Hurthle Cell Cancer

Hurthle cell cancer is a rare type of cancer that develops in the thyroid gland. The thyroid is a small, butterfly-shaped gland located in your neck. It produces hormones that help your body use energy and maintain its functions, like keeping your heart beating and your body temperature regulated.

This type of cancer is sometimes called Hurthle cell carcinoma or oxyphilic cell carcinoma. It's just one of several different kinds of thyroid cancers.

Unlike some other thyroid cancers, Hurthle cell cancer can sometimes grow and spread more quickly. The most common treatment is surgery to remove the entire thyroid gland. This is often necessary to get rid of the cancer completely.

Sometimes, Hurthle cell cancer doesn't show any noticeable symptoms. This means people might not know they have it until a doctor finds it during a regular check-up or while testing for something else.

However, when symptoms do appear, they might include:

• A swelling or lump in the neck, close to the Adam's apple: This lump could be small or noticeable.
• Neck or throat pain: This pain could be mild or severe.
• Changes in your voice: This could be hoarseness, a change in pitch, or trouble speaking clearly.
• Trouble breathing: Difficulty catching your breath or feeling short of air.
• Difficulty swallowing: Food or liquids might get stuck when trying to swallow.

Important Note: These symptoms could be signs of other health problems, too. For example, inflammation of the thyroid gland (thyroiditis) or an enlarged thyroid (goiter) can sometimes cause similar symptoms. It's crucial to see a doctor to get a proper diagnosis, as these symptoms aren't specific to Hurthle cell cancer. A doctor will consider your medical history and conduct tests to determine the cause of the symptoms.

If you're feeling unwell or have any health concerns, it's important to schedule a visit with your doctor. Don't ignore any symptoms that bother you. Talking to your doctor is a good way to get help and find out what's going on.

Hurthle cell cancer's exact cause isn't known. This type of cancer starts when cells in the thyroid gland have changes in their DNA. Think of DNA as a set of instructions for cells, telling them how to function. These changes, called mutations, tell the thyroid cells to grow and reproduce very quickly. Normally, cells have a programmed death, but these mutated cells keep living. This uncontrolled growth of cells creates a lump called a tumor. This tumor can spread into nearby healthy tissue and, sometimes, travel to other parts of the body (metastasize).

Several things can make it more likely that someone will get thyroid cancer. These include:

• Gender: Women are more often diagnosed with thyroid cancer than men. This isn't fully understood, but it's a known risk factor.

• Age: The risk of thyroid cancer tends to increase as people get older. This means that older adults are more likely to develop the disease than younger people.

• Past Radiation Exposure: If you've had radiation treatments to your head or neck, you have a higher chance of developing thyroid cancer later in life. This could be from medical treatments for other conditions. The radiation can damage the thyroid cells, making them more prone to becoming cancerous.

• Family History: If someone in your family has had thyroid cancer, you might have a higher risk of developing it yourself. This suggests a possible genetic link, meaning certain genes might make some people more susceptible to the disease.

Hurthle cell cancer can cause several problems.

• Eating and breathing difficulties. If the cancer gets bigger, it might press on the tube that carries food to your stomach (esophagus) or the tube that carries air to your lungs (trachea). This can make it hard to swallow or breathe.

• Cancer spreading. Hurthle cell cancer sometimes spreads to other parts of the body (metastasizes). This makes treating and recovering from the cancer more challenging because the cancer is now in multiple locations. This spread can affect other organs and tissues, which can lead to further complications.

Diagnosing Hurthle Cell Thyroid Cancer: Tests and Procedures

Doctors use several tests to find out if someone has Hurthle cell cancer and how far it has spread. These tests help them plan the best treatment.

Looking at the vocal cords (laryngoscopy):

One way to check for cancer spread is to look at the vocal cords. A doctor can use a small mirror and light (a type of laryngoscopy) to see the back of your throat and vocal cords directly. Another type of laryngoscopy uses a thin, flexible tube with a tiny camera and light, inserted through your nose or mouth. This lets the doctor see the vocal cords move when you talk. This test might be done if you're experiencing voice changes that are concerning, as it could show if the cancer has spread to the vocal cords.

Taking a tissue sample (biopsy):

A biopsy is a procedure where a small sample of tissue is removed for testing. To get a sample from the thyroid, a doctor uses a thin needle guided by ultrasound images. This needle is attached to a syringe, and the sample is taken out. A pathologist (a doctor who specializes in examining body tissues) will look at the sample under a microscope to see if there are cancer cells.

Physical Exam:

A doctor will check your neck. They will feel your thyroid gland and check for swollen lymph nodes. Swollen lymph nodes can sometimes indicate the spread of cancer.

Blood Tests:

Blood tests can show if your thyroid gland is working normally. Changes in thyroid function can be a sign of problems.

Imaging Tests:

Imaging tests like ultrasound and CT scans create pictures of the inside of your body. These pictures can help doctors see if there's a growth in the thyroid gland and how big it is.

Important Note: The information above describes common diagnostic procedures. The specific tests and procedures used in each case will depend on the individual patient's symptoms and health history. Always discuss your specific situation with your doctor for personalized guidance.

Hurthle cell cancer treatment often starts with surgery to remove the thyroid gland. This is called a thyroidectomy.

Thyroidectomy: The surgeon takes out most or all of the thyroid. They try to leave small pieces near the parathyroid glands (glands behind the thyroid that control calcium levels in the body), to avoid harming them. Removing the thyroid removes the source of thyroid hormones, which are essential for many bodily functions.

If doctors think the cancer might have spread to nearby lymph nodes, they may also be removed.

After Thyroidectomy: The body will need to replace the hormones the thyroid produced. This replacement is done with a daily medication called levothyroxine. You'll take this medicine for the rest of your life.

Radioactive Iodine Therapy: This treatment involves swallowing a capsule containing a radioactive liquid. It aims to destroy any remaining thyroid tissue, which might still have cancer cells. Radioactive iodine is sometimes used if the cancer has spread beyond the thyroid. While it can be very effective, it has potential side effects.

Possible side effects of radioactive iodine therapy:

• Temporary tiredness (fatigue)
• Dry mouth
• Changes in taste
• Sore throat
• Tenderness in the neck
• Nausea

Radiation Therapy: This uses high-powered beams (like X-rays) to target and kill cancer cells. The beams are precisely aimed at the cancer, and you'll lie still on a table while the machine moves around you.

Radiation therapy might be used if cancer remains after surgery and iodine therapy, or if the cancer has spread.

Possible side effects of radiation therapy:

• Temporary tiredness (fatigue)
• Sunburn-like skin rash

Targeted Drug Treatments: These medications attack specific weaknesses in cancer cells. Targeted therapy is sometimes used if the cancer comes back after other treatments or has spread far from the thyroid.

Possible side effects of targeted drug therapy:

• Temporary tiredness (fatigue)
• Diarrhea
• High blood pressure
• Liver problems
• Changes in taste

Important Considerations:

• Voice Changes: Surgery can sometimes affect the nerve that controls the voice box, leading to temporary or permanent hoarseness or voice loss.
• Parathyroid Problems: Damage to the parathyroid glands can cause problems with calcium levels, and medications might be needed to correct this.
• Bleeding: Excessive bleeding is a possible risk of surgery.

It's important to talk to your doctor about the best treatment options for your specific case of Hurthle cell cancer. New targeted therapies are constantly being studied, and doctors are always learning more about how to best treat this condition.