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Diagnosis of Thyroid Cancer
Sunday, 01 March 2009 16:26


Who do you need to see for diagnosis and treatment of thyroid cancer?


A primary care doctor can initial screen one by palpating the thyroid region for nodules.  If one has a family history of thyroid cancer, abnormal hormone levels, lump in neck, or high risk factors, the primary care provider will often order a thyroid ultrasound.  If there are any abnormal results one will be referred to a head and neck specialist or endocrinologist for further testing.  This testing  usually includes a fine needle aspiration (FNA) biopsy and additional blood work.


Thyroid cancers will be medically treated by an endocrinologist and/or oncologist.  The tumor will be surgical treated and removed by a surgeon, otolaryngologist.  If one has been diagnosed with thyroid cancer they will typically have at least two doctors working them.  



What test or examinations can be done to check for thyroid cancer?


1. Blood test to check for:


Elevated serum calcitonin (medullary cancer)

Elevated serum thyroglobulin (papillary/follicular cancer)

Abnormal T3, T4, TSH


2. Thyroid Ultrasound of thyroid


3. Thyroid scan with low radioactive iodine – cold nodule indicates non-thyroid tissue (does not light up)


4. Fine-Needle Aspiration (FNA), procedure of choice for thyroid nodules


The typical flow of events is:


1.  Patient is examined by their primary care doctor for a general physical or specific neck complaint.


2.  The primary care doctor palpates neck and notices mass, or family history of thyroid cancer.


3.  The primary care doctor orders blood test and ultrasound of thyroid.


4.  If nodule or abnormal thyroid levels the patient is referred to endocrinologist for further testing and a thyroid nodule biopsy (FNA).


5.  Endocrinologist does thyroid FNA and blood work.


6.  If cancer or suspicious for cancer the patient is referred to a surgeon to remove thyroid and thyroid cancer (thyroidectomy.)


7.  Radioactive iodine ablation of cancer is preformed weeks later.


8.  Patient begins thyroid hormone therapy medications.


9.  A whole body scan is done one week after radioactive therapy to monitor if there was any spread of the cancer throughout body.


10.  Patient follows up every 6-12 months for blood tests, neck ultrasound, and/or body scans to check for reoccurrences.


Last Updated on Friday, 17 February 2012 11:38

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