25: Thyroid Flashcards
What are risk factors for thyroid Cancer?
Exposure to high levels of radiation, particularly during infancy or early childhood
genetic mutations (20-25%)
females, between 25-65
family/personal history of thyroid conditions
Obesity
What is a dietary risk factor for thyroid cancer?
Iodine intake — chronic iodine deficiency is associated with increased risk for follicular carcinoma and high iodine intake is associated with increased incidence of papillary carcinoma
What are symptoms of thyroid cancer? How can it be differentiated from other ENT cancers?
Symptoms: cough, difficulty swallowing/breathing, enlargement of or lump on the thyroid gland, neck pain and hoarseness or change in voice
TSH (thyroid stimulating hormones) or calcitonin can be tested on blood tests, which would differ from other ENT tests
What is the first type of treatment for thyroid cancer?
Surgery – often a total or near-total thyroidectomy
How is radiation typically used for treating thyroid cancer? How does it work?
Radioactive Iodine Therapy (RAI)
first switch to a low-iodine diet to deplete the body of iodine (tested via urine). This is usually 1-2 weeks long of 50 mcg or less/day. This will result in the cancer having better uptake of the RAI. Take the iodine dose, drink/eat to flush out of system.
What are the guidelines of a low-iodine diet?
Read labels, only non-iodized salts, avoid eating out, avoid MVI with iodine including fish oil, do not use iodine tablets to purify water, avoid creams/lotions made with seaweed, avoid topical treatments that use iodine
Use milk substitutes (No dairy)
Egg whites or egg substitutes from egg whites (no whole eggs/yolks)
All fish is fine
All fresh meat/chicken/game is fine (no processed meats of any kind)
unsalted nuts/nut butters
all fruits in any form are find EXCEPT Maraschino cherries
most vegetables are fine in any form EXCEPT beans, seaweed/nori, commercially prepared potatoes
Vegetable/soy proteins—none that contain soy or whey
homemade breads, store bought breads without iodate conditioners, pasta/rice/grains, hold/cold cereals without milk —- read labels!
homemade baked goods
plain chips/crackers, fruit ice/popicles, jello, dark chocolate and nuts and seeds are fine (nothing with milk chocolate or dairy)
most condiments are fine (butter/mayo/soy sauce limited to 2 Tbsp/day) – no sour cream, cream-based sauces/salad dressings, molasses
What is a risk/concern during the low-iodine diet?
hyponatremia has occurred – likely from iatrogenic hypothyroidism, thiazide diuretics or an unnecessary restriction of ALL salt
