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Dr. Rajesh Patel, MD.
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Ask the Doctor!
November 2009
Q:
I'm 16 and practically my whole family has or had thyroid cancer-four female relatives including my mom. Am I at
risk of getting it too? Is there anything you can do to help prevent thyroid cancer?
-- A. Frederick, Austin, TX
A:
Excellent question. Thyroid cancer is more prevalent in women than men. This pattern seems evident in your family history. It's a reasonable concern. However, thyroid cancer tends to show up after the age of 45, if it occurs at all. Also, people who already have a swelling of the thyroid and/or nodules are more likely to develop thyroid cancer later on. Ultimately, most people who get thyroid cancer do not have any positive risk factors.
Of the different forms of thyroid cancer, medullary type most commonly runs in families. The RET gene is abnormal in people with medullary thyroid cancer. We can detect this abnormality through a blood test in people who have this kind of thyroid cancer. If the test is positive for an abnormal RET gene, screening this person's relatives is a common recommendation. Any other relative with this abnormal gene might benefit from either an early surgery (removal of the gland) or frequent testing of his/her lab work. Early detection and prevention is especially important since this cancer can sometimes be associated with other cancers as well (multiple endocrine neoplasia, MEN).
Another risk factor of this cancer (follicular and papillary types) is a high level of radiation. Radiation exposure is less of a concern today, unlike in the 1950's. We have since understood and taken the appropriate precautions towards greatly reducing this exposure.
Some other, less common risks of thyroid cancer include a family history of goiters with many nodules or a family history of multiple growths in the colon or rectum. Both of these conditions are likely to be associated with papillary thyroid cancer. There may also be a link to too much or too little iodine levels in the body. More research is needed on this subject.
The best thing to do is to bring a detailed family history, of all cancers, to your doctor. Also explain any unusual symptoms you may have had at any point. After careful review of this information, a blood test for the gene may be necessary. Thankfully, this condition is highly curable if detected early. So it's great that you are seeking this information at such an early age.
Submit your questions to askthedoctor@nowoodennickels.org
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