Treatment, Stages, and Diet: THYROID CANCER
The thyroid is a butterfly shaped gland located at the base of the throat near the trachea (windpipe). It has two lobes, a right lobe and a left lobe. The isthmus, a thin piece of tissue, connects the right and left lobes. A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin.
Figure 1: Structure of thyroid gland
The thyroid gland utilizes iodine, a mineral found in some foods and in iodized salt in order to synthesize several hormones, majorly triiodothyronine (T3) and thyroxine (T4). These hormones perform many vital body functions such as:
- Control heart rate, body temperature and metabolism.
- Control the calcium amount in blood.
- Thyroid hormone affects fertility, ovulation, and menstruation.
If one has thyroid cancer, a lump (nodule) in the gland may be found during a routine medical exam. A thyroid nodule is an abnormal growth of thyroid cells in the thyroid gland. Nodules may be solid or fluid-filled.
When a thyroid nodule is found, an ultrasound of the thyroid and a fine-needle aspiration biopsy are often performed to check for the signs of cancer. Blood tests to check thyroid hormone levels and for antithyroid antibodies in the blood can also be done to check for other types of thyroid diseases.
There are different types of thyroid cancer. Thyroid cancer can be described as either:
- Differentiated thyroid cancer, which includes well-differentiated tumors, poorly differentiated tumors, and undifferentiated tumors:
Well-differentiated tumors (papillary thyroid cancer and follicular thyroid cancer) can be treated and usually be cured. Poorly differentiated and undifferentiated tumors (anaplastic thyroid cancer) are comparatively less common. These tumors grow, disseminate quickly and have a poor chance of recovery. Patients with anaplastic thyroid cancer should have molecular testing for a mutation in the BRAF gene.
- Medullary thyroid cancer:
Medullary thyroid cancer is uncommon and accounts for 1–2% of all thyroid cancers. It is a neuroendocrine tumor that develops in C cells of the thyroid. The C cells secrete a hormone (calcitonin) that helps maintain a healthy level of calcium in the blood. It further has stage 1, stage 2, stage 3, stage 4A, stage 4B and stage 4C.
Figure 2: Stage 4A, 4B & 4C Thyroid cancer
The factors that put one a risk for thyroid cancer include the following:
Non-dietary risk factors such as exposure to to ionizing radiation, particularly during infancy or early childhood, genetic susceptibility for medullary carcinoma, benign thyroid conditions such as goiter & benign nodules,etc ; age between 25 and 65 years old, being female , being an asian, having a history of goiter, having certain genetic conditions like familial medullary thyroid cancer (FMTC), multiple endocrine neoplasia type 2A syndrome (MEN2A), or multiple endocrine neoplasia type 2B syndrome (MEN2B).
As per the best cancer nutritionist in India, dietary risk factors such as chronic iodine deficiency, a diet rich in fish and other seafood was associated with an increased incidence of TC. Recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease, and impaired vitamin D signaling has been reported in thyroid cancers.
Thyroid cancer may not cause any early signs or symptoms. It is sometimes found during a routine physical exam. Signs or symptoms may occur as the tumor increases in size. Other conditions may cause similar signs or symptoms. One must check with the physician if any of the following is observed:
- A lump (nodule) in the neck.
- Trouble breathing.
- Trouble swallowing.
- Pain when swallowing.
Tests that examine the thyroid, neck and blood are used to diagnose thyroid cancer. The tests and procedures such as physical exam & health history, laryngoscopy, blood hormone & blood chemistry studies, CT scan, Ultrasound exam, fine-needle aspiration biopsy, surgical biopsy, etc may be used to detect thyroid cancer.
Figure 3: CT scan of head and neck
When it comes to treatment, there are different types of treatment for patients with thyroid cancer. Six types of standard treatment are used:
- Radiation therapy, including radioactive iodine therapy
- Thyroid hormone therapy
- Targeted therapy
- Watchful waiting
Several new types of treatment are being tested in clinical trials.
While there isn’t yet enough robust kind of evidence to describe a specific anti-thyroid cancer diet, patients undergoing radioactive iodine therapy following surgery for thyroid cancer are usually placed on a strict low-iodine diet.
A low-iodine diet requires avoiding foods like: Iodized salt, dairy foods such as cheese, milk, yogurt, ice cream, and butter; packaged breads and baked goods, chocolate, skins of potatoes, fish and seafood, and other sea products like seaweed and kelp; soybeans and other soy products, lima beans, kidney beans, pinto beans, and other types of beans and egg yolks.
Relying majorly on fresh foods, particularly meats, fruits, and vegetables, is generally required to minimize iodine intake. A low iodine-diet is really a very healthy diet, full of fresh foods that are low in both calories and fats.
Another common symptom of thyroid cancer treatment is dysphagia, or trouble swallowing. Dysphagia may lead to inadequate food intake and result in weight loss, even before a thyroid cancer diagnosis is made. If there is a difficulty swallowing, then the patient should avoid coarse, dry foods such as toast, crackers, chips, and pretzels. Creamy, soft, moistened foods are usually well tolerated by such patients.
Here are some more tips to help prepare easy-to-eat foods for thyroid cancer patients:
- Do not season foods with iodized salt on a low-iodine diet.
- Try pureeing your meals if having trouble swallowing food.
- Prepare smaller meals, but eat more often — frequently throughout the day.
- Make sure foods are well cooked so that they’re softer and easier to swallow.
- Choose protein-rich foods to get the calories and energy that you need.
- Add plenty of fresh fruits and vegetables to the meals that you are preparing; steam or puree vegetables and stew or poach fruits to make them easier to chew and swallow.
Remember that your nutritional needs are unique to you and your cancer care. Nutrition recommendations should be individualized based on the type of treatment.
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