If You’re a Woman, You Have Three Times the Risk for Thyroid Cancer

Many of us probably pay little attention to the “butterfly” in our throats. But the thyroid gland – shaped like a monarch butterfly – is essential. Its main job is to manage how fast your body transforms the food you eat into energy. Your thyroid affects things like body temperature, heart rate, blood pressure, digestion, fertility and even your ability to concentrate. 

Cancer can attack the thyroid for several reasons. Possibly due to a family history of thyroid cancer or an iodine deficiency. (That’s why food producers started adding iodine to salt in the 1920s.) Thyroid cancer can also occur after exposure to radiation as a child – either from treatments for disease such as lymphoma or nuclear fallout. 

First, a clarification. There are several types of thyroid cancer. Women are about three times more likely than men to be diagnosed with papillary thyroid cancer. This slow-growing cancer is the most common, is rarely fatal and appears in women between the ages of 30 and 60.

A higher incidence of papillary thyroid cancer in women is thought to be because women are more likely than men to undergo tests for other medical issues. This is often when this kind of cancer is detected.

“There is no screening for thyroid cancer,” says Heiwon Chung, MD, Chief, Section of Surgical Oncology with Lehigh Valley Topper Cancer Institute. “But many people get unrelated tests, and a thyroid nodule is picked up incidentally. While we can’t know whether the nodule will grow and become a problem, about 95% of these nodules are noncancerous.”

With more advanced papillary thyroid cancers, the gender gap drops: women are about 2.5 times as likely as men to receive the diagnosis. Other types such as anaplastic thyroid cancer, medullary thyroid cancer and follicular thyroid cancer are rarer and more aggressive. These occur in men and women almost equally.

Dr. Chung notes that there aren’t definite symptoms for thyroid cancer. One may be small, painless lumps called nodules in the front of the neck. “If something is affecting your breathing, making swallowing difficult, there’s neck swelling or your voice changes, you need to be evaluated by your clinician,” she says.

Diagnosis can involve a physical exam, thyroid function blood tests, ultrasound imaging, a biopsy of the nodule, imaging with radioactive tracing and genetic testing. Information from the tests is used to determine the extent of the cancer and assign a stage. The cancer's stage provides information about the likely course of the disease and helps the care team in selecting the treatment.

Treatments for thyroid cancer might include surgery, chemotherapy or radiation, then hormone therapy afterward. “When the treatment is surgery, we either remove the entire thyroid gland or a portion of it,” Dr. Chung says. “When the thyroid is removed, the body gets adjusted with thyroid hormone therapy. This replaces or supplements the hormones produced in the thyroid.”

“For papillary thyroid cancer or follicular thyroid cancer, radioactive iodine therapy may be part of the treatment plan,” says radiation oncologist Alyson McIntosh, MD, with the Cancer Institute. “It’s a type of nuclear medicine that destroys any thyroid tissue that couldn’t be removed with surgery. It can also treat thyroid cancer that’s spread to the lymph nodes and other parts of the body.

“Chemotherapy, radiation to the neck and targeted therapy are only used very rarely for very advanced cases, when surgery is no longer a viable option,” Dr. McIntosh says.

When it comes to thyroid cancer, there isn’t a particular lifestyle that can prevent it. But like all cancers, there are fundamental guidelines that can dramatically improve your ability to avoid the disease – regardless of the type.

You’ve heard it many times, but acting on it is what’s important. The things we eat, drink, breathe and do affect our cancer risk. In fact, four in 10 cancer cases can be prevented. Here are the basics:

• Live smoke-free. That includes vaping and breathing someone else’s smoke.
• Be sun safe. No tanning beds and use sunscreen as a daily habit.
• Keep a healthy body weight. Find a way that works to shed your extra pounds.
• Eat well. Reduce your intake of ultra-processed food.
• Move more, sit less. Keep yourself active and your body systems flowing.
• Limit alcohol. It’s not good for your liver, heart, brain and everything else.