Advanced Medullary Thyroid Cancer: Symptoms, Treatment

Medullary thyroid cancer is one of the rarest forms of cancers, which accounts for only 3 to 4% of the total cancer diagnosis. The advanced medullary thyroid cancer can usually spread into the lymph nodes. If the advanced medullary thyroid cancer remains undiagnosed or untreated, it can spread to neck tissues or even reach out to liver, bone, brain and also lungs. Knowing the symptoms and treatment of advanced medullary thyroid cancer can help in early detection and prevention of spread.

The early diagnosis of the cancer can help prevent spread and aid in timely treatment. However, this cancer does not have any early signs. Hence it is important to keep an eye on its symptoms and diagnose it to prevent it at the earliest.

Here are the main symptoms of advanced medullary thyroid cancer for early detection and diagnosis;

1. Neck Lump: Single lump in front of the neck is considered as one of the most common sign of advanced medullary thyroid cancer. As per research, once the lump appears it is said that the cancer has already spread into the neck. It is advisable that neck self-exams are made from time to time, to examine any unusual growth of lumps.
2. Pain in Neck: Pain in front of the neck is another symptom that can be linked to the growth of thyroid tumor. This pain can also get extended to the ears.
3. Hoarseness: Nerves which controls the vocal records and run alongside trachea near the thyroid can get affected due to the growing tumor in advanced medullary thyroid cancer. If in case cancer spreads to vocal cord, then it can have an impact on the quality of voice. Hoarseness can be a symptom of advanced medullary thyroid cancer.
4. Cough: At times, thyroid cancer can also lead to cough. For persistent cough, which is not been treated for a long period of time and does not have signs of cold then it is highly advisable to seek medical opinion.
5. Swallowing Trouble: If the thyroid tumor in advanced medullary thyroid cancer has developed large in size, there are chances that it presses the esophagus causing pain or problem in swallowing.
6. Dyspnea: This symptom is also related to excessive growth of thyroid tumor. A big tumor has chances to push against the windpipe, causing trouble in breathing for individuals.
7. Severe Diarrhea: This is yet another symptom of advanced medullary thyroid cancer. The presence of cancer within the body, often leads to production of high level of hormone called calcitonin, a prostaglandin which causes severe diarrhea.
8. Pain in Bones: People suffering from advanced medullary thyroid cancer might suffer from severe bone pain, especially if the cancer has spread across the body to cause bone lesions.
9. Weight Loss: Weight loss is one of the most common symptoms of advanced medullary thyroid cancer. Weight loss usually occurs when cancer has spread beyond thyroid and has entered other organs.
10. Feeling Lethargic: It has often been witnessed that patients suffering with advanced cancer feels physically, emotionally and mentally weak. The causes of this kind of fatigue are quite complex to know or understand.
11. Facial Flushing: Red face, burning chest or neck can be some of the symptoms of advanced stage of cancer. The abnormal growth of tumor in advanced medullary thyroid cancer can lead to overproduction of hormones. It can also be the response of consumption of drugs, menopause or alcohol.

It has often been advised by doctors that patients diagnosed with MTC are also prone to other form of cancers, and might show other symptoms as well like that of pheochromocytoma and parathyroid tumor.

• Pheochromocytoma: The screening of this tumor is utterly important, before planning treatment of advanced medullary thyroid cancer as the use of anesthesia or surgery can make the situation more complex for the patient. If the doctors or surgeons are aware of the problem well before time, they can treat the patients with medicine before and then take them for a surgery afterwards.
• Thyroidectomy: The most widely followed treatment of advanced medullary thyroid cancer is thyroidectomy, in which the thyroid gland is removed. It is quite effective in case of patients suffering from Stage I or stage II MTC. Once the surgery is performed, thyroid hormone therapy might be required for the patient. It produces enough hormones for the patient to keep them healthy. However, studies show that it does not reduce the risk of cancer coming back elsewhere in the body.
• Treatment for Advanced Stages: Patients of stage III and IV of advanced medullary thyroid cancer are also required to go through the same surgery of thyroid removal. Following this thyroid hormone therapy is given, only if tumor is extensive and invades into the tissues again. External beam radiation therapy is also given to patients, such that reoccurrence of cancer can be reduced within the patients.
• Radioactive Iodine: Doctors usually give a dose of radioactive iodine to destroy any remaining thyroid tissue. If the radioactive therapy is opted for, the MTC cells present near the thyroid might have an impact on the cells and also the gland.

Chemotherapy is also another option, which can be given to patients to treat advanced medullary thyroid cancer. If in case sufficient results are not achieved with surgery, radiation therapy then other medications like vandetanib or cabozantinib can be chosen by doctors.

Advanced medullary thyroid cancer has been commonly seen in individuals across the world. Considering its impact on patients, doctors and various research institutions are making attempts to educate people about the disease and help them know the symptoms and treatment of advanced medullary thyroid cancer.