The thyroid gland is a butterfly shaped gland situated at the root of the neck. It produces a hormone – thyroxine, which is responsible for maintaining the normal metabolism of the body.
How serious are nodules in the thyroid?
Lumps or swelling of the thyroid (also called Goitre) are a common problem that a clinician faces in his practice. The vast majority of these nodules are benign and unless progressing or causing symptoms they are usually left alone and not operated upon. However, a small percentage (about 5%) of these nodules can be cancerous (malignant) and surgery becomes mandatory to remove the diseased gland. Quite often, the challenge facing the clinician is to differentiate between benign and cancerous nodules. When investigations such as ultrasound and needle aspiration do not resolve the issue, surgery is often recommended.
How is thyroid surgery done?
Surgery of the thyroid is done through an incision in the lower part of the neck. In most cases the incision heals well leaving behind a fine scar. Though surgery in experienced hands is totally safe, any injury to the delicate nerves running along the sides of the thyroid gland can result in permanent hoarseness. Since a neck scar may be psychologically upsetting to young patients, with the advent of the Robotic surgical systems, it is now possible to do thyroid surgery without opening the neck and without leaving a visible scar.
What is Robotic thyroid Surgery?
The Robotic system is a revolutionary innovation devised for performing surgical procedures in otherwise difficult or impossible locations using specially designed robotic arms. The robotic arms are controlled by a computer console which the surgeon operates using hand and foot controls – somewhat like a video-game, but a thousand times more precise and sophisticated. Using small and hidden incisions surgeons can remove complex tumors minimizing tissue damage, hastening recovery and reducing hospitalization. In recent times, the robotic system is also used to perform thyroid surgery by making an incision in the arm-pit instead of the neck, thus keeping the scar hidden.
How common is cancer in the thyroid gland and what are its causes?
Cancer of the thyroid gland is an uncommon cancer and accounts for just about
1%–1.5% of all cancers. The incidence of this cancer has shown a 2.4-fold increase in the last three decades (from 3.6 per 100,000 of the population in 1973 to 8.7 per 100,000 in 2004). This is believed to be due more to better diagnostic facilities such as ultrasound, which can pick up thyroid nodules much earlier, rather than any true increase in the incidence of the cancer. Exposure to ionizing radiation is one of the known risk factors for the development of thyroid cancer and the cancer often develops decades after the exposure has occurred. It is interesting to note that after the atomic bomb explosion in Hiroshima and Nagasaki, the incidence of thyroid cancer among the survivors increased by 200 times compared to the population which was not exposed to the effects of the bombing. Following the Chernobyl nuclear disaster, too, a study of 1000 inhabitants exposed to the radiation found that 62 developed thyroid cancer in the first 10 years after the exposure.
Is thyroid cancer curable?
Fortunately, the regular type of thyroid cancer (commonly referred to as well-differentiated thyroid cancer) is one of the most curable cancers known and provided that adequate surgery is performed, most patients with this cancer live their normal lifespan. Surprisingly, older patients with this cancer do not do so well. This is the only cancer in which the age of the patient is a very important factor determining the aggressiveness of the cancer and survival.
What other treatment is given to patients with thyroid cancer?
High-dose radioactive iodine treatment is administered to some patients after their thyroid surgery. This treatment is given post-operatively to all high-risk thyroid cancer patients to destroy any microscopic cancer that may be lurking unseen in any part of the body. Thyroid tissue (cancerous or otherwise) concentrates iodine and the radioactivity in the administered iodine destroys it. Following this treatment, patients are kept isolated for 72 hours, since the radioactivity emitted could be harmful to others around them.
What are the long-term effects of removing the thyroid gland?
Even though the thyroid gland is needed for vital body functions, removal of the thyroid gland does not affect the patient’s health in any way because of the availability of the thyroid hormone in a synthetic form in the form of tablets. This tablet has to be taken compulsorily by those who undergo complete removal of their thyroid gland.
Dr. Umanath Nayak
Contact: drumanathnayak@gmail.com