Thyroid cancer is the fastest growing cancer in the US, and is the 5th most common cancer in women. Nate Walsh, MD, a thyroid cancer surgeon with the Clayman Thyroid Center at the Hospital for Endocrine Surgery in Tampa, Florida, notes that many thyroid cancers have been present for a number of years before they are detected.
He has recently authored new article on the best ways to diagnose thyroid cancer for Thyroid Cancer Awareness Month.
“Like all cancers, thyroid cancer is much more curable if found early and therefore less likely to have spread to other organs or the surrounding lymph nodes,” says Walsh. “So primary care doctors as well as patients need to know how to diagnose thyroid cancer so it can be accomplished as soon as possible.”
While a thyroid cancer diagnosis can be scary to receive, the good news is that it is one of the most curable types of cancer. Of course, the first step toward treatment and being cured is a diagnosis. The following are the five best ways to diagnose thyroid cancer, according to Walsh.:
1: FNA or Needle Biopsy
“A fine needle aspiration biopsy (FNA or needle biopsy) remains the mainstay in the diagnosis of thyroid cancer,” says Walsh.
Thyroid needle biopsy is performed by sticking a very small needle into the thyroid lump or nodule. The doctor will use an ultrasound at the same time so he/she can watch the small needle go into the thyroid nodule. When the needle is removed it will contain a small sampling of cells from the thyroid nodule (or neck lymph nodes if the needle was put into a lymph node). Looking at those cells under a microscope is how the pathologist will diagnose the thyroid cancer.
2: Thyroid ultrasound
“An excellent ultrasound can be enough to make the diagnosis of thyroid cancer,” says Walsh.
During ultrasound, the technician must thoroughly examine the thyroid and all the areas of lymph nodes in both sides of the neck that can be involved with thyroid cancer. If your ultrasound is not comprehensive and does not include this important component, cancer may be missed and left behind after surgery.
3: Self-checks
“Thyroid cancer usually has no symptoms,” says Walsh, “so performing self-checks on your own neck regularly is very important.”
Often, a nodule or lymph node with thyroid cancer is diagnosed on examination. Regularly performing self-checks of your neck and thyroid, coupled with routine visits to your primary doctor, are crucial in the diagnosis and monitoring of thyroid cancer.
The thyroid is a butterfly shaped organ that lays in the middle of your neck right above your collar bone. To perform a self-check, move your fingers around the middle of your neck where your thyroid is located. You also want to move your fingers up and down your neck as well as along both sides of your neck near the muscle you can see and feel that helps turn your head. Lymph nodes that can harbor thyroid cancer are located anywhere from below your ear to your collar bone on both sides of your neck.
4: CT scan
“Every day, we see thyroid cancers that were diagnosed through a CT scan that was done for another reason,” says Dr. Walsh.
CT scans are frequently used to diagnose, follow, and treat numerous medical conditions. Due to widespread use, numerous cancers are found incidentally (or coincidentally) when someone gets a CT scan of their head, neck, and/or chest for another symptom or complaint (i.e., headache, neck pain, or difficulty breathing).
An ultrasound tells the doctor if there is something abnormal in the thyroid. The CT scan can further tell the doctor where the abnormality is located. Both studies complement each other.
5: Blood tests
“I often hear folks say that they had their annual blood work done and their thyroid levels were normal, so they’re fine,” says Walsh, “but the fact is, only a small percentage of thyroid cancers are diagnosed through blood tests.”
The most common type, papillary thyroid cancer, which accounts for roughly 85% of cases, cannot be diagnosed with labs. It cannot be stressed enough that normal hormone levels on your labs does not rule out this disease.
