Thyroid Cancer Diagnosis & Detection
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At Cancer Treatment Centers of America (CTCA), our first priority is to ensure a thorough and accurate thyroid cancer diagnosis. This step is fundamental in developing a treatment plan for you.
Within the first few days of your arrival at a CTCA hospital, we will perform a complete array of state-of-the-art diagnostic tests. Our clinicians will also review your medical records, including your health history. This information helps us formulate treatment recommendations for you.
Diagnostic Tools, Procedures and Tests for Thyroid Cancer
Your team of cancer experts at CTCA will use advanced thyroid cancer detection tests and tools to accurately diagnose your condition and formulate your individualized treatment plan. Throughout your treatment for thyroid cancer, we'll use imaging and laboratory tests to monitor your response to treatment and modify your treatment when needed.
A biopsy is performed to get a sample of cells from the suspicious area so a pathologist can look at them under a microscope to see if they are cancerous. Generally, this is done under local anesthetic using a technique called fine needle aspiration (FNA). In FNA, a thin, hollow needle is inserted into the suspicious area to extract cells and fluid.
Your doctor will usually take samples from several different areas of the nodule. If the nodule is too small to feel, an ultrasound machine may be used to help locate the suspicious area. If the results of the FNA biopsy are inconclusive, a more extensive biopsy or removal of part of the thyroid gland may be necessary in order to make an accurate thyroid cancer diagnosis.
Several types of imaging tests may also be used to detect if the cancer has spread and to monitor your response to treatment:
- Chest X-Ray – When diagnosing thyroid cancer, a standard X-ray of the chest may be performed to see if the cancer cells have spread to the lungs.
- Ultrasound – Images of the nodules in the thyroid can be created using the reflected echoes of high-frequency sound waves. Also known as sonography, this non-invasive procedure can help doctors determine the size of nodules on the thyroid and see how many are present. It can also help to see if the suspected nodule is solid, or filled with fluid. Sometimes, ultrasound is also used to guide the biopsy needle when nodules are small.
- Computed Tomography (CT) Scan – A CT scan is a special type of X-ray that generates three-dimensional, cross-sectional images throughout the body. Unlike a normal X-ray, CT scans can create detailed images of the internal organs, like the liver and lungs. This test for thyroid cancer is usually used to see if the disease has spread to other areas of the body, but may also sometimes be used to guide the biopsy needle.
- Magnetic Resonance Imaging (MRI) – MRI is also used to examine the soft tissues within the body, but unlike X-rays and CT scans, an MRI uses radiofrequency waves and powerful magnets to generate the images, so there is no radiation used. MRI is particularly useful for looking at the brain and spinal cord.
- Nuclear Medicine Scans – This type of test for thyroid cancer involves putting a small amount of radiation in your body, and then following where the radiation goes with a special camera to locate cells that are not behaving normally. The most common test used for patients with thyroid cancer is a radioiodine scan, which involves swallowing or injecting a small amount of radioactive iodine, or I-131. This test is often used in patients with differentiated forms of the disease (papillary, follicular, Hürthle cell). It may be used to identify abnormal areas of the thyroid gland, or to determine if the cancer has spread to other areas of the body.
- Positron Emission Tomography (PET) Scan – When diagnosing thyroid cancer, this imaging technique is used to look at metabolic activity within different organs of the body. A radioactive dye, usually a form of glucose, is injected, and a special camera is used to take a picture of radioactive areas within the body. Because cancer cells are growing rapidly and are often more metabolically active compared to normal cells, they absorb more of the radioactive glucose. PET scans are very sensitive, but they do not show much detail, so they will often be performed in combination with a CT scan (called PET/CT).
- Vocal Cord Exam (Laryngoscopy) – Because the thyroid gland is so close to the vocal cords, thyroid tumors may sometimes affect them. For this reason, your doctor may want to examine the cords first with special tools such as a laryngoscope if you are scheduled for surgery.
There are also several blood tests that your doctor may order to monitor how your thyroid gland is working, or to monitor your response following treatment. The most common tests for thyroid cancer check the levels of thyroid stimulating hormone (TSH), the thyroid hormones T3 and T4, thyroglobulin, calcitonin and carcinoembryonic antigen (CEA).
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