The thyroid gland, located near the base of the neck, is a butterfly-shaped gland that generates hormones that regulate a variety of vital biological processes, including bone maintenance, heart, muscle, and digestive function. The gland is made up of two types of cells: follicular cells, which govern metabolism, and parafollicular cells, which control calcium absorption.

Thyroid cancer is a rather common type of cancer, although it is sometimes misinterpreted as a universally deadly and aggressive disease. While it is critical to treat thyroid cancer swiftly and appropriately, it is also crucial to remember that not all instances are life-threatening and may not necessitate severe therapy.

Early signs of thyroid cancer

In the early-stages, thyroid cancer rarely causes visible symptoms, says Dr Sandeep Kharb, senior consultant, endocrinology, Asian Hospital. Often the first sign is a painless bump near the base of the neck that may feel substantially stiffer than the surrounding tissues. As the disease advances, patients may notice swelling in the neck, difficulty swallowing and breathing, pain in the front of the neck that extends to the ears, hoarseness, or other persistent voice alterations. A lingering cough not linked to a cold can also be an early red flag. These subtle signs should never be ignored.”

Speaking on the neurological impact of the condition, Dr. Praveen Gupta, Director  &Head of Neurology, Fortis Memorial Research Institute, said, “Though rare, thyroid dysfunction especially in cases where it is left untreated can result in neurological issues such as mood changes and memory problems to more severe complications like cognitive impairment and peripheral neuropathy. For this reason, timely diagnosis and a multidisciplinary approach to treating the condition is important not just to manage the cancer, but to safeguard overall neurological health.” 

Treating thyroid cancer

“The key to successful thyroid cancer treatment lies in early detection. Many cases are diagnosed incidentally during routine check-ups or imaging done for unrelated concerns. Simple diagnostic tools like neck ultrasound, fine-needle aspiration biopsy, and thyroid function tests can play a crucial role in identifying cancer at an early stage when it’s most treatable and requires less aggressive intervention. Timely diagnosis offers patients the best chance at recovery and a good quality of life,” says Dr. Sunita Kapoor,  Director & Laboratory Head, City XRay and Scan Clinic

Most thyroid malignancies can be successfully treated surgically, with radioactive iodine (RAI) therapy if needed. Researchers are looking for new treatments to treat thyroid cancer that do not respond to RAI therapy that are effective and would have fewer side effects.

Shedding light on current treatment approaches and advances for thyroid cancer, Dr.  Arun Kumar Giri, Director- Surgical Oncology, Aakash Healthcare said, “Surgery is usually highly effective, however, it can have long-term adverse effects, especially if the entire thyroid is removed. Researchers are currently investigating other methods for destroying thyroid cancers while preserving the majority of the healthy gland. This could result in fewer long-term adverse effects.

Techniques that remove (ablate) small portions of tissue are being employed to treat benign (non-cancerous) thyroid nodules. Some of these techniques are now being examined for use in tiny thyroid tumors, albeit they are still considered experimental at the moment. “

Radioactive Iodine (RAI) Therapy

Researchers are looking for ways to increase RAI's effectiveness in treating more thyroid cancers.

For example, BRAF gene mutations in some thyroid cancers may make the cells less susceptible to RAI therapy. Researchers are investigating if innovative medications targeting the BRAF pathway might be used to make thyroid cancer cells more likely to absorb radioactive iodine. These drugs may be useful for patients with advanced cancer who are no longer responding to RAI therapy.

Newer medications for thyroid cancer

Historically, advanced thyroid tumors that did not respond to RAI treatment were frequently treated with chemotherapy, says Dr.  Pratik Patil, Consultant - Medical Oncology, Jupiter Hospital,”Unfortunately, most thyroid tumors do not react well to chemotherapy. However, various types of drugs have become accessible in recent years, and others are now being researched.

Targeted therapies for thyroid cancer address specific gene and protein alterations within the cancer cells. These alterations are what distinguish thyroid cancer cells from normal cells. Targeted medications have become an essential aspect of treatment for many advanced thyroid malignancies since they are generally more effective than chemotherapy drugs, he added.

Immunotherapy makes use of medications to help the body's immune system detect and fight cancer cells. This method has become a significant aspect of the treatment of many cancers. It may also help treat certain types of thyroid cancer.

For example, immunotherapy drugs known as checkpoint inhibitors can frequently assist increase the immune system's response to cancer cells wherever in the body. These medications may be beneficial for persons whose thyroid cancer cells exhibit particular characteristics, such as several gene alterations.