Treatment for Thyroid Cancer & Disease
The Center for Thyroid Disease at Orange Regional Medical Center’s Spagnoli Family Cancer Center is dedicated to comprehensive and customized care for people with thyroid cancer and disease.
At Orange Regional Medical Center, we are committed to providing patients and their families with the highest quality and most comprehensive care available. We employ cutting-edge technologies through every phase of treatment. For thyroid cancer, our most common treatments, surgeries and procedures include:
The range of thyroid surgery extends from a lobectomy (removal of a half of a gland) to a subtotal thyroidectomy (leaving a strip of tissue next to the nerve) to a total thyroidectomy. In the United States, most patients will undergo a total removal of the gland. Removal of a half of a thyroid is generally reserved for benign (non-cancerous disease) or non-diagnostic preoperative biopsy. Patients with thyroid cancer may also require a neck dissection (removal of the lymph nodes) to increase their healing process as opposed to their cure rate.
The size of the incision will depend on the surgical approach that the surgeon chooses to employ. Generally, patients with large glands; large nodules; Hashimoto’s disease; thyroid cancer; heavy set neck and previous operations may not be candidates for a minimal access approach and may need a larger incision. A typical thyroid incision is about 2 to 3 inches, whereas a typical minimal access scar is between ¾ inch to 1 ½ inches. The duration of a thyroid/parathyroid surgery has many variables and your surgeon will discuss surgical time as it applies to your particular case.
Radioactive Iodine Ablation
Radioactive iodine treatment is administered after thyroid surgery to higher risk patients by a radiation oncologist to eradicate residual thyroid tissue after surgery or to treat thyroid cancer that has spread to other regions.
A surgical procedure used to remove a malfunctioning parathyroid gland. Most people (80 percent) will have one affected gland, however about 10 to 15 percent of patients will have four affected glands, and about two to five percent will have two glands. In the case of a well localized single gland disease, a small incision can be made. However, if a gland is not found on preoperative imaging or more than one gland is affected, a more involved exploration on both sides of the neck may be needed.
Hormonal Suppression Therapy
While all patients who have their entire thyroid gland removed take thyroid hormone medication, higher risk patients with thyroid cancers, take higher than normal doses of thyroid hormone to suppress growth signals to the thyroid (TSH).
Fine Needle Aspiration
Fine Needle Aspiration (FNA) is the most accurate and useful method to evaluate a thyroid nodule for cancer. FNA is a very safe and well-tolerated procedure in which a thin needle is inserted in the nodule to obtain a sample of cells for analysis. Often an ultrasound is used to ensure that the needle is placed accurately within the nodule. The procedure is usually performed by an interventional radiologist, endocrinologist or thyroid surgeon.
About Thyroid Cancer
Thyroid cancer is a type of cancer that forms within the thyroid gland and usually forms as a lump or nodule in the neck. The most common types of thyroid cancers are:
- Papillary carcinoma - the most common type of thyroid cancer (70 percent) and is most often curable and may spread to the lymph nodes.
- Follicular cancer - the second most common thyroid cancer (10 to 15 percent) and is usually curable. It may spread to lungs and bones.
- Medullary Thyroid Carcinoma - An aggressive, rare cancer that may be familial or sporadic. This cancer rapidly spreads to lymph nodes or other organs
- Anaplastic Carcinoma - A very rare and highly invasive form of thyroid cancer that is often deadly
According to the American Cancer Society’s most recent estimates for thyroid cancer in the United States for 2017:
- About 56,870 new cases of thyroid cancer (42,470 in women, and 14,400 in men)
- About 2,010 deaths from thyroid cancer (1,090 women and 920 men)
Most thyroid nodules are not cancerous and are about three times common in women than men. Thyroid cancer is commonly diagnosed at a younger age than most other adult cancers.
Nearly three out of four cases of Thyroid Cancer are diagnosed in women.
Symptoms, such as the ones below, do not mean that you have thyroid cancer. If present, your doctor should further evaluate you with a physical examination and diagnostic imaging. Many people with thyroid cancer do not have any symptoms and some cancers are found on imaging tests performed for other reasons.
- Neck lumps
- Difficulty swallowing or breathing
- Persistent throat or neck pain
- Persistent cough
- Diagnosis of a thyroid cancer
Lumps in the thyroid gland, or nodules, are extremely common; five to 10 percent of people will develop a palpable thyroid nodule sometime in their life. Most thyroid nodules are harmless, but some may cause problems. Occasionally nodules will produce a thyroid hormone independent of the body's need, leading to hyperthyroidism. Larger nodules can also cause a feeling of pressure or fullness in the neck, shortness of breath, difficulty swallowing or pain in the neck, jaw or ear. Although nodules are usually noncancerous (benign), about 5 percent are cancerous.
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Eileen Schmidt specializes in providing one-on-one guidance through your palliative care treatment. She also facilitates our Lung Cancer Support Group.
Arvind G. Kamthan, M.D., M.R.C.P. (U.K.), F.A.C.P.,
Dr. Kamthan completed his medical training at SMS Medical College in India and residency training at Charleston Area Medical Center at West Virginia University with a fellowship at Mt. Sinai Medical Center in New York. Dr. Kamthan has been practicing medicine for over 23 years.
Cleveland W. Lewis, Jr, MD,
Cleveland W. Lewis, Jr, MD is an Orange Regional Medical Group surgeon specializing in thoracic procedures. Dr. Lewis will also be serving as Assistant Director of the Surgical Residency program. Dr. Lewis received his medical degree and completed his Cardiothoracic Surgery Residency at Duke University School of Medicine, in N.C.
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Nathaniel Margolis, M.D. is medical director of the Ray W. Moody, M.D. Breast Center. His combination of breast disease clinical knowledge and humane, compassionate care makes him the perfect leader for our nationally-recognized breast care program.
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Paramjeet Singh, M.D., FACS is an Orange Regional Medical Group surgeon. He specializes in General Surgery and is Medical Director of Surgical Oncology. He provides patients with hepato-biliary surgical, trauma surgery surgical oncology services, as well as being a member of the Medical Group’s General Surgery team.
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Regina Toomey Bueno,
Eric Saint Clair,
Tumor Site Development
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Count on Michele’s personal and clinical experience to help guide you through the wide range of services and treatments available at the nationally-accredited Ray W. Moody, M.D. Breast Center.