Thyroid cancer

Our thyroid cancer team are involved in the diagnosis and management of thyroid cancer, as well as surgical and medical treatment.

Our services include:

initial investigation and diagnosis of suspected or confirmed thyroid and parathyroid cancer
surgical treatment for thyroid and parathyroid cancers
oncology treatment, including radioactive iodine, radiotherapy and tyrosine kinase inhibitor therapy
complementary therapist and counselling services
Midlands genetic thyroid oncology clinics for patients with a genetic susceptibility to thyroid cancer - this service accepts referrals from hospitals around the country
specialist medullary thyroid cancer centre
tertiary treatment centre
referrals from GPs

The team is made up of specialist healthcare professionals, including:

consultant thyroid and parathyroid surgeons
endocrinologists
oncologists
radiologists
histopathologists
Clinical Nurse Specialists (CNS)
nuclear medicine clinicians
dieticians
speech and language therapists
physiotherapists

Our Multidisciplinary Team (MDT) is made up of specialist surgeons, oncologists, cancer clinical nurse specialists, radiologists and histopathologists.

Cancer MDT information, UHB website

Why am I being referred?

You will have been referred if you have been diagnosed with or there is a suspicion you have thyroid cancer.

Signs and symptoms of thyroid cancer

The main signs and symptoms of thyroid cancer include:

a lump in the front, lower part of your neck that usually feels hard, slowly gets bigger and is not painful
a hoarse voice
a sore throat
problems swallowing or breathing
pain in the front of your neck, or a feeling like something is pressing against your neck

Other symptoms can include:

a red face (flushing) – this may be more difficult to see on darker skin tones
softer stools or diarrhoea
weight loss
a cough

If you find any new symptoms or unusual changes that persist for more than 2 weeks, please contact your GP.

If there is a suspicion of thyroid cancer, you will usually be sent for an ultrasound scan (USS). This may also include a Fine Needle Aspiration (FNA) of any suspicious nodules or lymph nodes within the thyroid or the neck.

Your results will then be discussed in our MDT meeting. You will usually be given the results of your USS and FNA in an outpatient appointment.

Types of thyroid cancer

Papillary and follicular

Papillary and follicular thyroid cancers are called Differentiated Thyroid Cancer (DTC), with papillary being the most common. Around 9 in 10 (90%) thyroid cancers are DTC. They are often treated in the same way, and most people with DTC can be cured.

Medullary

Medullary Thyroid Cancer (MTC) is a rare type of thyroid cancer. Around 5 to 10 out of 100 (5 to 10%) of thyroid cancers are MTC.

It is often slow growing and starts in cells in the thyroid gland called parafollicular cells, or C cells. These cells normally make a hormone called calcitonin, which helps control the level of calcium in the blood and can be used to monitor the response to treatment.

Anaplastic

Anaplastic Thyroid cancer is the rarest type of thyroid gland cancer, but it is also the most aggressive. It is more common in women and mostly affects people over the age of 60. It usually grows more quickly than other types of thyroid cancer. About 1 to 2 out of 100 (1 to 2%) of thyroid cancers are anaplastic. Anaplastic thyroid cancer cannot usually be removed. This is because it presents late and often invades the critical structures in the neck.

Treatment of thyroid cancer

Treatment for thyroid cancer is usually in the form of surgery. This can be a hemithyroidectomy (to remove half of the thyroid gland) or a total thyroidectomy (to remove the whole thyroid gland).

Removal of lymph nodes in the neck may also be needed; this is called a neck dissection. Some people also need further treatment in the form of Radioactive Iodine Therapy (RAI).

Anyone who has had their whole thyroid removed will need to be started on thyroid hormone replacement (levothyroxine). This is monitored with blood tests. Around 1 in 5 who have had half their thyroid removed will also need to be started on thyroid hormone replacement. Again, monitored with blood tests. Your surgeon will be able to explain which treatment choice is being recommended for you, the reasons for this treatment and any chance of side effects.

Further information on cancer treatment types

Contact and location details

Thyroid Clinical Nurse Specialist (CNS) team

The team are contactable between Monday to Friday, 09:00–17:00, and aim to respond back to any queries within 24-hours.

The team are available at the following sites:

Queen Elizabeth Hospital Birmingham (QEHB): Monday –Friday
Heartlands Hospital: Thursday and Friday - if you would like to be seen between Monday to Wednesday, then we will try to arrange this for you