Thyroid Cancer Specialist in Ahmedabad

What is thyroid cancer?

Thyroid cancer develops when cells of the thyroid gland grow abnormally, usually forming a nodule at the front of the neck. It is the most common endocrine cancer and its incidence is rising worldwide, partly because ultrasound now detects small tumours that once went unnoticed. It affects women about three times as often as men and is frequently diagnosed between the ages of 25 and 55. The outlook for the common types is excellent, with survival above 95 percent at ten years when treated appropriately.

There are four main types, and the type determines how aggressive the treatment must be:

Signs and symptoms

• A painless lump or nodule at the front of the neck, often noticed by the patient or on a scan for another reason
• A nodule that is hard, fixed or enlarging
• Swollen lymph nodes at the side of the neck
• Hoarseness or change in voice, suggesting the nerve is involved
• Difficulty swallowing or breathing from pressure on the oesophagus or windpipe
• Persistent cough not due to a cold

Most thyroid nodules, more than 90 percent, are benign. The task is to identify the few that are not. See thyroid nodules to cancer: when should you really worry?.

Risk factors

Radiation exposure to the neck in childhood, a family history of thyroid cancer or inherited syndromes such as MEN2 and familial adenomatous polyposis, being female, and certain benign thyroid conditions all raise risk. Iodine deficiency is associated with follicular cancer. In most patients, however, no cause is found.

Diagnosis and staging

1. 01

   High-resolution neck ultrasound

   Characterises the nodule (TIRADS grading) and surveys the central and lateral neck nodes. Suspicious features include microcalcifications, irregular margins, a taller-than-wide shape and marked hypoechogenicity.

2. 02

   Fine-needle aspiration cytology

   Ultrasound-guided sampling reported on the Bethesda system. Suspicious nodes are also sampled. Molecular testing can refine indeterminate results, as explained in the role of molecular testing in thyroid cancer care.

3. 03

   Blood tests and vocal cord check

   TSH, calcitonin when medullary cancer is suspected, calcium and vitamin D. A quick laryngoscopy records vocal cord function before surgery.

4. 04

   CT for advanced disease

   A contrast CT of the neck and chest is obtained when the tumour is large, fixed, or invades the airway, oesophagus or vessels, so that the operation can be planned in detail.

Thyroid cancer treatment in Ahmedabad

Surgery is the primary treatment for all types of thyroid cancer. The extent of surgery is matched to the risk of the individual tumour, following international guidelines, so that low-risk cancers are not over-treated and higher-risk cancers are cleared completely.

Hemithyroidectomy

For small (under four centimetres), low-risk papillary or follicular cancers confined to one lobe with no nodal spread, removal of that lobe alone is now standard. Most patients need no thyroxine and no radioiodine, and the risk to the opposite nerve and parathyroids is avoided.

Total thyroidectomy

For larger tumours, disease in both lobes, nodal spread, aggressive types or when radioiodine treatment will be needed, the whole gland is removed. Dr. Patel uses intraoperative nerve monitoring and preserves the parathyroid glands with their blood supply, as described on our thyroid surgery page.

Central and lateral neck dissection

When lymph nodes are involved, they are removed systematically in compartments: the central compartment around the trachea, and the lateral compartments at the side of the neck. The dissection preserves the accessory nerve, jugular vein and sternomastoid muscle so that shoulder function and neck contour are maintained. Dr. Patel's compartment-based technique was recognised with the FHNO gold medal in 2018.

Radioiodine and follow-up

After total thyroidectomy for intermediate- or high-risk papillary and follicular cancers, radioactive iodine (I-131) given in the nuclear medicine department destroys any remaining thyroid tissue and microscopic disease. Thyroxine is then adjusted to keep TSH suppressed where appropriate. Long-term follow-up uses thyroglobulin blood tests and ultrasound, and recurrence, when it occurs, is usually detected early and treated successfully. Medullary cancer is followed with calcitonin and CEA levels. Targeted drug therapy is available for the rare cancers that no longer respond to radioiodine.

Why Dr. Parin Patel

• Fellowship-trained Head and Neck Surgical Oncologist with more than thirteen years' experience at HCG Aastha Cancer Centre
• Risk-adapted surgery following current international guidelines: neither too little nor too much
• Nerve monitoring and parathyroid preservation as routine
• Expertise in compartment-oriented neck dissection and re-operative thyroid surgery
• Coordinated pathway with endocrinology, nuclear medicine and pathology under one roof

Learn more on the about page.

Recovery and life after thyroid cancer

Most patients go home the day after surgery and return to normal activities within one to two weeks. Voice may be slightly weak for a few weeks; permanent change is uncommon. After total thyroidectomy, calcium is monitored and supplemented if low, and a daily thyroxine tablet replaces thyroid hormone. Radioiodine, if required, is given a few weeks after surgery as a short admission. Thereafter, life is essentially normal, with an annual check-up, a blood test and an ultrasound. Read can thyroid surgery affect your voice? for what to expect.

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