Symptoms | Therapy | Surgery in thyroid cancer | Successful outcome | Counselling
The worldwide incidence of thyroid cancer is increasing. One of the reasons for the increasing number of cases nowadays is the much more frequent use of ultrasound, CT and MRI. Not infrequently these investigations, often performed for a different reason, reveal smallish nodules in the thyroid gland that then prove to be thyroid cancer. Previously these findings went undetected. Unfortunately, however, there is also an increasing number of cases of advanced stages of thyroid cancer, the cause of which as yet remains unclear. Various environmental influences are postulated.
Radioactive radiation is a clear risk factor. For example, people who lived in the vicinity of Chernobyl have a much higher risk.
Just like breast cancer in the breast, a worrying nodule in the neck can suddenly become apparent. Thyroid cancer, which affects women considerably more often than men, usually does not cause any pain. In these cases an ultrasound scan and puncture of the nodule are required to confirm the diagnosis.
Predominantly the treatment involves a surgery. In most cases the thyroid gland must be removed completely. In early stages, however, the healthy half of the thyroid gland can be left in the body. Only the lobe in which the cancer nodule is located must be removed.
Thyroid surgery is high-precision work. Thank to neuromonitoring it is possible to spare the laryngeal nerve, which is responsible for the mobility of the vocal folds. When the tip of the detection probe approaches the nerve, an acoustic signal is heard, and a deflection is visible on the surgical monitor. This instrument has undergone constant improvement over the years and prevents injury to this important nerve. It is equally important that the parathyroid glands are spared. The surgical challenge of thyroidectomy, as it is known, is to preserve the blood supply as far as possible to these four tiny glands that lie on the thyroid capsule and are responsible for calcium metabolism. A state-of-the-art infrared camera for intraoperative use has recently become available to us for this purpose, allowing better visualization of the blood supply to the parathyroid glands during surgery and enabling the thyroid tissue to be identified as such. Initial studies indicate that the parathyroid glands are better spared with the use of this camera. Essentially, anatomical knowledge and a precise operating technique are the main factors for avoiding surgical complications. This requires the surgeon to undertake a certain minimum number of thyroidectomies each year. The hospital stay is about three days. The missing thyroid hormones are replaced immediately postoperatively by a daily tablet. While early stages of cancer can be cured by surgery alone, in advanced cases additional radioiodine therapy is recommended. The remaining thyroid cells and in particular cancer cells that are not visible to the surgeon’s eye are destroyed by the radioiodine therapy.
Fortunately, papillary thyroid carcinoma, by far the most common thyroid carcinoma in Switzerland, is less aggressive than other forms of cancer. The cure rate for thyroid gland cancer in Switzerland is over 95%.
Our doctors have many years of experience and a high level of expertise in thyroid, parathyroid and adrenal surgery.