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September Is Thyroid Cancer Awareness Month
Mount Sinai promotes early detection and announces new Thyroid Center in New York City
(New York – September 6, 2018) – September is Thyroid Cancer Awareness Month, and Mount Sinai Health System experts stress early detection and symptom awareness in high-risk groups.
“While the majority of thyroid cancers arise without a family history, if you have a family history of thyroid cancer, you should have any new lump or mass in your neck evaluated by your physician. Also, people with a history of Hashimoto’s thyroiditis, radiation exposure to the neck, or familial colon polyps are at increased risk,” says Brett Miles, MD, DDS, Associate Professor and Co-Chief of the Division of Head and Neck Oncology at the Icahn School of Medicine at Mount Sinai. “A good rule of thumb is that swollen lymph nodes or lumps in your neck that do not go away after about 3-4 weeks, should be evaluated.”
According to the American Cancer Society, thyroid cancer cases are on the rise. It estimates 54,000 new cases will be diagnosed in 2018, 75 percent of them in women. Even though women are, for unknown reasons, at higher risk of getting thyroid cancer, anyone in any age group can get the disease. Symptoms can present themselves earlier in women, who are typically diagnosed in their 40s or 50s, while men commonly get diagnosed in their 60s or 70s.
“Most patients with thyroid cancer are asymptomatic when they are diagnosed. These cancers are often only identified during routine physical examination by a physician,” says Raymond Chai, MD, Assistant Professor of Otolaryngology at the Icahn School of Medicine at Mount Sinai. “It’s important to note the vast majority of early stage thyroid cancers can be successfully treated, and that’s why early detection is critical.”
Facts about Thyroid Cancer
- Thyroid cancer is a cancerous tumor or growth within the thyroid gland in the front of the neck.
- There are several types of thyroid cancer; the most common is papillary carcinoma, which is highly curable, especially if caught early.
- Symptoms of thyroid cancer include a lump in the neck by the thyroid, neck pain (sometimes going up the ears), hoarseness in the voice, difficulty swallowing and breathing, persistent cough, and enlarged lymph nodes in the neck.
- A family history of thyroid cancer; a history of radiation exposure to the head, neck, or chest; and a diet low in iodine are important risk factors.
- Regular follow-up care is an important part of treatment for patients with thyroid cancers.
Symptoms
- A lump and/or enlarged lymph nodes in the neck
- Neck pain or tightness
- Hoarseness/persistent cough
- Difficulty swallowing/breathing
Tips for Prevention
- Have a physical exam every year
- Have a thyroid physical exam every three years if you are 20-39 years old
- Have a thyroid physical exam every year if you are 40 or older
- Avoid unnecessary exposure to radiation
- Get frequent checks if you’ve been exposed to radiation of the head, neck, or chest and have a family history
- Perform a thyroid neck self-exam, looking for asymmetries or protrusions below the Adam’s apple
New Mount Sinai Thyroid Center
The Mount Sinai Thyroid Center, which opened in early 2018 at Mount Sinai Union Square is the only facility south of 34th Street in Manhattan to offer coordinated services in a single location, providing comprehensive thyroid care to ensure an accurate diagnosis and the best possible management of the disease. Surgeons, endocrinologists, radiologists, and pathologists work together to create specialized treatment plans and seamlessly coordinate treatment. Lab tests, thyroid ultrasound, and biopsies are done on the spot to ensure quick diagnosis and expedite therapy.
For more information on the Mount Sinai Thyroid Center at Union Square, see the link below https://www.mountsinai.org/locations/union-square/services/thyroid
For more information on our different offices, see the link below:
https://www.mountsinai.org/locations/center-thyroid-parathyroid-diseases/locations
For details on Mount Sinai thyroid cancer care, see the link below: https://www.mountsinai.org/locations/center-thyroid-parathyroid-diseases/conditions/thyroid-cancer
Breakthrough Technique for Nerve Monitoring During Thyroid Cancer Procedures
Mount Sinai surgeons are currently using a novel technique they developed to monitor laryngeal and vagus nerve function while patients are under anesthesia during otolaryngology procedures, including those for thyroid cancer. The method could save patients from vocal paralysis, maintain their swallowing function, and transform the way doctors perform surgeries.
This technique has been used on more than 200 Mount Sinai patients undergoing thyroid procedures since 2017. Our surgeons say it has significantly reduced the number of nerve injuries sustained during thyroid surgeries, and could transform the way doctors perform them across the country.
“This monitoring technique will enable patients to feel more confident going forward in their surgeries without complications,” says Catherine Sinclair, MD, Assistant Professor, Otolaryngology, Icahn School of Medicine at Mount Sinai.
Mount Sinai’s new and less invasive technique continuously oversees the nerve function throughout thyroid procedures. It relies solely on a special type of breathing or endotracheal tube, which the anesthesiologist inserts at the start of the surgical procedure. Surgeons use the tube to both stimulate and monitor nerve responses during the entire surgery, which is a first in the field of otolaryngology. This technique allows them to see how different surgical maneuvers affect nerve function, and then change their approach to prevent postsurgical voice and swallowing complications resulting from nerve dysfunction during the procedure.
Laryngeal nerve injuries following thyroid or anterior cervical spine surgeries affect approximately 10 percent of patients. To prevent these injuries, doctors typically monitor these nerves intermittently by stimulating them at various times through the procedure. But with intermittent monitoring, a possible nerve injury can be missed. Continuous stimulation allows doctors to see damage before it occurs and take preventive measures, but until now the only method of continuous monitoring has required doctors to place an electrode around the vagus nerve in the neck (a cranial nerve that extends from the brainstem to the abdomen and helps control voice and swallowing functions as well as the heart, lungs, and digestion), which is invasive for the patient and can cause surgical complications.
Molecular Testing
Molecular testing for genetic abnormalities has become an important tool for physicians to screen for thyroid cancer and determine the malignant potential of nodules. The accuracy has been greatly refined over the last few years, and is a widely available and useful option for patients. If a needle biopsy of the thyroid does not clearly define a benign or malignant nodule, genetic testing can be done to look for possible genetic abnormalities in the cells that might increase the risk of cancer. This testing gives doctors additional information, and when combined with risk factors and other tests, allows them make better decisions on whether to observe or consider surgery sooner rather than later.
Patient Story
Our patient, 39-year-old Nikki Smith, is a recent thyroid cancer survivor, and her story serves as a warning to pay attention to symptoms and an example of how early detection can save lives.
A routine checkup at the OBGYN first alerted Ms. Smith that something was potentially wrong. That’s when the doctor discovered a lump in the front of her neck. It turns out Ms. Smith had had difficulty swallowing for several months prior, but assumed it was a sore throat and had no intention of getting it checked out. When her gynecologist found that lump, Ms. Smith realized this could be the reason for her swallowing issues, which turned out to be the case.
Ms. Smith then got a biopsy and ultrasound, and doctors determined this was a complex thyroid cancer nodule. They referred her to Catherine Sinclair, MD, at Mount Sinai West, who took swift action. Dr. Sinclair successfully removed the half of the left side of Ms. Smith’s thyroid where the cancer cells were present. Dr. Sinclair says that had the cancer been detected any later, it could have spread into her lymph nodes. Months after the procedure, Ms. Smith is cancer free and feeling great. Since she’s in the high-risk age group she wants others to learn from her experience.
“I had never even heard of thyroid cancer. I never had any family members with thyroid cancer so I didn’t know to be aware of symptoms,” said Ms. Smith. “My advice to others is, if you feel something is wrong in your neck or throat get it checked out immediately. Had I waited for my symptoms to get worse, who knows where I would be today.”
About Mount Sinai Health System
The Mount Sinai Health System is New York City’s largest integrated delivery system encompassing seven hospital campuses, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai’s vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The System includes approximately 6,600 primary and specialty care physicians; 10 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report’s “Best Medical Schools”, aligned with a U.S. News & World Report’s “Honor Roll” Hospital, No. 13 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report’s “Honor Roll” of top U.S. hospitals; it is one of the nation’s top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 “Best Hospitals” issue. Mount Sinai’s Kravis Children’s Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat, while Mount Sinai Beth Israel, Mount Sinai St. Luke’s and Mount Sinai West are ranked regionally. For more information, visit http://www.mountsinai.org/, or find Mount Sinai on Facebook, Twitter and YouTube.
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