Why is thyroid cancer the fastest rising cancer in women?

Tana Amen, RN was 23 and Charlie Nox was 29 when they were diagnosed with thyroid cancer—now the fastest rising cancer among women.

Not only have rates of the disease soared by 240 percent over the past 20 years, but it’s expected to become the third most common cancer in the US by 2019, according to Julie Ann Sosa, MD FACS, chief, section of endocrine surgery and director of health services research, department of surgery, at Duke University School of Medicine.

This year, more than 60,000 Americans—including more than 45,000 women—will be diagnosed with the disease, which typically targets people under age 55. Another scary fact: about 2 percent of cases occur in children and teens, the American Cancer Society reports.

“Almost all of the increase is papillary thyroid cancer, which used to account for 80 percent of thyroid cancer cases and has recently risen to 90 percent,” reports Dr. Sosa. The disease occurs in the thyroid: a butterfly-shaped gland in the neck just below the Adam’s apple.

Nothing “Good” About Thyroid Cancer

Because the disease has a high survival rate (over 97 percent) it’s often perceived as a “good,” “easy” or “safe” cancer—descriptions that patients like Amen and Nox say trivializes their terrifying ordeal.

“For 11 years, while my friends were falling in and out of love, studying for exams, and starting their careers, I endured horrendous surgeries and radiation treatments,” recalls Amen, a nutrition coach and author of The Omni Diet.

“A lot of people told me that this is the ‘easy cancer’ and acted like it was no big deal, but I can tell you that having cancer is really scary and changes your life forever,” says Nox, a dating coach who is working on a book about continuing to date with cancer.

“I was shocked at the diagnosis,” Nox adds, “ I thought, ‘I do yoga. I eat salad. I feel great. How can I have cancer at 29?”

What’s behind rising rates of the disease?

Particularly over the past decade, rates of thyroid cancer have dramatically and continuously increased around the world, according to a new review published in Journal of Cancer Epidemiology.

Although many experts theorize that increasing use of medical imaging has lead to greater detection of small, asymptomatic cancers, there’s also evidence that large cancers have become more common, the researchers report.

And despite earlier diagnosis and better treatments, deaths from the disease have also gone up, according to the paper. The researchers theorize that environmental carcinogens—and increased exposure to medical radiation (such as x-rays or CT scans)--are the most likely risk factors.

Another risk factor, particularly in middle-aged or older adults with the disease, is medical exposure to sunlamps, which used to be a common treatment for acne and other conditions, says Dr. Sosa.

It’s also possible that dental x-rays could be a risk, though dentists typically shield patients’ thyroids to avoid this danger, she adds. Other risk factors include a family history of thyroid cancer and having a thyroid disorder called Hashimoto’s disease.

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The Telltale Symptom That Patients and Doctors Ignore

Looking back, Amen says, “For five or six years before I was diagnosed, I had a lump in my neck that slowly got bigger until it looked like a man’s Adam’s apple. But my ob/gyn never checked my neck, so I thought this was normal. I was a teenager at the time and had never heard of thyroid cancer.”

By the time Amen was finally diagnosed, she had advanced thyroid cancer that had spread to her lymph nodes. Despite aggressive treatment with multiple surgeries, radioactive iodine, and other therapies, the cancer has returned three times. It’s relatively common for the disease to recur, says Dr. Sosa.

Nox also noticed a small lump on her neck, but considered it such a minor problem that she waited six months to consult a doctor. However, the cancer was still caught early, allowing her to avoid the risks and side effects of radiation therapy. Instead, she was treated with surgical removal of the thyroid.

While thyroid cancer usually doesn’t have early symptoms, potential warning signs include a lump that can be felt through the skin of the neck, hoarseness or other changes in the voice, trouble swallowing, neck or throat pain, and swollen lymph nodes in the neck, according to the Mayo Clinic.

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How to Check Your Neck

Jeffrey Mechanick, MD, clinical professor of medicine, endocrinology, diabetes and bone disease at Mount Sinai Medical Center in New York and president of the American Association of Clinical Endocrinologists, recommends using these steps to perform a thyroid neck check self-exam:

  • Hold a mirror in your hand, focusing on the lower front area of your neck, above the collarbones, and below the voice box (larynx). Your thyroid gland is located in this area.
  • Tip your head back, take a drink of water and swallow.
  • As you swallow, check your neck for any bulges or protrusions in this area when you swallow. Reminder: Don’t confuse the Adam’s apple with the thyroid gland. The thyroid gland is located further down, closer to the collarbone.
  • If you see any bulges in this area, consult your healthcare provider. You may have an enlarged thyroid gland or a thyroid nodule that should be evaluated for cancer and other thyroid conditions. Dr. Sosa also advises having your neck checked during your annual physical or other routine medical visits, even if you don’t notice any lumps.

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