Dr Tan Teik Hin and Dr Wong Mei Wan outlined thyroid cancer symptoms, diagnosis, treatment and follow-up in Malaysia in remarks published in a Sunway Medical Centre feature article.

Thyroid cancer ranked as the eighth most common cancer among women in Malaysia, according to the Malaysia National Cancer Registry Report 2017-2021. The report gave an incidence rate of 4.2 per 100,000 population. The source said women were more affected than men.

Dr Wong said the thyroid produced thyroxine, which was essential for metabolism. Dr Tan said most thyroid cancer patients had normal thyroid function. He said the cancer usually appeared as a physical growth or nodule and was not caused by hyperthyroidism or hypothyroidism.

Dr Wong said the diagnosis usually began when a patient noticed a hard neck lump. Other symptoms included changes in voice, difficulty swallowing, and swollen lymph nodes. She said ultrasound and biopsy helped distinguish benign from malignant nodules.

Dr Tan said most Malaysians are now detected with thyroid cancer at Stage 1 through health screenings. He said about 85% of cases were slow-growing papillary or follicular cancers. He said Stage 4 disease, which spreads to the lungs or bones, reduced survival to below 50%.

Dr Tan said treatment often began with surgery, followed by radioactive iodine therapy for high-risk cases. He said radioactive iodine also helped detect hidden spread. Dr Wong said patients usually need lifelong thyroid hormone replacement after surgery.

Dr Tan said Stage 1 and 2 patients were usually checked every six months for two years, then yearly for up to five years. He said tyrosine kinase inhibitors were used when radioactive iodine no longer worked. The source said side effects included fatigue, skin problems, proteinuria and hypertension.