Chapter 26: MNT For Thyroid Cancer

Question 1

Symptoms of thyroid cancer?

Answer 1

Cough, difficulty swallowing or breathing, enlargement of or lump on the thyroid gland, neck pain, and hoarsness or chanfe in voice.

Question 2

How is Thyroid cancer diagnosed?

Answer 2

Blood tests: TSH or calcitoni, thyroid ultrasound, radioactive scans, and biopsy

Question 3

Which type of thyroid cancer is always type IV?

Answer 3

Anaplastic carcinoma

Question 4

Rusk factors for thyroid cancer?

Answer 4

Radiation exposure, especially in infancy/early childhood, genetic factors, over 45 y/o, and female, family history and goiters.

Question 5

What is the dietary factor leading to thyroid cancer!

Answer 5

Iodine intake.
An iodine deficiency leads to increased risk of follicular carcinoma.
High iodine intake (through supplementation) leads to increased risk of papillary carcinoma.

Question 6

What are the 4 types of thyroid cancer?

Answer 6

Papillary (differentiated)
Follicular (differentiated)
Medullary (cancer of C cells)
Anaplastic (undifferentiated)

Question 7

Which type of thyroid cancer is slow growing and curable when diagnosed early?

Answer 7

Papillary

Question 8

Which kind of thyroid cancer raises calcitonin levels?

Answer 8

Medullary

Question 9

Which type of thyroid cancer is aggressive and usually fatal with survival of 3-6 months?

Answer 9

Anaplastic

Question 10

Which type of yhyroid cancer is easily cured but most likely to recur?

Answer 10

Follicular

Question 11

What is the most common NIS of thyroid cancer?

Answer 11

Dysphagia d/t the enlarged thyroid compressing the structures involved in swallowing.

Question 12

What is the most common treatment of thyroid cancer?

Answer 12

Surgery. Total or near total thyroidectomy.

Question 13

What is RAI?

Answer 13

Radioactive iodine therapy. RAI is concentrated by thyroid cells leading to their distruction.

Question 14

What are NIS of RAI?

Answer 14

Nausea, dry mouth, change in taste, late onset damage of salvary glands and dental caries.

Question 15

RAI has no roll in the treatment of _____ and _____?

Answer 15

Medullary and anaplastic thyroid cancers.

Question 16

T/F: Presenting symptoms of thyroid cancer do not commonly include weight loss.

Answer 16

True

Question 17

DRIs for energy, macro- and micronutrient content?

Answer 17

They are consistent with age and gender specific DRIs.

Question 18

What is a LID?

Answer 18

Low iodine diet.

Question 19

How does a LID work?

Answer 19

It is done with a RAI to deplete whole body iodine stores and optimize RAI uptake in thyroid cells.

Question 20

What is the iodine goal in a LID?

Answer 20

< 50 micrograms iodine/day

Question 21

How long should LID be followed?

Answer 21

1-2 weeks for pts undergoing RAI

Question 22

Teo challenges of LID?

Answer 22

Determining the accurate iodine content of foods and palatability of food

Question 23

Foods to avoid on a LID?

Answer 23

Iodized salt
Seafood and seasalt products
Dairy products 
Egg yolks
Red-dye #3/erythrosine
Iodate dough conditioners

Question 24

What else should be avoided on LID?

Answer 24

Multivitamin containing iodine
Selenium and fish oil made from sea-based products
Iodine tablets for water purification system
Creams/lotions made from seaweed
Topical iodine antiseptics

Question 25

T/F: iodine is generally not found in enteral formulas and TPN formulas.

Answer 25

True