by Anna Melissa S. Lo, MD
As endocrinologists, we primarily care for patients with hormonal disorders, including thyroid diseases.
The thyroid gland is a butterfly-shaped organ located in the neck that secretes hormones vital to regulating the body’s day-to-day functions, including metabolism, energy, heart rate, and bone health, to name a few.
Most thyroid disturbances involve changes in function, either having too much hormone (hyperthyroidism) or too little hormone (hypothyroidism). In addition, we also evaluate abnormal growth on the thyroid itself.
One of our main concerns is determining whether these are benign, which the majority are, or something more concerning, such as thyroid cancer.
Thyroid cancer is the most common cancer within the endocrine system. It occurs when cancerous tumors or nodules grow in the thyroid gland.
According to the American Cancer Society (2026), the rate of new thyroid cancer diagnoses has been increasing faster than that of any other cancer in the United States.
This is largely due to more thyroid tumors being detected during imaging tests performed for other medical reasons, which may not have been found otherwise.
Although more patients are being diagnosed with thyroid cancer, the overall prognosis is very good. It is one of the most treatable cancers, with a 5-year relative survival rate of approximately 98.3% (2016–2022, National Institutes of Health).
Thyroid cancer is three times more common in women than in men, for reasons that are not entirely clear. It can occur at any age but is more commonly seen in adults between their 30s and 60s.
Most cases are sporadic, meaning they occur without a known cause. However, certain risk factors can increase the likelihood of developing thyroid cancer, including a family history of thyroid cancer and prior radiation exposure, especially during childhood.
There are four main types of thyroid cancer: papillary (the most common), follicular, medullary (less common and sometimes genetically related), and anaplastic (rare and more aggressive).
Fortunately, the majority of cases are papillary thyroid cancer, which tends to grow slowly and is highly treatable.
Many people with thyroid cancer have no symptoms, as these growths tend to develop slowly and may go unnoticed. Some people may notice a lump or swelling in the neck.
Others may have trouble swallowing, neck or throat discomfort, or changes in the voice, such as hoarseness. Swollen lymph nodes may also be present, as some cancers can spread to these areas.
If there is concern for possible thyroid cancer, it is important to seek medical care so that a proper physical examination can be performed and the next appropriate steps can be determined.
A thyroid ultrasound is usually the first imaging test ordered, as it helps better characterize any nodules within the gland. If nodules are identified, a fine needle biopsy may be recommended to determine whether they are cancerous.
This is a simple office procedure in which a thin needle is used to collect a small sample of thyroid tissue, which is then examined under a microscope. It typically takes only a few minutes, and most people tolerate it very well.
If cancer is diagnosed, treatment options are discussed between the patient and their provider. The mainstay of therapy is surgical removal of the thyroid gland, either partially or completely, depending on the extent of the disease.
If the cancer is confined to one side, only part of the thyroid may be removed. If it is more extensive, removal of the entire thyroid may be necessary.
After surgery, thyroid hormone replacement is required, often for life, to provide the body with the hormones the thyroid would normally produce.
In some cases, particularly when the cancer is more advanced or aggressive, additional treatment with radioactive iodine may be recommended to reduce the risk of recurrence.
Regardless of the treatment plan, close follow-up with an endocrinologist is essential for ongoing monitoring. This typically includes periodic blood tests and imaging to watch for any signs of recurrence.
While hearing the word “cancer” can be distressing, thyroid cancer is highly treatable, and most patients go on to live with normal, healthy lives.
Paying attention to changes in your body and seeking timely medical care can make a meaningful difference. In many cases, evaluation provides reassurance, and when treatment is needed, it is often very effective.
ANNA MELISSA LO, MD is board-certified through the American Board of Internal Medicine, both in Internal Medicine and Endocrinology, Diabetes, and Metabolism. She is currently practicing at the Primary Specialty Clinic of Hawaii across different islands, including Oahu, Lihue, and Hilo.
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