Do you feel a lump in your neck? Or have you noticed a change in your voice or difficulty swallowing recently? These may be normal. However, in rare cases, they can also be a sign of a thyroid problem. Today we are talking about one such rare but very important cancer. That is Hürthle cell carcinoma.
What is Hürthle Cell Carcinoma?
Simply put, this is a rare type of cancer that develops in the thyroid gland. Think of it as a small butterfly-shaped gland in the front of our neck. This is what we call the thyroid gland . Many important functions in our body, especially metabolism, are controlled by the hormones produced by this gland.
Hürthle cell carcinoma is an aggressive type of cancer that develops in the thyroid gland. The tumors can cause difficulty speaking and breathing. If not treated properly, the cancer can spread to other parts of the body, such as the lymph nodes, lungs, and bones . The main treatment for this is surgery to remove all or part of the thyroid gland.
How does this condition affect the body?
In many cases, this cancer can grow in the body without showing any symptoms in the early stages. For some people, it is discovered incidentally, during tests for another condition.
But when symptoms start to appear, you may first notice a lump in the front of your neck. As these lumps grow, they can start to press on your esophagus. This can make it difficult to swallow . Also, if these lumps press on your trachea/windpipe, it can cause difficulty breathing . Sometimes, these lumps can affect your vocal cords and cause a change in your voice .
The important thing is that tumors caused by Hürthle cells can be cancerous or noncancerous. Sometimes even a doctor can't tell the difference between the two until they take a piece of the tumor and examine it under a microscope.
Although this condition can develop at any age, it is most common in people over the age of 55 and in women . However, it is not a very common cancer. It occurs in a small number of people, about 3% of all people who develop thyroid cancer.
What are the main symptoms of this disease?
Although there may be no major symptoms at first, the following symptoms may appear as the cancer progresses. If you experience any of these, it is very important to see a doctor as soon as possible.
| Symptom | Description |
|---|---|
| A lump in the neck | Feeling a painful lump in the front of the neck, below the collarbone. |
| Difficulty swallowing and breathing (Dysphagia) | Feeling like you're choking when swallowing food or liquid. Difficulty breathing. |
| Voice change | The voice becomes hoarse or has a different quality than usual. |
| Swollen ankle | Swelling of the lymph nodes on both sides of the neck. |
| Other features | Frequent fatigue and weight loss for no apparent reason. |
Why does this type of cancer develop? What are the risk factors?
The exact cause of this is not yet known, but researchers have identified several factors that increase the risk of developing this cancer.
- Family history: If your mother, father, or siblings have had thyroid cancer, you may also be at risk.
- Iodine deficiency: Our body needs the mineral iodine to produce thyroid hormones. We get it from the foods we eat. Long-term iodine deficiency can be a risk factor.
- Exposure to radiation: Doctors believe that exposure to radiation, such as X-rays or radiation therapy for cancer, also increases the risk.
How does a doctor accurately diagnose this disease? (Diagnosis)
When you see a doctor, he or she will examine you, ask about your symptoms, and ask about any family history of illness. Then, they may run some tests to confirm the diagnosis.
- Blood tests: A healthy thyroid gland produces a protein called thyroglobulin. In this cancer condition, the level of this protein in the blood can be elevated.
- Thyroid uptake scan: This checks for cancer cells in the thyroid gland. A small amount of radioactive iodine is injected into the body, and a PET scan is used to identify the locations of the cancer cells.
- Laryngoscopy: This test is done to see if your vocal cords are affected.
- Fine Needle Aspiration (FNA): This is the most common test. Using a very thin needle, a small sample of cells is taken from the lump. It is then examined under a microscope to see if there are any cancer cells.
- Surgical diagnosis (Lobectomy): Sometimes, a biopsy alone cannot confirm the diagnosis. In such cases, the doctor will perform surgery to remove the part of the thyroid gland that contains the lump and send it for examination.
- CT scan: If cancer is confirmed, other tests, such as a CT scan, are done to see if it has spread to other parts of the body.
How are cancer stages classified?
Treatment for any cancer is planned based on its stage. For this, doctors use a system called the TNM staging system.
- T (Tumor): Size of the tumor.
- N (Node): Whether the cancer has spread to the nodes.
- M (Metastasis): Whether it has spread to distant organs in the body.
In this type of cancer, the patient's age also plays a role in determining the stage. For example, if a person under the age of 55 develops the disease, it is considered early stage (Stage I or II), regardless of how large the tumor is or whether it has spread to the lymph nodes.
What are the treatments for this?
The main and most effective treatment for this disease is surgery . Depending on your condition, the surgeon will remove all or part of the thyroid gland. They will also remove any nodules where the cancer has spread. In most cases, this surgery can completely remove the cancer.
After surgery, other treatments are given to prevent the cancer from coming back.
- Hormone therapy: After surgery, since the thyroid gland is no longer there, the hormones it produces must be taken in pill form for the rest of your life. This also controls the growth of cancer cells.
- Radioactive iodine therapy: This treatment is given to destroy any cancer cells that may remain after surgery.
Can this disease be cured? What is life like after treatment?
Yes, this is a completely curable condition in most cases. The chances of recovery are very high, especially after the cancer is removed by surgery. A recent study showed that 95% of people diagnosed with this disease are still alive after 5 years and 93% after 10 years.
After treatment, you can live a normal life. However, because your thyroid gland was removed, you will need to take thyroid hormone replacement medication for the rest of your life.
Also, since this cancer can sometimes recur, it is imperative to go for follow-ups as prescribed by the doctor. If you experience any symptoms, such as a lump in your neck or a change in your voice, you should inform your doctor.
Take-Home Message
- Hürthle cell carcinoma is a rare but treatable type of thyroid cancer.
- If you have symptoms such as a lump in your neck, a change in your voice, or difficulty swallowing, do not ignore it and see a doctor immediately.
- The main treatment for this is surgical removal of the thyroid gland. It is a very successful treatment.
- After surgery, it is essential to take hormone pills for the rest of your life and to undergo regular medical checkups.
- The earlier the disease is detected, the more likely it is to be treated successfully. So be aware of the symptoms.
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