Thyroid Cancer Care at Mount Sinai
The multidisciplinary management of thyroid cancer at Mount Sinai involves collaboration among surgical, medical/endocrinology, and nuclear medicine specialists. The thyroid surgical team at Mount Sinai’s Department of ENT/Head and Neck Surgery includes Eric Genden, MD, Raymond Chai, MD, Ilya Likhterov, MD, Brett Miles, MD, Stimson Schantz, MD, Edward Shin, MD, Marita Teng, MD, Mark Urken, MD, Mike Yao, MD, and facial plastics and reconstruction surgeon Joshua Rosenberg, MD. Our team works closely with other experts and collaborates together to craft the least invasive, personalized treatment plan for each patient to minimize scarring and hospital stays.
Minimal Thyroid Surgery Scarring
Our head and neck surgeons are recognized for their expertise in minimizing scarring for those who require thyroid surgery. Patients often remark during their postoperative visit that the size of the incision is “tiny,” and that friends have complimented them on the scar appearance. During surgery, the incision is camouflaged in a natural skin fold and our team employs plastic surgery techniques to ensure the least visible scar possible. Dissolvable stitches are strategically hidden under the skin, and then covered with a skin-colored surgical tape. It is common to see swelling and a ridge form around the scar area temporarily, but within a few months, the great majority of our patients are extremely happy with their barely noticeable scar.
Types of Thyroid Cancer
Thyroid cancer is a malignant growth in the thyroid - the butterfly-shaped gland in the base of the neck. The thyroid produces the hormone that controls a variety of metabolic functions in the body, such as heart rate, weight, and body temperature. When present, thyroid cancer usually manifests in the form of a palpable nodule or mass. The most common types of thyroid cancer include:
- Papillary carcinoma: The most common type of thyroid cancer, papillary carcinoma usually grows slowly and has potential to spread to lymph nodes in the neck. This type of thyroid cancer is overwhelmingly likely to be curable.
- Follicular carcinoma: Most often, follicular cancer remains in the thyroid gland and does not usually travel to lymph nodes, but can spread to other sites such as lungs and bones. When caught early, this type of thyroid cancer is also very often curable.
- Medullary thyroid carcinoma: This cancer develops from special thyroid cells called C-cells. Medullary cancer has more metastatic potential than the previously described types. There are two types of medullary cancer, sporadic and familial.
- Anaplastic carcinoma: A rare type of thyroid cancer, anaplastic carcinoma often quickly invades the neck and other parts of the body and can be fatal.
Thyroid Cancer Risk Factors
- History of radiation to the head, neck, or chest, especially in infancy or childhood
- Family history of thyroid cancer
- Female gender
- Age 30 and over
- Exposure to radiation from nuclear accidents or nuclear testing areas
Symptoms of Thyroid Cancer
- A lump in the neck
- Neck pain or tightness
- Difficulty swallowing
- Difficulty breathing
- Persistent cough
- Enlarged lymph nodes in the neck
Thyroid Cancer Diagnosis and Treatment
At Mount Sinai, our physicians have expertise in diagnosing and treating all stages of thyroid cancer. Diagnosing thyroid cancer involves a careful examination of your neck and throat to detect lumps or swelling, as well as a discussion about your medical history. One or more of the following tests may be ordered to determine if the cancer has spread and the optimal treatment plan:
- Fine needle aspiration biopsy
- Thyroid scan
- Blood tests for hormone levels
- CT, MRI, or PET scan
Treatment depends on the stage of the cancer. Other than a few rare forms of thyroid cancer, the primary treatment modality is surgery. Examples of treatment options include:
- Minimally Invasive Surgery: Thyroidectomy is the surgical removal of a portion or all of the thyroid gland. If the nearby (central compartment) lymph nodes appear involved, they may be removed in the same setting. In the event that additional lymph nodes are involved, they may also be removed through an extended incision in the same operative setting. These surgeries are usually performed under general anesthesia, and sometimes may require a one-night hospital stay. Our surgical approaches at Mount Sinai are minimally invasive, utilizing small incisions, often as tiny as 2 centimeters. Skin closure is accomplished with absorbable sutures and a small waterproof surgical tape. Because of these techniques, interference with normal lifestyle is generally negligible, and surgical recovery is typically quite rapid.
- Radioactive iodine therapy: Radioactive iodine is a medication administered orally to destroy any remaining thyroid tissue without affecting the rest of the body. This treatment is designed to eliminate microscopic bits of thyroid tissue and thyroid cancer. Its administration is overseen by an endocrinologist and a nuclear medicine doctor.
- External radiation therapy: Radiation beams can be directed at the tumor from a source outside the body. This treatment is uncommonly used for thyroid cancer, but remains an option for advanced, recurrent, or inoperable disease. A radiation oncologist designs and monitors this treatment.
Thyroid Cancer Prevention
Detecting thyroid cancer early and treating it is the best way to ensure the most successful outcome. Routine physical exam screening is generally performed by general practitioners, internists, and gynecologists. Patients between the ages of 20 and 39 should have a thyroid exam every three years and every year for those 40 and over. If you or your loved one has prior radiation exposure or a family history of thyroid cancer, screening should be more frequent.