News anchor’s case highlights symptoms of thyroid cancer
Associated Press
Deborah Norville attends the October 2014 24th Annual Broadcasting and Cable Hall of Fame Awards at the Waldorf-Astoria in New York.
Dr. Erik Interval
Adil Chaudry
Newscasters are used to viewers commenting on their appearance whether it’s pertaining to their hairstyle, makeup or clothing choices.
However, when “Inside Edition” anchor Deborah Norville heard from a viewer who noticed a lump on her neck, it caught her attention.
Norville had noticed a lump at the base of her throat and had her doctor check it only to be told it was nothing. After the viewer’s comment, she saw her doctor again and learned the lump was thyroid cancer, a localized form of cancer that begins in the thyroid gland in the front of the neck.
Norville had it removed and is doing fine. Now, she wants viewers to know about her case to shed light on the disease.
It may be surprising to learn thyroid cancer is the most rapidly increasing type of cancer in the United States. The American Cancer Society estimates nearly 52,000 new cases of it will be diagnosed in the United States this year.
Why the sudden rise?
Dr. Erik Interval, a head a neck surgeon with Allegheny Health Network Division of Otolaryngology, credits that to several factors.
“First, we may be diagnosing more and more thyroid cancer that otherwise may have gone undetected,” Interval said. “Second, there is some thought that there might be more thyroid cancer now than previously for reasons not entirely known.”
Interval said although incidence of thyroid cancer has skyrocketed, the rate of people dying from the disease remains unchanged.
Dr. Adil Chaudry, a radiologist at Monongahela Valley Hospital, said part of the rise in cases may be due to advancing technology.
“Much of this rise appears to be the result of the increased use of thyroid ultrasound, which can detect small thyroid nodules that might not otherwise have been found in the past,” Chaudry said.
Thyroid cancer can produce symptoms such as pain, swelling, hoarseness, coughing and difficulty swallowing or breathing.
Chaudry said it can also produce a fast-growing lump in the neck usually in the lower middle part.
“Any lump on the neck you should have checked out by your physician,” he said. “If they feel it’s something worrisome, the next way to evaluate it is with an ultrasound. If it’s a nodule in the thyroid, a lot of times we don’t do anything with them because they’re just benign. But sometimes based on their size and appearance, we would recommend a biopsy to make sure that they are not cancerous.”
Interval also said many of his thyroid cancer cases start with a lump in the neck as a first symptom.
“This is a relatively common way to find thyroid cancer,” he said. “Many of my referrals come from patients’ primary care physicians or OB/GYN providers who felt a nodule.”
However, it is also very common to find a thyroid nodule or thyroid cancer incidentally on imaging done for other reasons.
For example, somebody may get into a car accident and have multiple CAT scans, one of which picks up some incidental thyroid nodules.
Chaudry said in those cases, an ultrasound is the next step that can give radiologists a better look at the shape, appearance and any calcifications in an area of concern.
If the ultrasound results are reason for concern, a doctor will then recommend a biopsy to determine whether the nodule is benign or malignant.
“It is important to note that not all thyroid nodules are cancer,” Interval said. “In fact, middle-aged women may have as high as a 60 percent rate of thyroid nodules.”
This may have been the reason why Norville’s doctor initially believed her lump was nothing to worry about.
“A nodule is a general term for something in the thyroid whether it be a benign growth, a cyst, or a cancer,” Interval said. “Further workup, often including blood work, ultrasound imaging and possibly needle biopsy, is needed for somebody newly diagnosed with a nodule.”
Though the recent rise in the number of thyroid cancer cases is worrisome, the good news is that it is generally a very treatable condition.
“The most common types are called papillary thyroid carcinoma and follicular thyroid carcinoma,” Interval said. “The prognosis of papillary thyroid carcinoma in young people is so good that it generally does not affect how long that person will live. This is even despite the fact that this kind of cancer tends to go to lymph nodes. This good prognosis is, of course, assuming proper treatment.”
He added there are some studies being done to determine the value of even treating certain thyroid cancers. Interval noted one being done in Japan where patients who meet certain criteria are being observed with ultrasound regularly rather than undergoing surgery first.
There are exceptions to the good prognosis, of course, and Interval added in rare cases papillary thyroid cancer can invade the windpipe or the nerve to the voice box.
“Also, there are very rare types of thyroid cancer which can be very aggressive,” Interval said. “These tend to present with blockage of the airway, meaning people can have trouble breathing.”
The main takeaway from Norville’s story is that it’s important to have any lump in your neck checked by a doctor.
While many thyroid cancer symptoms can be caused by other noncancerous conditions, it is important to consult a doctor if any are present.
“Thyroid cancer is very easily treatable because the diagnosis can be made relatively quickly,” Chaudry said. “The main thing is if someone feels a lump, they should go to their doctor, their primary care doctor, and they can decide whether or not they need further testing.”