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Health & Exercise Forum

Thyroid Cancer Awareness

Jul 28, 2014

Dr. Mackarey's Health & Exercise ForumNEPA has one of the highest cancer rates in the country, particularly thyroid cancer! The purpose of this column on thyroid cancer is to raise the level of awareness for early detection and successful treatment for this disease.

Thyroid Gland

The thyroid gland is a butterfly shaped structure located in the front of your neck. It is responsible for secreting hormones that control the way your body uses energy to work at maximum function.

Thyroid cancer, while not common, has shown a dramatic increase in the United States with nearly 22, 500 cases diagnosed in 2011. According to Mark Frattalli, MD, one reason for the escalation in diagnosed cases of thyroid cancer is the advent of more accurate and sensitive diagnostic tests. However, environmental exposures are also believed to have a significant impact.

Women are three times more likely than men to get thyroid cancer. However, when a nodule is discovered in the thyroid of a male, it is more likely to be malignant (cancerous) than in females. More importantly, the good news is that only 10% of all thyroid nodules are malignant. The most common malignancies have an excellent prognosis, as less than 7% of all cases lead to death.

A diagnosis of a thyroid nodule usually begins by the discovery of a lump on the gland on physical exam by your physician. The second most common method of diagnosing a thyroid nodule occurs by chance when ultrasound is performed to another area of the head or neck. Diagnostic ultrasound is also used to confirm or locate the nodule and once diagnosed, treatment options are discussed. Based on the ultrasound test, your physician may recommend a needle biopsy to rule out a malignancy (cancer) and to determine the need for surgery. Surgical options involve the removal of half or all of the thyroid gland. Your surgeon may refer you to a radiation oncologist (radiologist with a specialty in cancer) to consider radioactive iodine (RAI). The RAI pill is ingested and, by taking up iodine, it will destroy remaining thyroid tissue in your body. Chemotherapy is sometimes recommended for the most aggressive tumor types.

Once treatment is concluded, close follow-up is required. Patients usually must take a thyroid hormone to replace the loss of thyroid function from the gland removal and to suppress the thyroid-stimulating hormone (TSH) which is secreted in the pituitary gland to reduce the risk of reoccurring cancer. Follow-up also includes blood level monitoring for TSH and thyroglobulin and a thyroid scan can be performed if necessary.

The surgical decision is complicated and requires a thorough discussion with your surgeon to determine the best choice for the individual patient. For those concerned about the cosmetics of a surgical scar in the front of the neck, surgeons utilize microinvasive methods with small incisions. While robotic thyroid surgery eliminates the neck incision  because it goes through the armpit, extended surgical times and higher complication rates make it less attractive for most surgeons and patients.

In summary, thyroid cancer is not common and, like all cancers early detection is critical. Visit your physician regularly for physical exams. Moreover, the good news is that only 10% of all thyroid nodules are malignant and the most common malignancies have an excellent prognosis.

What you need to know about thyroid cancer:

  • Excessive radiation exposure increases your risk
  • A dental X-ray will NOT increase your risk
  • Often there are not symptoms associated with the disease – especially in the early stages…so visit your physician regularly for routine check-ups
  • SYMPTOMS INCLUDE (but not limited to):
    • A lump or swelling in the front of your neck is the most common symptom
    • Pain in your neck or ears
    • Difficulty swallowing
    • Difficulty breathing or constant wheezing
    • Raspy or hoarse voice
    • Persistent cough not associated with a cold


Medical Expert/Contributor: Mark Fratalli, MD – Head and Neck Surgeon at Delta Medix; Chairman of Head and Neck Surgery at Regional Hospital; Surgery Education Director at The Commonwealth Medical College – Scranton, PA.

Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, and exercise regularly

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.


This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:


Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.