Can you have thyroid cancer without knowing?

The thyroid is a small, butterfly-shaped gland at the base of the neck. It’s responsible for the hormones that control your heart rate, blood pressure, temperature and metabolism. 

When thyroid cells grow abnormally, they can cause thyroid cancer. But because symptoms are vague and may mimic other less-serious conditions, it’s possible you could have thyroid cancer for months or even years without knowing it. 

Thyroid cancer surgeon Nancy Perrier, M.D., explains how thyroid cancer can go unnoticed – and what you can do to catch it early when it’s easiest to treat. 

Thyroid cancer symptoms can go unnoticed 

Unfortunately, thyroid cancer doesn’t have many obvious symptoms, and they can vary from person to person. Some signs of thyroid cancer include:

• a lump in the front of the neck
• swollen thyroid or swelling in the neck
• pain in the front of the neck that may stretch to the ears
• hoarse voice
• trouble breathing
• persistent cough
• problems swallowing

If you experience any of these symptoms for three weeks or longer, see your health care provider to have them checked out.

Accurate diagnosis is key 

Because thyroid cancer symptoms may also be associated with other conditions, like enlarged lymph nodes in the neck, thyroiditis or Hashimoto’s disease, an accurate diagnosis is important. There are several tests your health care provider may use to find out if you have thyroid cancer.

The first thing they’ll likely do is perform a physical exam, to feel for any lumps or swelling in the neck. Firm nodules that don’t go away may be cause for concern. Soft, short-lasting nodules don’t usually cause problems. 

After a physical exam, your care team will likely perform: 

• Imaging exams: Ultrasound and later a CT scan may be used to get a better look at the size, shape and location of thyroid nodules. These exams can also show if thyroid cancer has spread to lymph nodes or other areas of the body. 

• Biopsy: If the initial imaging shows a potential tumor, a biopsy may be used to remove a small number of cells so a pathologist can look at them under a microscope. 

If the biopsy and imaging exams suggest you have thyroid cancer, it’s important to seek care from a cancer center with thyroid cancer specialists to get an accurate diagnosis. For example, you may have several nodules, but if the wrong one is biopsied and deemed benign, a cancerous nodule may get overlooked and cause problems in the future. 

At MD Anderson, we have a team of pathologists who exclusively look at thyroid cancer all day, every day. 

Certain types of thyroid cancer can grow slowly 

Papillary thyroid cancer is the most common and least aggressive type of thyroid cancer. It can occur in one or both thyroid lobes and can grow over several years. Certain people may be at risk for papillary thyroid cancer, like those with some types of young-onset colon cancer.

Patients diagnosed with papillary thyroid cancer often have symptoms that they dismiss for years until receiving a diagnosis. 

Other, less common types of thyroid cancer, like anaplastic thyroid cancer or poorly differentiated thyroid cancer, are more aggressive. They tend to present as a large lump that shows up suddenly over a few weeks or months.

Thyroid cancer doesn’t always need treatment right away

If a thyroid nodule isn’t causing problems, patients may choose to take a watch-and-wait approach, where their care team will monitor the lump for any changes before moving forward with treatment. 

Most of the time, when patients go to get a lump checked out, it’s already causing trouble breathing or swallowing. In this case, the most common treatment is surgery to remove part or all of the thyroid. 

Patients with genetic mutations – especially children at high risk for thyroid cancer – may live for years before needing treatment. We monitor these patients with ultrasounds and lab work.

It’s sometimes better to let the body release thyroid hormones naturally for as long as possible before moving forward with treatment. But, if we know someone is at high risk for developing thyroid cancer, we can watch them closely and, if needed, remove the thyroid quickly, before the disease has a chance to spread. 

Seek treatment from thyroid cancer experts

Don’t be afraid to get a second opinion. You want the right treatment at the right time from the right place. The thyroid is such a delicate gland, and it’s in a very challenging area. So, it’s vital to seek treatment from experts who have experience treating – and removing – the tumor so you can achieve the best quality of life possible. 

 Request an appointment at MD Anderson online or by calling 1-877-632-6789.