September is Thyroid Cancer Awareness Month, and doctors in the Mount Sinai Health System are promoting early detection by encouraging high-risk groups to be aware of symptoms.
“While the overall prognosis for the majority of thyroid cancers is excellent, early diagnosis and treatment are critical to improve survival and decrease the risk of future recurrence. In addition, in many cases, early diagnosis and appropriate surgical management often obviates the need for additional therapies such as radiation or chemotherapy,” says Brett Miles, MD, DDS, Professor and Co-Chief of the Division of Head and Neck Oncology at the Icahn School of Medicine at Mount Sinai. “Regardless of whether you have a family history of thyroid cancer, you should have any new lump or mass in your neck that does not resolve in about 3-4 weeks evaluated by your physician. The risk of thyroid cancer is higher in females and in people with a history of Hashimoto’s thyroiditis, radiation exposure to the neck, or familial colon polyps.”
According to the American Cancer Society, thyroid cancer cases are on the rise. The group estimates that 52,070 new cases will be diagnosed in 2019, nearly 75 percent of them in women. It is the fifth most common cancer in women, and even though women are, for unknown reasons, at higher risk of getting thyroid cancer, anyone in any age group can get the disease. Symptoms can present themselves earlier in women, who are typically diagnosed in their 40s or 50s, while men commonly get diagnosed in their 60s or 70s.
“Although most thyroid cancers are highly treatable, the extent of treatment can be minimized when they are identified at earlier stages,” says Raymond Chai, MD, Assistant Professor of Otolaryngology at the Icahn School of Medicine at Mount Sinai. “Given that many thyroid cancers are asymptomatic when first detected, it is important to pay attention to subtle changes in the neck and to see a physician if there are any concerns.”
Facts about Thyroid Cancer
- Thyroid cancer is a cancerous tumor or growth within the thyroid gland in the front of the neck.
- There are several types of thyroid cancer; the most common is papillary carcinoma, which is highly curable, especially if caught early.
- Symptoms of thyroid cancer include a lump in the neck by the thyroid, neck pain (sometimes going up the ears), hoarseness in the voice, difficulty swallowing and breathing, persistent cough, and enlarged lymph nodes in the neck.
- A family history of thyroid cancer; a history of radiation exposure to the head, neck, or chest; and a diet low in iodine are important risk factors.
- Regular follow-up care is an important part of treatment for patients with thyroid cancers.
- A lump and/or enlarged lymph nodes in the neck
- Neck pain or tightness
- Hoarseness/persistent cough
- Difficulty swallowing/breathing
Tips for Prevention
- Have a general physical exam every year
- Have a thyroid physical exam every three years if you are 20-39 years old
- Have a thyroid physical exam every year if you are 40 or older
- Avoid unnecessary exposure to radiation
- Get frequent checks if you have been exposed to radiation of the head, neck, or chest and have a family history
- Perform a thyroid neck self-exam, looking for asymmetries or protrusions below the Adam’s apple
Our patient, 27-year-old Aubrie Cogan, is a recent thyroid cancer survivor and her story demonstrates this disease can affect younger patients. Her scare also serves as a warning to not ignore lumps in the neck and get an ultrasound for further evaluation.
In early 2019, Ms. Cogan noticed a swollen lymph node under her ear; besides feeling tired, she didn’t have other symptoms. Weeks later the lump hadn’t gone away, which prompted her to see Catherine Sinclair, MD, Director of Head and Neck Surgery at Mount Sinai West.
Dr. Sinclair did an ultrasound and found that specific lymph node was benign for cancer, but the scan did show obvious signs of cancer throughout Ms. Cogan’s thyroid and it had spread to other lymph nodes in her neck. “I was shocked with this diagnosis, I had never heard of anyone this young having thyroid cancer, and never thought this could happen to me with no family history of thyroid problems,” Ms. Cogan explained.
In July, she underwent cancer surgery. Dr. Sinclair removed her entire thyroid and 35 lymph nodes. The art student is recovering well and feeling stronger every day. She wants others to learn from her experience and see a doctor if you have a lump in your neck that isn’t going away.
“Thyroid cancer can affect people of all ages, and although it is more common in women, men can also be affected. A neck mass that persists for more than two to four weeks without size fluctuation or a history of recent infectious cause should be evaluated by a medical professional. Ultrasound is a great initial investigation to determine which neck masses warrant further evaluation by biopsy,” says Dr. Sinclair. “In Aubrey’s case, if I’d just felt the lymph node she presented with (which ended up having no cancer in it) and not done the ultrasound, I would have missed the thyroid cancer that had already spread to other lymph nodes in her neck. Ultrasound is quick to perform and very sensitive for screening people with persistent neck masses and/or worrisome thyroid nodules.”
Both Dr. Sinclair and Ms. Cogan are available for interviews to talk about this case.
About Mount Sinai Health System
The Mount Sinai Health System is New York City’s largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai’s vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report’s “Best Medical Schools”, aligned with a U.S. News & World Report’s “Honor Roll” Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report’s “Honor Roll” of top U.S. hospitals; it is one of the nation’s top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 “Best Hospitals” issue. Mount Sinai’s Kravis Children’s Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and the South Nassau Communities Hospital is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke’s, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.