When Ken Brown* broke his left clavicle in a dirt-bike accident, he never
imagined it might help save his life.
In November of 2006, Ken went to Jawbone Desert, Calif., with a group of
friends to ride dirt bikes. The getaway weekend took a turn for the worse when
Ken wrecked his bike, going about 60 mph. Ken was lucky that his only injury was
the broken collarbone (clavicle).
The emergency room doctor prescribed hydrocodone/acetaminophen (Vicodin) to
manage Ken's pain until he could be seen by a surgeon who specialized in
shoulders. Within a week of the accident, Ken had surgery to repair his
clavicle, using a plate and screws.
The surgery went smoothly, or so Ken thought, until he started experiencing
numbness in his pinky finger afterward. Over the next couple of weeks, the
numbness traveled up his elbow and caused painful muscle spasms in his arm and
back.
Brown went to his doctor who determined that he did not have carpal tunnel
syndrome but couldn't find an explanation for the numbness. He referred Ken to a
neurologist.
Within the next few days, Ken visited the neurologist who ordered a spinal
MRI scan of his neck. When the neurologist contacted Ken about his MRI results,
he asked if Ken was aware of a lump in his thyroid area. "No," Ken said. The
neurologist was concerned about the lump, known as a nodule, especially with its
large size of 3 cm.
The thyroid gland produces thyroid hormones which
are important in the normal regulation of the metabolism of the
body.
Thyroid cancer is three times more common in
women than in
men.
There are four major types of thyroid cancer: papillary, follicular,
medullary, and anaplastic.
The cause of thyroid cancer is unknown, but certain
risk factors have been identified and include a family history of
goiter,
exposure to high levels of radiation, and certain hereditary syndromes.
The National Cancer Institute recommends that
anyone who received radiation to the head or neck in childhood
be examined by a doctor every one to two years to detect potential thyroid cancer.
The only certain way to tell whether a thyroid
lump is cancerous is by examining the thyroid tissue obtained using
a needle or surgery for biopsy. A CEA blood test, physical exam, X-rays,
CT scans, PET scans,
ultrasounds, and
MRIs may also be used to
help establish a definitive diagnosis and determine staging.
Surgery is the most common form of treatment
for thyroid cancer that has not spread to other areas of the
body. Radiation therapy, chemotherapy,
and
radioactive iodine treatment are also treatment options for thyroid cancer.
The survival rate and prognosis of thyroid cancer depends upon a few factors, including the individual's age,
the size of the tumor, and whether the cancer has metastasized.
It is not possible to prevent most cases of thyroid cancer.
What is the thyroid?
The thyroid is a gland in the neck. It has two kinds of cells that make
hormones. Follicular cells make thyroid hormone, which affects heart rate,
body temperature, and energy level. C cells make calcitonin, a hormone that
helps control the level of calcium in the blood.
The thyroid is shaped like a butterfly and lies at the front of the neck,
beneath the voice box (larynx). It has two parts, or lobes. The two lobes
are separated by a thin section called the isthmus.
A healthy thyroid is a little larger than a quarter. It usually cannot be
felt through the skin. A swollen lobe might look or feel like a lump in the
front of the neck. A swollen thyroid is called a goiter. Most goiters are
caused by not enough iodine in the diet. Iodine is a substance found in
shellfish and iodized salt.
What is cancer, and what are the types of thyroid cancer?
Cancer is a group of many related diseases. All cancers begin in cells, the
body's basic unit of life. Cells make up tissues, and tissues make up the organs
of the body.
Normally, cells grow and divide to form new cells as the body needs them.
When cells grow old and die, new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. These extra cells can
form a mass of tissue called a growth or tumor. Growths on the thyroid are
usually called nodules.
Benign nodules are not cancer. Cells from benign nodules do not spread to
other parts of the body. They are usually not a threat to life. Most thyroid
nodules (more than 90 percent) are benign.
Malignant nodules are cancer. They are generally more serious and may
sometimes be life threatening. Cancer cells can invade and damage nearby tissues
and organs. Also, cancer cells can break away from a malignant nodule and enter
the bloodstream or the lymphatic system. That is how cancer spreads from the
original cancer (primary tumor) to form new tumors in other organs. The spread
of cancer is called metastasis.
The following are the major types of thyroid cancer:
Papillary and follicular thyroid cancers account for 80 to 90 percent of all
thyroid cancers. Both types begin in the follicular cells of the thyroid. Most
papillary and follicular thyroid cancers tend to grow slowly. If they are
detected early, most can be treated successfully.
Medullary thyroid cancer accounts for 5 to 10 percent of thyroid cancer
cases. It arises in C cells, not follicular cells. Medullary thyroid cancer is
easier to control if it is found and treated before it spreads to other parts of
the body.
Anaplastic thyroid cancer is the least common type of thyroid cancer (only 1
to 2 percent of cases). It arises in the follicular cells. The cancer cells are
highly abnormal and difficult to recognize. This type of cancer is usually very
hard to control because the cancer cells tend to grow and spread very quickly.
If thyroid cancer spreads (metastasizes) outside the thyroid, cancer cells
are often found in nearby lymph nodes, nerves, or blood vessels. If the cancer
has reached these lymph nodes, cancer cells may have also spread to other lymph
nodes or to other organs, such as the lungs or bones.
When cancer spreads from its original place to another part of the body, the
new tumor has the same kind of abnormal cells and the same name as the primary
tumor. For example, if thyroid cancer spreads to the lungs, the cancer cells in
the lungs are thyroid cancer cells. The disease is metastatic thyroid cancer,
not lung cancer. It is treated as thyroid cancer, not as lung cancer. Doctors
sometimes call the new tumor "distant" or metastatic disease.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Dysphagia is the medical term for the symptom of difficulty
swallowing, derived from the Latin and Greek words meaning difficulty eating.
Mechanism of swallowing
Swallowing is a complex action.
Food is first chewed
well in the mouth and mixed with saliva.
The tongue then propels the chewed food
into the throat (pharynx).
The soft palate elevates to prevent the food from
entering the posterior end of the nasal passages, and the upper pharynx
contracts, pushing the food (referred to as a bolus) into the lower pharynx. At
the same time, the voice box (larynx) is pulled upwards by muscles in the neck,
and, as a result, the epiglottis bends downwards. This dual action closes off
the opening to the larynx and windpipe (trachea) and prevents passing food from
entering the larynx and trachea.
The contraction of the muscular pharynx
continues as a progressing, circumfe...