Thyroid Troubles : It started with a peanut-sized bump

News Article
Thyroid Troubles : It started with a peanut-sized bump
Thursday, 25 l 03 l 2010 ; Source: Mind Your Body, The StraitsTimes
By Geraldine Ling
What receptionist Tan Li-Na dismissed as a symptom of heatiness turned out to be thyroid cancer. GERALDINE LING reports Ms Tan Li-Na opted to remove herentire thyroid gland three years ago. Then, the 43-year-old receptionist was told she had thyroid cancer. About a year prior to her diagnosis, she had felt a lump the size of a peanut around her thyroid. The single mother of two, aged 17 and 20, had dismissed it, thinking her body was too “heaty”. “Heatiness” is a traditional Chinese medicine concept often associated with fever, sore throats and irritability. However, by the end of the year, the lump was still there. Worried, Ms Tan decided to seek medical advice. She was referred to Dr Ranjiv Sivanandan, who was then the chief at the Head & Neck Service at Singapore General Hospital. He is now practising at The Thyroid Head and Neck Surgery Centre. The tears flowed when she heard she had early stage thyroid cancer. “I was crying like mad and I asked ‘Why me?’.” She rationalised that stress probably triggered her condition. Before discovering the lump, she was working as an assistant manager in a non-profit organisation. Work stress caused her to suffer from insomnia, frequent headaches, a stiff neck and severe hair loss resulting in bald patches on her scalp. For her health’s sake, she resigned from her job and took a break for about seven months before finding a new job as a purchasing officer. She later took on her current job. Dr Ranjiv’s advice was that her entire thyroid gland should be removed. However, since her cancer was relatively small, there was also the option of removing just the left part of the gland where her tumour was. She chose the former, with the support of her children. “It was a very difficult decision for me. I knew the body’s metabolism depended on the thyroid.” However, she reasoned that if the cancer recurred in the right half of the gland, she would have to go under the knife again to remove it. Regardless of which option she chose, she would still have to be on thyroid hormone supplements for the rest of her life. “So I decided to remove everything once and for all,” she said. She was in hospital for three days. During that time, a drainage bottle was attached to her surgical wound to collect blood and other fluids. Her voice turned hoarse immediately after the procedure, but it was back to normal in a week. She was then treated with radioactive iodine after the surgery to remove remnant cancer cells. She is currently in remission, but unrelated to the thyroid cancer, a recent scan revealed more bad news in the form of liver cysts. Although the cysts are still benign, Ms Tan is now under the watch of a liver specialist. Medical expenses, she said, are a huge worry. Still, she was glad she chose to remove her thyroid gland. “Initially, I was worried that I would get fat due to the metabolic changes, but that did not happen. I am happy because I do not have to worry about thyroid cancer anymore.”
FACTS ABOUT THYROID PROBLEMS
The thyroid is a butterfly-shaped gland at the front of the neck (near the Adam’s apple in the case of men), which makes and releases two hormones: T4 (thyroxine) and T3 (triiodothyronine). Thyroid hormones control metabolism, or the rate at which every part of the body works. To make these hormones, the thyroid captures and concentrates iodine from our food. What can go wrong with the thyroid? Thyroid disorders can range from a small, harmless goitre (enlarged gland) to cancer. The most common thyroid problem involves an abnormal production of thyroid hormones. An over-production of these hormones results in hyperthyroidism. An under-production can lead to hypothyroidism. Who is most at risk of thyroid disorders? Women are five times more likely to develop thyroid disorders, especially those aged between 20 and 50. What is the most common thyroid disorder in Singapore? Grave’s disease, which is an autoimmune disorder, said Professor Lee Kok Onn, the head of the division of endocrinology at National University Hospital. The body’s immune system produces abnormal antibodies which stimulate the thyroid gland, causing an over-production of hormones. It is estimated to affect about 1.28 per cent of people here. Should people with hypothyroidism avoid soya? Soya has been thought to interfere with the body's ability to absorb thyroid hormone supplements, which are used to treat hypothyroidism. However, there is no evidence that people with hypothyroidism should avoid soya completely, reported the Mayo Clinic in the United States on its website. Still, it is best to wait four hours after taking thyroid medication to consume any products that contain soya, the report said. Does iodine intake affect the thyroid? Iodine is found in foods like seaweed and seafood. Contrary to popular belief, iodine-rich foods do not alleviate thyroid disorders, said Dr Daphne Khoo, the head and senior consultant in the department of endocrinology at Singapore General Hospital. Extra iodine is only useful in iodine-deficiency goitre, which is a condition rarely seen here as people have enough iodine in their diet. In both Graves’ Disease and another thyroid-linked condition, Hashimoto’s Thyroiditis, extra iodine may actually aggravate matters. What is Graves’ Disease and Hashimoto’s Thyroiditis? Graves’ Disease, named after its discoverer, Irish physician Robert J. Graves, is an autoimmune disorder that leads to overactivity of the thyroid gland, or hyperthyroidism. Hashimoto’s thyroiditis, named after Japanese doctor Hakaru Hashimoto, is also an autoimmune condition where the body attacks the thyroid, causing it to be underactive, often leading to hypothyroidism.