Thyroid cancer is one of the most diagnosed cancers in adolescents and young adults – and its incidence in young people is rising. The good news, however, is that the mortality rate of thyroid cancer remains low.
“About 90% of the thyroid cancer we see is called differentiated thyroid cancer,” says Natalia Genere, M.D., an endocrinologist who specializes in thyroid cancer at Henry Ford Health. “It’s a type of thyroid cancer that’s most common in adolescents and young adults. It has a very good prognosis, as it’s typically slow growing. That is the type that’s increasing in frequency. “
There’s also medullary thyroid cancer, which is more hereditary, and then poorly differentiated (or anaplastic) thyroid cancer, which is very aggressive. Fortunately, anaplastic thyroid cancer is very rare. And it’s not common in young adults.”
What Accounts for the Rising Rate of Thyroid Cancer In Young People?
There are clearly defined risk factors for differentiated thyroid cancer:
- Having radiation treatment – specifically as a child.
- Although rare, living around nuclear disasters like Chernobyl.
- Having three or more family members with differentiated thyroid cancer. (That said, this type of thyroid cancer is not usually genetic.)
Thyroid cancer is around three times more common in women than men. While it’s not completely known why, Dr. Genere says it may have something to do with increased estrogen exposure. (Estrogen also plays a role in increasing someone’s risk for breast cancer.)
But Dr. Genere doesn’t think the above risk factors are what’s driving the increase in thyroid cancer. “Detection bias is the main theory as to why thyroid cancer seems to be increasing,” she says. “Nowadays, just in the U.S. each year there are tens of millions of CT scans done for a variety of reasons. Yet these scans can detect small thyroid nodules – so thyroid cancer is being found incidentally.”
Environmental factors may also play a role (think: pollutants in the air and water, processed diets, endocrine disruptors, etc.), but as of yet, Dr. Genere says a clear link between environmental triggers and thyroid cancer hasn’t been found.
Thyroid Cancer Care at Henry Ford Health
There does, however, seem to be an association between obesity and thyroid cancer. “This may be a true increased risk due to changes in inflammation and some proteins in the blood related to obesity, but again, it may also be a detection bias, since individuals who are overweight or obese tend to receive more imaging for other unrelated reasons.”
Treatment for Thyroid Cancer
Fortunately, most cases of thyroid cancer that are found incidentally may not even cause a problem for someone. (Past studies done on autopsies have found that 5% - 10% of people live and die with a small thyroid nodule that never affects them.) In select cases, active surveillance – or a “watch and wait” method – may be used. But it depends upon the individual: this may not be the best choice for a young adult who would require years and years of monitoring.
“Treatment for thyroid cancer usually involves removing half or the whole thyroid gland,” says Dr. Genere. “If the entire thyroid gland is removed, they’ll need to be on lifelong hormone treatment. And then some patients will need additional treatments like radioactive iodine to destroy any remaining cancer tissue. Or we’ll give someone a bit more thyroid hormone than their body is used to because it may help reduce the risk of recurrence.”
In cases of advanced thyroid cancer, radiation and chemotherapy are often used – but this is a minority of cases, and thankfully less commonly required in young adults who develop thyroid cancer.
Symptoms of Thyroid Cancer
Feeling a lump in your throat is the main symptom of thyroid cancer. “People sometimes describe it as a frog in their throat, or having difficulty swallowing,” says Dr. Genere. “You could also experience a hoarseness in your voice. This can also be caused from reasons aside from thyroid cancer – i.e., a cold, allergies, acid reflux, certain types of inhalers – but it’s important to talk to your doctor if you have any questions or suspect you may have thyroid cancer.
“Those who are diagnosed should ensure they see an endocrinologist and thyroid surgeon with experience in thyroid cancer to help determine the appropriate treatments for them.”
Reviewed by Natalia Genere, M.D., an endocrinologist who specializes in thyroid cancer at Henry Ford Medical Center – Columbus and Henry Ford Medical Center – New Center One.
