Doctors unsure why thyroid cancer cases on the rise
By Shari Rudavsky, The Indianapolis Star
– Thyroid cancer, which affects about 11 people per 100,000 each year, seems to be on the rise. It’s a trend that baffles medical researchers.
Argentina’s president, Cristina Fernandez, recently had her thyroid removed for what doctors thought was a cancerous nodule. After the operation, they learned the mass was not cancer.
National Cancer Institute statistics suggest that in recent years the number of cases of this often curable cancer has increased by about 6.5%. Over a decade, that has added up to make thyroid cancer the fastest-increasing cancer, says Tod Huntley, an otolaryngologist and head and neck surgeon with the Center for Ear, Nose, Throat and Allergy in Indianapolis.
“Ten years ago, if I saw four new thyroid cancer patients a year, it would have been a lot,” says G. Irene Minor, a radiation oncologist with Indiana University Health Central Indiana Cancer Center. “Now sometimes I see that many in a month, and I have seen three in a week.”
Thyroid cancer is more common in women younger than 45, Minor said. Doctors don’t know why that’s the case, but thyroid problems in general — such as hyper- or hypo-thyroidism — are more common in women.
The thyroid helps regulate heart rate, blood pressure, body temperature and weight. Thyroid cancer is three times more common in women than men.
Why is it more prevalent?
Experts remain divided on the cause of the increase.
By the numbers
56,460: Estimated new U.S. cases
of thyroid cancer in 2012
1,780: Estimated deaths
Source: National Cancer Institute
Some attribute it to better screening. Many smaller tumors are picked up on ultrasounds or scans done for other reasons, says Michael Moore, a head and neck surgeon with Indiana University Simon Cancer Center.
Autopsies conducted on people who died for non-thyroid-related reasons reveal that as many as 80% of people older than 60 have a thyroid lump or malignancy that went undiagnosed, Moore says.
Some think that better screening alone can’t explain the increase in thyroid cancer. A recent study showed that the increase is not just in smaller tumors, which might have to do with detection, but also in larger ones, Huntley says.
“There is definitely something going on,” he says. “How much is due to increased surveillance and detection and how much is due to an actual biological change in disease prevalence, we don’t know, but we know it’s both.”
Obesity, radiation exposure and diets low in fruits and vegetables are three potential culprits, Huntley says. People who are overweight have a 20% increase in thyroid cancer; those who are obese have a 53% increase. The more dental X-rays a person has, the higher the risk, studies show.
Often, thyroid cancer has no symptoms but is diagnosed when a person or his physician notices a lump in the neck. When symptoms do occur they can include difficulty swallowing or the sensation of a lump in the throat or voice changes.
Amber Skipper, 29, who was diagnosed with thyroid cancer, had felt something in her neck but thought it was a swollen lymph node. She had been prone to bronchitis and fatigue, but she attributed that to being a working mother with two small children.
When she learned she had cancer, she vowed to fight it. Numbers were on her side. The five-year survival rate for thyroid cancer is 97%.
In October 2010, Skipper, of Westfield, Ind., had her thyroid and many lymph nodes removed and underwent treatment with radioactive iodine. She now takes a daily replacement thyroid hormone pill.
Separated from family
Because the iodine is radioactive, Skipper had to be isolated from her family for seven days. She ached to see her two young daughters, now 4 and 2, as well as her husband, Ryan, who would leave her food outside her door.
Argentina’s president, Cristina Fernandez, recently had her thyroid removed for what doctors thought was a cancerous nodule. Only after the operation did they decide the mass was not cancer.
In the year since her operation, Skipper started eating more organic foods and taking vitamins. Doctors may not be able to tell her why she got cancer, but she wants to make sure she stays healthy. She also decided to become a medical assistant to help others who are sick.
Her second iodine isolation, which lasted two days, was harder than the first. Her daughters were old enough to miss her.
At the end, she got the answer she wanted: She is cancer-free.
Says Huntley: “If you had to pick a cancer, this is what you would pick.”