The Thyroid Cancer Book, Second Edition, by M. Sara Rosenthal Ph.D.; (Your Health Press: 2003)

Revised and updated, this new edition now includes a Low Iodine Cookbook! Recommended by Johns Hopkins Thyroid Tumor Center, The American Foundation for Thyroid Patients, The Thyroid Foundation of Canada, CancerHelpUK, and thyroid cancer patients from both Thyca and Thry’Vors.

Downloadable Press Release (1.45 MB)

Audio
Hear thyroid expert, Dr. Kenneth Ain, and author of the Low Iodine Diet Cookbook, Norene Gilletz, discuss thyroid cancer issues on the radio show The Thyroid Cancer Show.
Download the MP3 (12.5 mb)

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Buy The Thyroid Cancer Book and the Low Iodine Diet Cookbook together and save over $10! This special package price is available exclusively from Trafford Publishing. Call 1-888-232-4444, or click here to order your books now!

TABLE OF CONTENTS
Introduction

Chapter 1: Who Gets Thyroid Cancer?
Chapter 2: Finding (or Looking for) Lumps
Chapter 3: All about Papillary and Follicular
Chapter 4: Medullary Thyroid Cancer
Chapter 5: Anaplastic Thyroid Cancer
Chapter 6: Radioactive What?
Chapter 7: Follow-Up Scans, Treatments, and Blood Tests
Chapter 8: Emotional, Psychological, and Spiritual Issues
Chapter 9: Self-Healing and Complementary Therapies

Resources
Bibliography

AUTHOR'S INTRODUCTION FROM THE BOOK
Many of you reading this book already know parts of my story, which I have revealed in past works on thyroid disease, such as The Thyroid Sourcebook, first published in 1993 (now in its fourth edition). I was diagnosed with thyroid cancer in 1983, at the age of 20. (Okay—now you know my age!) All I heard was “cancer;” I had no idea what a thyroid gland was. The product of a broken home, a bitter custody battle and a “deadbeat Dad” who refused to pay child support despite ample means, I was living with my mother, who was trying to make ends meet on a secretary’s salary. We hovered above the poverty line in 1983; I was in second year university and planned to apply to law school (even though I was really a writer). My dream at that time was to go into family law so I could represent children who, like myself, were torn apart in custody battles. I never wrote my L-SAT. Instead, I got thyroid cancer and my whole world changed. But the goal of turning my “lemons” into lemonade was still met—just in an entirely different way than I planned.

Had I lived in the United States, my mother would not have had the money to pay for the medical treatment I needed, and probably would not have had adequate insurance coverage. In Canada, I was covered under my provincial health care. At the time my cancer was diagnosed, it had spread throughout my neck, and was in a secondary stage. I had a total thyroidectomy (removal of the thyroid gland) and neck dissection (removal of cancerous lymph nodes), followed by a 100 millicurie dose of radioactive iodine—the maximum allowable dose in my hospital at that time. Depressed and hypothyroid, I dragged around my university campus, and prepared for various scans. The last part of my treatment entailed taking the bus everyday for a month to the bowels of the hospital for my external radiation therapy treatments, which made me sicker than any of the previous treatments. As I sit here pushing 40, I’m amazed I went through this experience with almost no information about what cancer was or what a thyroid gland was. When the fourth year medical student on duty during my thyroid surgery asked me out on a date (after I had gone home), I accepted because I saw it as an opportunity to get some information. In essence, I dated my way to thyroid cancer information because it was the only way I could get it. In fact, I suffered more from a lack of information about thyroid cancer than from the actual cancer itself. This is the book I wish I had when I was first diagnosed, and it is also the book I need now, as a long-time survivor of thyroid cancer.

What I thought at the time was a lot of information about my cancer from my head and neck surgeon would sound today like See Spot Run. Now, having completed my doctorate in bioethics (also called medical ethics), I can’t believe what I wasn’t told. And I have spoken in public about the inept handling of my biopsy procedure, an older procedure not done anymore in which the initial “lump” was removed in its entirety. (I wasn’t given any pain medication, nor was I given enough local anesthetic, and told that it was such a “simple” procedure that there was no need to bring anyone to the hospital with me.) When I cried in pain, the tanned plastic surgeon biopsying the lump actually yelled at me, yet he was not at all the appropriate person to do the procedure. (I was referred to him by my family doctor when I insisted on having the lump removed—something my family doctor didn’t think was necessary.) Incredibly, when the lump was found to be cancerous, no one told me about it. Instead, my doctor called my mother and told her about my cancer. And so it was she who told me the news, in the absence of any physician. She could barely explain it to me properly, and for the first several minutes of that discussion, I thought it was she who had cancer. From both the lay and academic perspectives, this was an outrageous way for a doctor—even in 1983—to handle the cancer diagnosis of a 20-year-old woman.

I have seen thyroid cancer go from an unheard-of cancer that barely received a paragraph of note in most cancer books or materials put out by cancer organizations to a commonly diagnosed cancer inspiring large support networks, including the recently formed Thyroid Cancer Survivor’s Association (www.thyca.org) and Thry’vors (http://groups.yahoo.com/group/Thryvors/join), a Canadian organization of thyroid cancer survivors. When I wrote the first non-technical consumer book on thyroid disease, The Thyroid Sourcebook, I never imagined that there would be enough of an audience to warrant a separate book on thyroid cancer. For many years, the chapter I included in The Thyroid Sourcebook on thyroid cancer was the only accessible information that thyroid cancer patients could turn to. I became convinced in the later 1990s that a separate thyroid cancer book ought to be written, but no one would publish it because thyroid cancer remained a “rare” cancer. Essentially, that means no mainstream publisher could justify spending the money on a book geared towards what’s still considered a small market. In 2000, when I launched my health promotion company and website (sarahealth.com), I had a vision of creating a health publishing company that would service the needs of people suffering from rare or stigmatizing health problems—health problems about which little or nothing is written. What followed was the birth of a series of books by Your Health Press™, which are dedicated to orphan diseases such as thyroid cancer, as well as controversial or stigmatizing health issues. As of this writing, this is the first thyroid cancer book written for the consumer by a thyroid cancer survivor. It’s designed as a complete and comprehensive resource for thyroid cancer survivors. But before you move on to other chapters, there are two things you need to know before you can put it all together. You need to understand what a thyroid gland does in the body, and you need to understand what cancer does in the body.

THYROID CANCER BOOK FAQ
Q. Who gets thyroid cancer?
A. By all accounts, thyroid cancer is still considered a rare cancer, accounting for two percent of all cancers. But actually, thyroid cancer is now the fastest growing cancer, according to studies tracking cancer incidence (based on the number of cases per 100,000 people per year). Thyroid cancer was seen to increase at a steady rate of 6.6 percent among women and 4.2 percent among men per year. In 2001, there were 19,500 new cases of thyroid cancer in the United States, and about 1,300 deaths, according to the latest statistics available from the American Cancer Society. In fact more people were diagnosed with thyroid cancer in 2001 than those with liver or brain cancer, which demonstrates that thyroid cancer ought to be considered a common cancer today. At the 2003 American Thyroid Association conference, thyroid cancer was ranked as the fastest rising cancer in women, topping lung and breast cancers. Women outnumber men in developing thyroid cancer by three to one. Put another way, women account for 77 percent of all new cases of thyroid cancer, and 61 percent of all deaths from thyroid cancer occur in women.

Q. What are the signs of thyroid cancer?
A. In the great majority of people with thyroid cancer, the first sign of cancer is a non-tender lump in the neck that is found by themselves, a relative, or a doctor during a routine exam. It’s important to recognize the signs of thyroid cancer, particularly if your thyroid has been exposed to radiation. Often the signs are not that obvious, but they can include:

• A hard and painless lump (also called nodule) anywhere on your neck.
• A thyroid nodule that continues to enlarge.
• Difficulty swallowing food or liquids.
• Change in your voice or hoarseness (this may indicate that the cancer is spreading beyond the thyroid gland).
• Pain in your neck tissues, jawbone, or ear (this is a very uncommon sign of thyroid cancer but has been reported).
• A diagnosis of “sleep apnea,” which has come on suddenly (this is a sleep disorder characterized by interrupted breathing). This is very rare, but there have been cases where thyroid cancer patients have been falsely diagnosed with sleep apnea when, in fact, a growing thyroid tumor was present. In these cases, difficulties with breathing were actually caused by a spreading thyroid tumor, which can block breathing passages!

Q. I heard that thyroid cancer is a “good cancer”. Is that true?
A. Since the 1940s, the most common types of thyroid cancer (papillary, follicular or a mix of the two) have been completely treatable 95 percent of the time. The reason is that papillary and follicular thyroid cancers grow relatively slowly, compared to other kinds of cancers, such as colon, prostate, or breast. In essence, most types of thyroid cancers take a very long time to spread. In fact, you could conceivably walk around with undiagnosed thyroid cancer for a decade and still respond well to treatment.

Also, radioactive iodine (discovered in the 1940s) can often eradicate and/or control the growth of thyroid cancer. In a way, radioactive iodine is close to a “miracle cure” for thyroid cancer. So the first thing most people diagnosed with thyroid cancer hear is: “This is a good cancer.” But the “good cancer” line is also deceiving, especially when we know that some people do die from thyroid cancer, particularly those who are diagnosed with a rare form of thyroid cancer known as anaplastic thyroid cancer. Also, in some cases, thyroid cancers can become more aggressive with time. Essentially, it’s misleading to call thyroid cancer a “good cancer” when it’s a type of cancer demonstrating the full range of cancer behaviors, from slow growing, treatable cancers to one of the most aggressive types of cancers.

Q. Is there a way you can do a self-exam for thyroid cancer?
A. There is something called The Thyroid Self Exam, also known as the“Neck Check” and works along the same principles of BSE. The Neck Check was developed by the American Association of Clinical Endocrinologists. To do a neck check, you’ll need a glass of water and a hand-held mirror. Here are the standard steps:

1. Hold the mirror in your hand, focusing on the area of your neck just below the Adam’s apple (which some people confuse with the thyroid gland) and immediately above the collarbone.
2. While focusing on this area in the mirror, tip your head back slightly.
3. Take a drink of water and swallow. Normally, as you swallow, your windpipe raises and then goes back to its normal position.
4. As you swallow, look at your neck. Check for any bulges or a protrusion in this area when you swallow. (The thyroid gland is located further down on your neck, closer to the collarbone.) Repeat this a few times to be sure you’re “all clear.”

THYROID CANCER LINKS
ThyCa (The Thyroid Cancer Survivor's Association): network of programs linking survivors and healthcare professionals around the world.

American Foundation of Thyroid Patients

Thyroid Foundation of Canada

Thyroid Foundation of America Inc.

American Thyroid Association

Thyroid Federation International: thyroid disease in a global perspective.

National Graves Disease Foundation

The Endocrine Society

American Academy of Ophthalmology

International Council for the Control of Iodine Deficiency Disorders

Congenital Hypothyroidism for Parents