THYROID TUMORS

First of all, in case you found this page first, instead of page one, I need to restate that I am not a medical doctor.  My knowledge of thyroid tumors and the associated illnesses comes from first hand experience, which is a form of knowledge that cannot be learned in a college classroom or from a textbook.  

Most people know that the thyroid gland is the big butterfly-wings shaped gland in the neck.  It is located in the anterior, or front neck, below the skin and muscle layers.  The two "butterfly" wing shapes are the left and right thyroid lobes, and they wrap around the trachea, or wind pipe.  The function of the thyroid is to make thyroid hormone.  This hormone has an effect on nearly all tissues of the body where it increases cellular activity.  Therefore, the function of the thyroid is to regulate the body's metabolism.

The thyroid gland can develop several problems, some of which are extremely common. Often, these problems can concern the production of hormone, too much or too little.  Sometimes, the unusually increased growth of the thyroid can cause compression of important neck structures.   People have also developed nodules or lumps within the thyroid which are worrisome for the presence of thyroid cancer.  I've personally dealt with all of these thyroid problems, so I can describe them in some detail, but I want to focus on Medullary Thyroid Cancer on this page.

Many thyroid cancers are curable.  The most common types of thyroid cancer, papillary and follicular are the most curable.  Medullary cancer of the thyroid is significantly less common, and it has a worse prognosis. Medullary cancers tend to spread to large numbers of lymph nodes very early on, and therefore it requires a much more aggressive operation than does the more localized cancers such as papillary and follicular. This cancer requires complete thyroid removal and a dissection to remove the lymph nodes of the front and sides of the neck.  If this cancer is found after it has already spread, it cannot be cured in most cases. The cancer can hide, and often an operation cannot remove all the tumors.  This cancer has to be carefully watched, and frequent blood test need to be done.

Medullary tumors are the third most common of all thyroid cancers. Unlike the papillary and follicular thyroid cancers which arise from thyroid hormone producing cells, medullary cancer of the thyroid originates from the parafollicular cells, or "C cells" of the thyroid.  These C cells make a different hormone called Calcitonin, which has nothing to do with the control of metabolism the way thyroid hormone does.  The production of this hormone can be measured after an operation to determine if the cancer is still present, and if it is growing.  This cancer has a much lower cure rate than does the "well differentiated" thyroid cancers. Overall 10 year survival rates are 90% when all the disease is confined to the thyroid gland, 70% with spread to cervical lymph nodes, and 20% when spread to distant sites is present.

My thyroid was completely removed in 1981.  A blood test for Calcitonon is an indicator of medullary thyroid cancer.  At that time, normal Calcitonin scale was considered to be 40 or below, and my level was greater than 4000.  There was cancer in both medullary sections of my thyroid, so the gland was useless.  After removal, it was determined from blood tests for Calcitonin, that the cancer had already spread to other parts of my body.  Since it could not be determined where the cancer had spread and situated itself, further surgery was useless.  

In 1997, when I had tumorous parathyroids removed, the surgeon wanted to remove some possible cancers that had been noted in an MRI performed on me previous week.  But the parathyroid surgery turned out to be so complex that the surgeon had to postpone the removal of the possible cancer lesions.  Six months later, I received a call from that doctor, reminding me that those possible cancers noted in the MRI should be removed as soon as possible.  

A few months later, I had another MRI done, and the "possible cancers" were gone!  The good news is they were gone. The bad news is where did they go?  My Calcitonin level is increasing again, which indicates that they are still there and increasing.  There is no easy answer that a doctor can give me.  I know I'm not  in the 90% group mentioned above, but I don't know if I am in the 70% or 20% group.

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Footnotes:
None, except the dictionary definition from Merriam Webster. All other text is based on my personal experiences, or those of my family. My father's family has a long history of MEN, along with additional blood vessels, and unusual conditions. My mother's family has problems with stomach cancer and heart attacks. My mother recently died of heart failure, as a complication of pancreatic cancer.