By Ned M. Weiss, M.D. Princeton HealthCare System
It may start with an unexplained sense of fatigue. Or maybe you noticed a change in your voice or have been feeling anxious for no apparent reason. All of these signs could point to a problem with your thyroid.
Fortunately, with today’s advanced technology thyroid problems are easier to spot — and treat.
Part of the endocrine system, the thyroid gland, located in the front of the neck just below the Adam’s Apple, produces hormones that regulate your body temperature, physical energy, and the speed of many bodily functions.
Nearly 13 million Americans suffer from some form of thyroid disease, according to the American Thyroid Association, including:
• Hyperthyroidism or overactive thyroid, a condition in which your thyroid produces too many hormones.
• Hypothyroidism or underactive thyroid, a condition in which your thyroid produces too few hormones.
• Thyroid nodules or cancer.
In fact, thyroid cancer is the most rapidly increasing form of cancer in the United States. Last year alone, more than 44,000 new diagnoses were expected, mainly among women between the ages of 20 and 55.
However, thyroid cancers are much less common than benign nodules, and with treatment, the cure rate for thyroid cancer is more than 90 percent, according to the Centers for Disease Control and Prevention.
Early thyroid cancers are often first found when patients undergo diagnostic tests for other health problems, such as ultrasounds of the carotid arteries, MRIs of the cervical spine and CT scans of the back.
As a result, at University Medical Center at Princeton an increasing number of patients are undergoing thyroid scans by the hospital’s Nuclear Medicine Services Department, resulting in the treatment of potentially cancerous nodules sooner.
Possible signs of thyroid cancer or nodules can include:
• A lump or swelling in the neck.
• Pain in the front of the neck.
• Difficulty swallowing or breathing.
• Extended hoarseness or change in voice.
• Protracted cough.
Other thyroid conditions can produce a variety of symptoms, ranging from unexplained exhaustion or overstimulation to unexplained weight loss or rapid weight gain.
The symptoms of thyroid disorders are also associated with a number of other health conditions, making it all the more important to see your doctor for a complete medical evaluation.
Those most at risk for thyroid disease are women, especially pregnant and postpartum women and women with a family history of thyroid disease.
Doctors use a number of different tools to diagnosis thyroid disorders, including blood tests to detect the levels of thyroid-stimulating hormones (TSH) in your blood to nuclear medicine scans and biopsies to analyze nodules.
Performed at a limited number of specialized laboratories, thyroid nuclear medicine scans involve a small amount of radioactive iodine being swallowed in a pill form or injected into a vein. The iodine is absorbed by the thyroid and a special camera is then used to measure its distribution in and around the thyroid gland.
Hypothyroidism and hyperthyroidism can typically be treated and managed with medication to bring the thyroid hormones into balance.
Benign nodules can often be left alone and monitored by a physician for any changes that would require treatment. If the nodule is so big that it is causing problems with swallowing, breathing or talking, doctors may recommend surgery to remove it.
In cases of multiple nodules or a nodule that is causing the overproduction of hormones, doctors often use radioactive iodine for treatment. The iodine shrinks the nodules and causes the symptoms of hyperthyroidism to subside.
Thyroid cancer is usually treated by surgically removing the cancerous nodule and often the entire thyroid. Many patients also receive further treatment with radioactive iodine. Patients treated for thyroid cancer require lifelong thyroid hormone replacement therapy.
Thyroid cancer surgery is not without risk. In addition to the normal risk associated with general anesthesia, risks of thyroid surgery include damage to the nerve that controls your vocal chords and damage to the parathyroid glands that help control your calcium levels. If you are a candidate for surgery, be sure to discuss the risks with your doctor.
UMCP’s Nuclear Medicine Services Department is the only facility in the region to receive a prestigious three- year accreditation from the American College of Radiology for all three modes of imaging: general nuclear medicine, CT scans and nuclear cardiology imaging.
For more information about UMCP’s Nuclear Medicine Services or to find an endocrinologist on staff with Princeton HealthCare System call 888-742-7496 or visit www.princetonhcs.org.
Princeton HealthCare System’s Head and Neck Cancer Support Group of Central Jersey meets on the third Wednesday of the month from 12 to 1 p.m. at University Medical Center at Princeton, 253 Witherspoon Street, Princeton. For more information or to register, call 609-497-4475.
Ned M. Weiss, M.D., is board-certified in Endocrinology and Metabolism, as well as Internal Medicine. He is a member of the medical staff at University Medical Center at Princeton.
