Vivian Hsu confirmed to be suffering from thyroid cancer! Doctor reveals signs of illness: The lump in the neck "can't be pushed", go get it checked quickly
Well-known artist Vivian Hsu was confirmed to be suffering from “thyroid cancer” and revealed that she “has always maintained a good health, exercise habits, and pays attention to a balanced diet.” Unfortunately, she carries a family genetic gene, and a tumor was discovered during a medical examination. In recent years, with the popularization of health check-ups in Taiwan, the diagnosis and prevalence of thyroid cancer have indeed increased. In the past, patients whose thyroid nodules were only diagnosed when they grew to 2-3 centimeters may be discovered when they are only 1 centimeter long.
Is “swollen neck” a sign of thyroid cancer? Female elders with medical conditions should be careful
Dr. Li Mingcang, from the Department of Metabolism at Far Eastern Memorial Hospital, once said in an interview that the average person’s chance of developing thyroid nodules is about 5%, of which only 1-2% are cancerous nodules. The proportion may not seem high, but if you have risk factors or develop nodules at a young age, you need to be more vigilant. There is no clear reason for the occurrence of thyroid nodules. It is currently estimated to be genetically related, and the proportion of women is 3-4 times higher than that of men. If the female elders in the family, such as aunts, aunts, grandmothers, etc., have a history of thyroid-related diseases, they should be particularly vigilant.
Generally, if a thyroid nodule is smaller than 1 cm, it is difficult to distinguish with the naked eye or palpation. Only when the nodule is nearly 3 centimeters long or is located in a superficial location can it be easily palpated. Dr. Li Mingcang emphasized that feeling a lump in the neck may not necessarily be a thyroid nodule or thyroid tumor. It may also be a bulging lymph node. If you have any doubts, you should go to the otolaryngology or metabolism department for examination and judgment by a doctor.
Dr. Li Mingcang pointed out that even if a thyroid nodule is benign by biopsy cytology, there is still a 2% chance of it being malignant. Therefore, clinical treatment must be comprehensively evaluated based on age, gender, family history and ultrasound. Generally speaking, the incidence of thyroid nodules will increase with age. If there are nodules at 3, 40 or even younger, or In men, considerable attention needs to be paid to changes in thyroid nodules.
What are the symptoms of thyroid cancer? The lump in your neck “can’t be pushed”, go get it checked quickly
Dr. Wu Xiyuan, chief physician of the General Surgery Department of the Tri-Service General Hospital, was also interviewed and pointed out that feeling a “fixed lump that cannot be pushed” around the neck is a major warning sign of thyroid cancer. According to the 2020 cancer statistics, thyroid ranks seventh among the top ten cancers and fourth in female cancer incidence. In addition to Vivian Hsu, Taiwanese celebrities such as Lee Ming-yi and Bao Ma have all been diagnosed with thyroid cancer.
Possible clinical symptoms of thyroid cancer include neck enlargement, hoarseness, difficulty swallowing, cervical lymph node enlargement, or neck pressure. Dr. Wu Xiyuan said that thyroid cancer often has no obvious symptoms when it is small in size. When there are symptoms, it has usually grown to a certain extent, or the patient is accidentally discovered during a health check-up. Once an abnormal tumor appears around the neck and feels hard and immovable, you should seek medical examination as soon as possible.
Thyroid cancer also has the risk of distant metastasis! Is it necessary to remove the thyroid gland during surgery?
Dr. Wu Xiyuan said that there are three main types of thyroid cancer, 85% of which are “papillary thyroid cancer”, about 10% are “follicular thyroid cancer”, and 1% are “medulla thyroid cancer”. In addition, there are also a very small number of A more aggressive form of anaplastic thyroid cancer. Lymph node metastasis is more common in papillary thyroid cancer, while distant metastasis such as lung metastasis is more likely in follicular thyroid cancer.
Although most thyroid nodules are benign, a very small number of them are diagnosed as malignant tumors. The necessity of subsequent treatment and follow-up will be evaluated based on the nodule characteristics or biopsy results. If the nodule shows the possibility of malignancy on ultrasound images, it is necessary to undergo “fine needle aspiration” of the thyroid gland to check whether there are malignant cells; if malignant cells are suspected, surgical removal is required to confirm the diagnosis and also serve as treatment for thyroid cancer.
Surgery is the first line of treatment for thyroid cancer. In addition to removing the tumor, surgery will also evaluate whether the thyroid cancer has lymphatic metastasis, and depending on whether there is metastasis, a decision will be made whether to perform a unilobar thyroidectomy or a total thyroidectomy. Lymph node dissection surgery may be required. When there is lymphatic metastasis, extrathyroidal invasion or a higher-risk pathological pattern, adjuvant radioactive iodine therapy will be given. However, medullary carcinomas and undifferentiated carcinomas do not respond well to radioactive iodine therapy, so surgery and new targeted therapies are the main treatments.
Does thyroid cancer also require genetic testing? Targeted therapy response rate exceeds 50%
In recent years, thyroid cancer treatment has also entered the era of “precision treatment”. Dr. Wu Xiyuan pointed out that the pathogenesis of thyroid cancer is a series of processes controlled by multiple genes; genes are like “switching gates” from upstream to downstream in the body. Currently, the most relevant gene found to be associated with thyroid cancer is “BRAF”. BRAF gene mutation is not only related to the aggressiveness of thyroid cancer, but also a major breakthrough point for targeted therapy.
In addition to the BRAF gene, RET, NTRK, TERT, RAS, TP53, etc. are all genes related to the thyroid cancer pathway. People generally consider that genetic testing is expensive. In addition to choosing a testing plan, you can consider BRAF, RET, NTRK and other genes most related to thyroid cancer. You can also consult a medical center or pathology laboratory to see if there is a test method for BRAF specimen staining as a gene test. Initial reference basis for testing.
Dr. Wu Xiyuan further explained that among the targeted drugs currently available, the first line is “multi-targeted” targeted drugs, which target upstream receptors in the pathogenesis of thyroid cancer, including angiogenesis, fibroblast growth factors, and more. The purpose is to stabilize the tumor or slow down its spread. However, first-line targeted drugs often have severe side effects such as fatigue, diarrhea, loss of appetite, rash, and even cardiovascular and renal effects. Nowadays, there are second-line targeted drugs for advanced thyroid cancer with BRAF gene mutations. The treatment response rate is more than half, which can achieve tumor shrinkage and maintain good quality of life.
Do thyroid cancer patients need a low-iodine diet? Medical Refutation: Magnesium deficiency can cause malnutrition
There are nearly 5,000 patients with thyroid cancer every year. How to adjust your work and rest to achieve stable control? Dr. Wu Xiyuan pointed out that the rate of change of thyroid cancer varies from person to person, so regular tracking is the most important. It is generally believed that patients with thyroid cancer need a “low-iodine diet”, but in fact they only need to control it 2 weeks before receiving radioactive iodine treatment. Patients still mainly eat a balanced diet. Excessive lack of iodine intake may cause nutritional imbalance or metabolic abnormalities.
In addition, patients who undergo total thyroidectomy require lifelong oral thyroxine. Dr. Wu Xiyuan reminded that most thyroxine drugs should be taken on an empty stomach in the morning. They must be separated by one hour from food, coffee, and tea to avoid affecting absorption. Patients must take the medicine regularly. During regular follow-up visits every 3 months, it is recommended to undergo blood drawing and ultrasound examination at the same time to understand whether there are abnormal changes in the tumor and to provide the most appropriate treatment in a timely manner.
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