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Thyroid cancer - medullary carcinoma

  • Definition
    • Medullary carcinoma of the thyroid is cancer of the thyroid gland that starts in cells that release a hormone called calcitonin. These cells are called "C" cells. The thyroid gland is located inside the front of your lower neck.

  • Alternative Names
    • Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary

  • Causes
  • Symptoms
    • MTC often begins as a small lump (nodule) in the thyroid gland. There may also be lymph node swelling in the neck. As a result, symptoms may include:

      • Problems swelling
      • Hoarseness
      • Breathing problems due to narrowing of airways
      • Cough
      • Cough with blood
      • Diarrhea due to high calcitonin level
  • Exams and Tests
    • Your health care provider will perform a physical exam and ask about your symptoms and medical history.

      Tests that may be used to diagnose MTC include:

      People with MTC should be checked for certain other tumors, especially pheochromocytoma.

  • Treatment
    • Treatment involves surgery to remove the thyroid gland and surrounding lymph nodes. Because this is an uncommon tumor, surgery should be performed by a surgeon who is familiar with this type of cancer and experienced with the operation required.

      Chemotherapy and radiation do not work very well for this type of cancer. Radiation is used in some people after surgery. New treatments are being investigated in clinical trials. Your provider can tell you more about these, if needed.

  • Support Groups
    • You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

  • Outlook (Prognosis)
    • About 86% of those with medullary carcinoma of the thyroid live at least 5 years after diagnosis. The 10 year survival rate is 65%.

  • Possible Complications
    • Complications may include:

      • Cancer spreads to other areas of the body
      • Parathyroid glands are accidentally removed during surgery
  • When to Contact a Medical Professional
    • Call your provider if you have symptoms of medullary carcinoma of the thyroid.

  • Prevention
    • Prevention may not be possible. But, being aware of your risk factors, especially your family history, may allow for early diagnosis and treatment. For people who have a very strong family history of MTC, the option to remove the thyroid gland may be recommended. You should carefully discuss this option with a doctor who is very familiar with the disease.

  • References
    • National Cancer Institute. PDQ thyroid cancer treatment. Bethesda, MD: National Cancer Institute. Updated February 4, 2016. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Accessed April 4, 2016.

      National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: thyroid carcinoma. Version 2.2015. www.nccn.org/professionals/physician_gls/PDF/thyroid.pdf. Accessed April 4, 2016.

      Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancer of the endocrine system. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier; 2014:chap 71.