Diagnosis of Thyroid Cancer

Diagnosis of Thyroid Cancer

Early thyroid cancer often does not have symptoms. But as the cancer grows, symptoms may include:
  • A lump in the front of the neck
  • Hoarseness or voice changes
  • Swollen lymph nodes in the neck
  • Trouble swallowing or breathing
  • Pain in the throat or neck that does not go away
If you have symptoms that suggest thyroid cancer, you may have one or more of the following tests to confirm the diagnosis:
  • Physical Exam: Your doctor feels your thyroid for lumps 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. You may be checked for a high level of calcitonin and have other blood tests.
  • Ultrasound: An ultrasound device uses sound waves that people cannot hear. The device aims sound waves at the thyroid, and a computer creates a picture of the waves that bounce off the thyroid. The picture can show thyroid nodules that are too small to be felt.
  • Thyroid scan: Your doctor may order a scan of your thyroid. You swallow a small amount of a radioactive substance, and it travels through the bloodstream. Thyroid 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 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. It can be of following types: Fine-needle aspiration: A sample of tissue is taken from a thyroid nodule with a thin needle. An ultrasound device can help your doctor see where to place the needle.
  • Surgical biopsy: If a diagnosis cannot be made from fine-needle aspiration, a surgeon removes the whole nodule during an operation. If the doctor suspects follicular thyroid cancer, surgical biopsy may be needed for diagnosis.
 

Staging

Staging is a careful attempt to learn whether the cancer has spread and, if so, to what parts of the body. The doctor may use ultrasonography, magnetic resonance imaging (MRI), or computed tomography (CT) to find out whether the cancer has spread to the lymph nodes or other areas within the neck. The doctor may use a nuclear medicine scan of the entire body, such as a radionuclide scan known as the “diagnostic I-131 whole body scan,” or other imaging tests to learn whether thyroid cancer has spread to distant sites.