risk patients.
RAI is not recommended for patients with low-risk differentiated thyroid cancer due to side effects, such as impacts on salivary function and genital glands, as well as a potential increase in the risk of developing second primary malignancies.
RAI is generally recommended for high-risk patients.
Hormone replacement therapy: It is a common treatment method for patients with thyroid cancer, especially after thyroidectomy (total or partial removal of the thyroid gland). Since the thyroid gland plays an important role in producing thyroid hormones (T3 and T4) that help regulate many bodily functions, the loss of the thyroid gland or reduced thyroid function will lower the levels of these hormones, leading to hypothyroidism. Hormone replacement therapy helps supplement these hormones, maintain normal bodily functions, and reduce the risk of recurrence of thyroid cancer.
Chemotherapy: Chemotherapy is a cancer treatment method that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken orally or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Typically, chemotherapy is only applied in cases of undifferentiated or recurrent cancer.
RAI can be administered in high doses as adjuvant therapy to treat remaining localized cancer or metastases beyond the neck to improve disease-free survival rates or recurrence rates in high-risk patients.
RAI is not recommended for patients with low-risk differentiated thyroid cancer due to side effects, such as impacts on salivary function and genital glands, as well as a potential increase in the risk of developing second primary malignancies. RAI is generally recommended for high-risk patients.
Hormone replacement therapy: It is a common treatment method for patients with thyroid cancer, especially after thyroidectomy (total or partial removal of the thyroid gland). Since the thyroid gland plays an important role in producing thyroid hormones (T3 and T4) that help regulate many bodily functions, the loss of the thyroid gland or reduced thyroid function will lower the levels of these hormones, leading to hypothyroidism. Hormone replacement therapy helps supplement these hormones, maintain normal bodily functions, and reduce the risk of recurrence of thyroid cancer.
Chemotherapy: Chemotherapy is a cancer treatment method that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken orally or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Typically, chemotherapy is only applied in cases of undifferentiated or recurrent cancer.
Targeted Therapy: In recent years, doctors have begun using newer, targeted drugs to treat thyroid cancer. Unlike standard chemotherapy drugs, which work by attacking rapidly growing cells (including cancer cells), targeted drugs attack specific parts of cancer cells.
Targeted drugs for thyroid cancer attack certain genetic and protein changes within cancer cells. These changes are what make thyroid cancer cells different from normal cells.
► Early screening for thyroid cancer – Enhancing treatment outcome
Screening for thyroid cancer is a regular health check-up process aimed at early detection of abnormalities or thyroid cancer in asymptomatic individuals. Early detection of thyroid cancer helps improve treatment prognosis and reduces the risk of metastasis. If cancer is only detected when symptoms have appeared, the disease may have progressed and metastasized to other organs, making treatment more difficult.
The screening tests used in the screening of various types of cancer in asymptomatic individuals.
► To diagnose thyroid cancer, the doctor may recommend the following tests and procedures:
Physical examination and health history: A general check-up to detect abnormal signs such as tumors or swelling in the neck, larynx, and lymph nodes.
Laryngoscopy: Using mirrors or an endoscope to examine the larynx, helping to assess vocal cord function.
Blood hormone tests: Measuring levels of hormones such as TSH, calcitonin, and antithyroid antibodies to evaluate thyroid function.
Blood biochemistry test: Evaluate the levels of substances such as calcium in the blood, helping to detect signs of related pathological conditions.
Ultrasound: Use ultrasound waves to determine the size and characteristics of thyroid nodules, assisting in guiding biopsies.
CT scan: Perform computed tomography to create detailed images of the neck region, helping to determine the extent of tumor spread.
These tests help doctors diagnose accurately and develop appropriate treatment plans for patients.
► Who should undergo early thyroid cancer screening?
Individuals with a family history: If a relative has thyroid cancer, especially medullary thyroid carcinoma.
Women over 30 years old: Because females have a higher risk of developing thyroid cancer compared to males.
Individuals with unusual symptoms: The presence of a lump in the neck, persistent hoarseness, difficulty swallowing, or unexplained neck pain.
Individuals who have been exposed to radiation: Particularly those who have undergone radiation therapy in the head and neck area or live in areas with high radiation levels.
FREE CANCER SCREENING WITH JAPANESE PROFESSORS AT AMERICAN INTERNATIONAL HOSPITAL (AIH)
In an effort to control and contribute to the fight against cancer in Vietnam, the American International Hospital (AIH) officially launched the program “1,000 consultations and 12 free surgeries for cancer patients” in 2025, aimed at supporting patients with cancer or suspected breast, thyroid, lung, and digestive system cancers have opportunity to access high-quality medical services right in Vietnam. Patients will receive health assessments, appropriate treatment plan consultations, and guidance on the next steps in their healing process. Especially, the program will support 12 cancer patients who have a surgical indication to be treated for free.
To participate in the “1,000 consultations and 12 free surgeries for cancer patients” program in 2025 at AIH, patients can register through the dedicated cancer website: ungthu.aih.com.vn or by calling the Hotline (028) 3910 9999.
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