Sharon Vinegrad spent four years hopping from doctor to doctor trying to figure out what was going on with her body. She was suffering from chronic laryngitis, the longest episode lasting for 10 weeks. One year she gained 30 pounds; another year she lost 30 pounds. And, progressively, she became extraordinarily tired, she said.
The final prognosis: thyroid cancer.
The thyroid is a butterfly-shaped gland located on the neck and right below the Adam’s apple. It may be tiny, but it has a large impact on the body. Thyroid hormones regulate everything from the heartbeat, to the rate at which the body burns fat and digests food. If it doesn’t work properly, your body won’t either.
In 2012, about 56,460 new cases of thyroid cancer will be diagnosed, 43,210 in women, and 13,250 in men, according to the American Cancer Society. Studies have suggested that women’s production of estrogen may contribute to the higher thyroid cancer rates in women.
The death rate is low compared with other cancers; it doesn’t even crack the top 15 causes of death among cancers, according to the book, Thyroid for Dummies, by Dr. Alan Rubin.
One of the main risk factors for thyroid cancer is low-grade radiation exposure at a young age to the neck or face area. “Children who received neck and face irradiation for benign conditions such as acne or enlarged tonsils have also developed thyroid cancer — as many as 40 years after the irradiation,’’ Rubin writes.
The cancer often manifests itself as a thyroid nodule, although many nodules are not cancerous. Thyroid cancer has a strong genetic disposition.
Dr. Diane Krieger, an endocrinologist for Baptist Health South Florida, said that that there are three main issues that can go wrong with the thyroid: “The thyroid can under-function (hypothyroidism), over-function (hyperthyroidism), or have nodules and cancer in it.”
Dr. R. Mack Harell, endocrinologist and certified ultrasonographer for Memorial Healthcare System was the doctor who did the imaging needed for Vinegrad’s surgery. He said the three problems don’t tend to overlap. “The thyroid hormone level usually doesn’t give you any clue to whether a patient has thyroid cancer or not.”
This was the case with Vinegrad, who didn’t have hypo or hyperthryroidism.
Vinegrad, 50 and of Davie, had been seeing an ear nose and throat doctor regularly, but he couldn’t figure it out. Oddly enough, the person who put his finger on it, literally, was her rheumatologist — a doctor who specializes in arthritis treatment. He noticed a lump on her neck, “something I couldn’t even feel myself” Vinegrad said.
The lump was 2.5 centimeters wide and when test results returned, Vinegrad received the news that she had thyroid cancer, which explained the symptoms she had been experiencing all these years. A blood test can determine whether a patient has elevated levels of thyroglobulin, the chemical that doctors monitor when following thyroid-cancer patients.
Within a week of being diagnosed, Vinegrad found herself in the operating room.
“After the surgery, and once the symptoms were gone, I was relieved, but the initial reaction to learning I had cancer wasn’t relief,” Vinegrad said.
Her surgery was more complicated than most who have thyroid cancer because by the time it was discovered, the cancer had spread to 75 lymph nodes. All 75 lymph nodes were removed, as well as her thyroid gland. Immediately after the surgery, Vinegrad took radioactive iodine pills that are used to kill any cells that are cancerous and either couldn’t be removed, or were left over. She now takes thyroid hormones orally to replace what her body would naturally produce and says she feels fantastic.
Because the thyroid is so close to other vital organs such as the vocal chords, the surgeon needs to be very precise in what he removes, Harell said. That’s where imaging comes into play.
While Harell could rely on an ultrasound technician to do the imaging for him, he would rather do the work himself.
“I do the ultrasounds on my patients. Because when you do thyroid work, you can’t afford to miss anything and there’s a lot you can miss if the patient’s not lying there in front of you,” he said.
Vinegrad offers a piece of advice for anyone who’s not feeling well but doesn’t know why: “You know how you feel. No one can tell you how you feel. And if you don’t feel right, take a proactive approach and get the problem resolved.”