Thyroid cancer: symptoms, causes, tests and treatment

The NHS lists the main symptoms as a lump in the front, lower part of the neck that usually feels hard, slowly gets bigger and is not painful, a hoarse voice, a sore throat, difficulty swallowing or breathing, and pain in the front of the neck or a feeling like something is pressing against it. Other symptoms can include a red face (flushing), softer poos or diarrhoea, weight loss and a cough.

The NHS notes that if you already have a thyroid condition, such as a goitre, you may regularly get symptoms like these and become used to them, so it is important to be checked by a GP if they change, get worse or do not feel normal for you. It also stresses that these symptoms are very common and can be caused by many different conditions, so having them does not definitely mean you have thyroid cancer. It says that if they are caused by cancer, finding it early may mean it is easier to treat.

• A new neck lump, or an existing lump that is getting bigger: see a GP.

• A hoarse voice, sore throat or cough for more than 3 weeks: see a GP.

• Pain in the front of the neck, or a feeling of pressure there: see a GP.

• Difficulty swallowing or breathing: ask for an urgent GP appointment or get help from NHS 111.

The thyroid gland sits in the front, lower part of the neck and makes and releases hormones. Cancer Research UK describes thyroid cancer as when abnormal cells in the thyroid gland start to divide and grow in an uncontrolled way. The NHS describes it as quite rare in the UK.

Cancer Research UK explains that the type of thyroid cancer refers to the type of cell the cancer started in, and the stage tells you its size and whether it has spread. The NHS says the treatment you have depends on the size and type of thyroid cancer, whether it has spread and your general health, which is why two people with the same diagnosis can have different plans.

The NHS says anyone can get thyroid cancer and it is not always clear what causes it. You might be more likely to get it if you are a woman who has not been through the menopause, if you have a condition that affects the thyroid such as a swollen thyroid (goitre), Hashimoto disease or non-cancerous nodules, if a brother, sister, parent or child has had thyroid cancer, if you were exposed to a lot of radiation or had radiotherapy in the past, especially as a child, or if you have had certain cancers before, such as breast cancer, oesophageal cancer, testicular cancer or non-Hodgkin lymphoma.

Cancer Research UK mentions age, being very overweight and some non-cancerous thyroid conditions among risk factors. The NHS says many thyroid cancers are linked to lifestyle, and that you cannot always prevent them, but losing weight if you are overweight, avoiding drinking more than 14 units of alcohol a week and trying to quit smoking can lower your chances of this and other cancers.

The NHS says the GP may feel your neck and might arrange a blood test. You may get an urgent referral for more tests or to see a specialist if the GP thinks your symptoms could be cancer, which does not definitely mean you have cancer. At the specialist stage, tests you may have include blood tests, an ultrasound scan of your neck and a small sample taken from your thyroid gland using a needle (biopsy), which is checked for cancer. You may not have all of these tests.

The NHS says it should take about 2 weeks to get the results, but sometimes it might take longer, and that a long wait does not definitely mean anything is wrong. You can call the hospital or GP if you are worried. If you are told you have thyroid cancer, you will usually need more tests, such as a CT, MRI or PET scan and a test where a thin, flexible tube with a small camera is passed through the nose to check your vocal cords, to find the size of the cancer and how far it has spread (the stage).

The NHS says thyroid cancer is often treatable and treatment will usually include surgery. It may also include hormone therapy, radioactive iodine treatment, targeted medicines, radiotherapy or chemotherapy. Surgery is the most common treatment: depending on the type and stage of the cancer you may have all of your thyroid removed (total thyroidectomy) or part of it (partial thyroidectomy or lobectomy), and some lymph nodes in the neck may be removed if the cancer has or might have spread to them.

If you have had your thyroid removed you usually need hormone tablets to replace the hormones your thyroid made, which can also help stop the cancer coming back; you may also need them after part of your thyroid is removed. Radioactive iodine treatment, a small amount of radiation taken as a tablet or drink, may be used after surgery to kill any cancer cells left behind or help stop it coming back, or if the cancer has come back or spread. The NHS says targeted medicines may be used if other treatments are not an option or no longer working, radiotherapy if the cancer cannot be removed by surgery or has spread, and chemotherapy is not usually used but may be if the cancer has come back or spread.

If a cure is not possible, the NHS says the aim of treatment is to limit the cancer and its symptoms and help you live longer, with the palliative care or symptom control team working alongside your specialists.

The NHS says you will have regular check-ups during and after any treatments, and may have tests and scans, and that you do not need to wait for your next check-up if you have symptoms or side effects you are worried about. A clinical nurse specialist is your main point of contact. Cancer Research UK highlights that practical and emotional support is available to help you cope with the diagnosis.

On outlook, Cancer Research UK says survival depends on the type and stage of your thyroid cancer and is generally very good for papillary and follicular thyroid cancers. Your own team can discuss what this means for you.

On the NHS, the route usually starts with a GP, who may arrange an urgent referral for tests or to see a specialist in hospital if the symptoms could be cancer. The NHS says a group of specialists will look after you throughout your diagnosis, treatment and beyond, and that the team will include a clinical nurse specialist who is your main point of contact.

If you consider a private opinion, ask which team will be responsible for the whole of your care, who will be the operating surgeon, what type and stage of cancer you have, and how long-term follow-up and monitoring will be arranged afterwards.