Tài liệu What You Need To Know About™ - Thyroid Cancer docx

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About is Booklet
is National Cancer Institute (NCI) booklet is for you—
someone who has just been diagnosed with cancer of
the thyroid.
is booklet shows words that may be new to you in bold.
See the Words to Know section to learn what a new word
means and how to pronounce it.
In 2012, more than 43,000 women and 13,000 men will be
diagnosed with thyroid cancer in the United States. Most
will be older than 45.
Learning about medical care for thyroid cancer can help you
take an active part in making choices about your care. is
booklet tells about…
■ Diagnosis and staging
■ Treatment
■ Follow-up care
■ Taking part in research studies
You can read this booklet from front to back. Or you can
read only the sections you need right now.
is booklet has lists of questions that you may want to
ask your doctor. Many people nd it helpful to take a list
of questions to a doctor visit. To help remember what your
doctor says, you can take notes. You may also want to have a
family member or friend go with you when you talk with the
doctor—to take notes, ask questions, or just listen.
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For the latest information about thyroid cancer, please visit
NCI’s website at http://www.cancer.gov/cancertopics/
types/thyroid.
Also, NCI’s Cancer Information Service can answer your
questions about cancer. We can also send you NCI booklets
and fact sheets. Call 1-800-4-CANCER (1-800-422-6237).
Or, chat using LiveHelp, NCI’s instant messaging service, at
http://www.cancer.gov/livehelp.
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e yroid
e thyroid is a gland at the front of your neck beneath your
voice box (larynx). A healthy thyroid is a little larger than a
quarter. It usually can’t be felt through the skin.
e thyroid has two parts (lobes). A thin piece of tissue (the
isthmus) connects the two lobes.
e thyroid makes hormones:
■ yroid hormone: e thyroid follicular cells make
thyroid hormone. is hormone aects heart rate, blood
pressure, body temperature, and weight. For example,
too much thyroid hormone makes your heart race, and
too little makes you feel very tired.
■ Calcitonin: e C cells in the thyroid make calcitonin.
is hormone plays a small role in keeping a healthy
level of calcium in the body.
Four or more tiny parathyroid glands are on the back of
the thyroid. ese glands make parathyroid hormone. is
hormone plays a big role in helping the body maintain a
healthy level of calcium.
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Lymph nodes
Isthmus
Thyroid
Larynx
Parathyroid
glands
Lobes
Isthmus
The pictures show the front and back of the thyroid.
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Cancer Cells
Cancer begins in cells, the building blocks that make up
tissues. Tissues make up the thyroid and other organs of
the body.
Normal thyroid cells grow and divide to form new cells as
the body needs them. When normal cells grow old or get
damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when
the body does not need them, and old or damaged cells
do not die as they should. e buildup of extra cells oen
forms a mass of tissue called a nodule. It may also be called a
growth or tumor.
Most thyroid nodules are benign. Benign nodules are not
cancer (malignant):
■ Benign nodules:
• Are usually not harmful
• Don’t invade the tissues around them
• Don’t spread to other parts of the body
• Usually don’t need to be removed
■ Malignant nodules (thyroid cancer):
• May sometimes be a threat to life
• Can invade nearby tissues and organs
• Can spread to other parts of the body
• Oen can be removed or destroyed, but sometimes
thyroid cancer returns
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yroid cancer cells can spread by breaking away from the
thyroid tumor. ey can travel through lymph vessels to
nearby lymph nodes. ey can also spread through blood
vessels to the lungs, liver, or bones. Aer spreading, cancer
cells may attach to other tissues and grow to form new
tumors that may damage those tissues.
See the Staging section on page 10 for information about
thyroid cancer that has spread.
Types of yroid Cancer
ere are several types of thyroid cancer:
■ Papillary: In the United States, papillary thyroid cancer
is the most common type. About 86 of every 100 people
with thyroid cancer have this type. It begins in follicular
cells and usually grows slowly. If diagnosed early, most
people with papillary thyroid cancer can be cured.
■ Follicular: e second most common type is follicular
thyroid cancer. A little more than 9 of every 100 people
with thyroid cancer have this type. It begins in follicular
cells and usually grows slowly. If diagnosed early, most
people with follicular thyroid cancer can be treated
successfully.
■ Medullary: Medullary thyroid cancer is not common.
About 2 of every 100 people with thyroid cancer have
this type. It begins in C cells and can make abnormally
high levels of calcitonin. Medullary thyroid cancer tends
to grow slowly. It can be easier to control if it’s found and
treated before it spreads to other parts of the body.
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Medullary yroid Cancer Sometimes Runs in Families
A change in a gene called RET can be passed from parent
to child. Nearly everyone with a changed RET gene
develops medullary thyroid cancer. e disease occurs
alone, as familial medullary thyroid cancer, or with
other cancers, as multiple endocrine neoplasia
(MEN) syndrome.
A blood test can usually detect a changed RET gene. If
it’s found in a person with medullary thyroid cancer, the
doctor may suggest that family members also be tested.
For those who have a changed gene, the doctor may
recommend frequent lab tests or surgery to remove the
thyroid before cancer develops.
■ Anaplastic: e least common type is anaplastic thyroid
cancer. About 1 of every 100 people with thyroid cancer
has this type. Most people with anaplastic thyroid cancer
are older than 60. e cancer begins in follicular cells of
the thyroid. e cancer cells tend to grow and spread very
quickly. Anaplastic thyroid cancer is very hard to control.
Tests and treatment options depend on the type of thyroid
cancer.
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Diagnosis
If your doctor thinks that you may have thyroid cancer,
you’ll have one or more of the following tests:
■ Physical exam: Your doctor feels your thyroid for lumps
(nodules). Your doctor also checks your neck and nearby
lymph nodes for growths or swelling.
■ Blood tests: Your doctor may check for abnormal levels
of thyroid-stimulating hormone (TSH) in the blood.
Too much or too little TSH means the thyroid is not
working well. If your doctor thinks that you may have
medullary thyroid cancer, you’ll be checked for a high
level of calcitonin and have other blood tests.
■ Ultrasound: An ultrasound device uses sound waves
that can’t be heard by humans. e sound waves make a
pattern of echoes as they bounce o organs inside your
neck. e echoes create a picture of your thyroid and
nearby tissues. e picture can show thyroid nodules
that are too small to be felt. Your doctor uses the picture
to learn the size and shape of each nodule and whether
the nodules are solid or lled with uid. Nodules that are
lled with uid are usually not cancer. Nodules that are
solid may be cancer.
■ yroid scan: Your doctor may order a scan of your
thyroid. You swallow a small amount of a radioactive
substance (such as radioactive iodine), and it travels
through the bloodstream. yroid cells that absorb the
radioactive substance can be seen on a scan. Nodules
that take up more of the substance than the thyroid
tissue around them are called “hot” nodules. Hot
nodules are usually not cancer. Nodules that take up less
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substance than the thyroid tissue around them are called
“cold” nodules. Cold nodules may be cancer.
■ Biopsy: A biopsy is the only sure way to diagnose thyroid
cancer. A pathologist checks a sample of thyroid tissue
for cancer cells using a microscope.
Your doctor may take tissue for a biopsy in one of two ways:
■ With a thin needle: Your doctor removes a sample of
tissue from a thyroid nodule with a thin needle. An
ultrasound device can help your doctor see where to
place the needle. Most people have this type of biopsy.
■ With surgery: If a diagnosis can’t be made from tissue
removed with a needle, a surgeon removes a lobe or
the entire thyroid. For example, if the doctor suspects
follicular thyroid cancer, the lobe that contains the
nodule may be removed for diagnosis.
You may want to ask the doctor these questions before
having a biopsy:
■ Will I have to go to the hospital?
■ How long will it take? Will I be awake? Will it hurt?
■ Are there any risks? What is the chance of infection or
bleeding afterward?
■ Will I have a scar on my neck?
■ How soon will I know the results? Who will explain
them to me?
■ If I do have cancer, who will talk to me about the next
steps? When?
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Staging
If the biopsy shows that you have cancer, your doctor will
need to learn the extent (stage) of the disease to help you
choose the best treatment.
e stage is based on the size of the nodule and whether the
cancer has invaded nearby tissues or spread to other parts
of the body. yroid cancer spreads most oen to nearby
tissues in the neck or to lymph nodes. It may also spread to
the lungs and bones.
When cancer spreads from its original place to another part
of the body, the new tumor has the same kind of cancer
cells and the same name as the original tumor. For example,
if thyroid cancer spreads to the lungs, the cancer cells in
the lungs are actually thyroid cancer cells. e disease is
metastatic thyroid cancer, not lung cancer. It’s treated as
thyroid cancer, not as lung cancer. Doctors sometimes call
the new tumor in the lung “distant” disease.
Staging may involve one or more of these tests:
■ Ultrasound: An ultrasound exam of your neck may
show whether cancer has spread to lymph nodes or other
tissues near your thyroid.
■ CT scan: An x-ray machine linked to a computer takes a
series of detailed pictures of your neck and chest area. A
CT scan may show whether cancer has spread to lymph
nodes, other areas in your neck, or your chest.
■ MRI: MRI uses a powerful magnet linked to a computer.
It makes detailed pictures of your neck and chest area.
MRI may show whether cancer has spread to lymph
nodes or other areas.