Goiters and Thyroid Nodules

It can take months or years for a goiter to develop. In teens, goiters are usually caused by the autoimmune thyroid conditions discussed above, which might show no obvious symptoms until the goiter is visible as a swelling at the front of the neck. People with this problem might have the sensation that food is stuck in the throat, especially when they lie down or sleep on their backs.

Generally, treatment of the thyroid disease causing the goiter will decrease or control the enlargement. If the thyroid continues to get larger despite treatment and becomes large enough to cause discomfort or a lump in the neck, surgery may be required. However, surgery is not necessary for most people.

A thyroid nodule is a lump or enlarged area in the thyroid gland. Sometimes a nodule can appear in a healthy gland. It may feel like a lump in the throat, or there may be tenderness or pain in the front of the neck. If the nodule is large enough, it may be visible at the front of the neck.

Most thyroid nodules are harmless. A nodule may simply be an overgrowth of normal thyroid tissue, a swelling caused by inflammation (such as in autoimmune thyroid diseases) or a collection of fluid called a cyst.

The doctor usually discovers nodules by touch during a physical examination. If the doctor finds a nodule, blood tests might be needed to find out how the thyroid gland is working. A doctor may also take an ultrasound image of the gland to detect whether the nodule is a cyst or a solid growth or tumor.

In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called themedical history.

Another test called a thyroid scan can tell the doctor what type of nodule a person has. For this test, a person swallows a pill containing a small amount of radioactive iodine or another radioactive substance. The thyroid absorbs the radioactive substance. Next, a special camera measures where the radioactive substance is taken up by the thyroid gland, giving the doctor a better picture of the location, size, and type of thyroid nodule.

In addition, a fine-needle biopsy may be done to help determine whether a nodule is cancerous. During the biopsy, the doctor inserts a thin needle through the skin into the thyroid nodule (the skin is numbed with medication first). Through the needle, the doctor takes a sample of tissue or some fluid from a cyst. The tissue or fluid is then sent to a lab to be examined. In some cases, a person might need to have the nodule surgically removed for more detailed examination in the lab.

Fortunately, cancer is rare in children and teens, and most thyroid cancers can be cured or controlled with treatment.

Hypothyroidism

A person with mild hypothyroidism may feel just fine — in fact, the condition might cause no symptoms at all. However, symptoms can become more obvious if hypothyroidism progresses.

People with underactive thyroids might feel depressed and sluggish. They might gain weight, even though they're not eating more or getting less exercise than usual. Teens with hypothyroidism also might have slow growth in height, slow sexual development, irregular menstrual periods in girls, muscle weakness, dry skin, hair loss, poor memory, and difficulty concentrating.

Hashimoto's thyroiditis (pronounced: hah-she-moe-toes thy-roy-dye-tiss) is also an autoimmune disease and is the most common cause of hypothyroidism in teens. In this condition, the body's immune system attacks the cells in the thyroid gland, preventing it from producing enough thyroid hormone. The thyroid responds by working harder to make enough hormones. This can make it become enlarged and may result in a goiter.

Hypothyroidism is usually easily diagnosed with a physical examination and blood tests, and treatment with thyroid hormone replacement pills can restore normal levels of thyroid hormone in the blood. This treatment is pretty simple, but it does require doctor visits once or twice a year for an examination, blood tests, and medication adjustments as needed.

Hyperthyroidism

Hyperthyroidism can cause nervousness, irritability, increased perspiration, intolerance to heat, fatigue, difficulty sleeping, a fast heartbeat, irregular menstrual periods in girls, and muscle weakness.

People with this problem might lose weight even though they're eating more than usual. The eyes may feel irritated or look like they're staring. Sometimes the tissues around the eyes become inflamed and swollen, and the eyes appear to bulge out, but this is less common in teens than in adults with hyperthyroidism.

Graves disease, an autoimmune disease, is the most common cause of hyperthyroidism. The condition makes a person's immune system produce abnormal types of antibodies (normally antibodies help the body fight infection). These abnormal antibodies make the thyroid gland produce more thyroid hormones.

Eventually, the thyroid gland enlarges, which can result in a goiter. For reasons that doctors don't yet understand, autoimmune thyroid diseases like Graves disease are much more common in women and are most likely to occur in teens and young and middle-aged adults.

Doctors usually diagnose Graves disease based on a person's symptoms, a physical examination, and blood tests that show high levels of thyroid hormone in the blood.

Once the diagnosis is made, a teen with Graves disease will usually start taking an anti-thyroid medication, which blocks the thyroid's production of thyroid hormones. Medication usually brings the hormone levels down to the normal range in 1 to 2 months.

However, in most cases, the disease doesn't go away. Some people continue taking medication for months or years to keep Graves disease under control, but it can be a hassle to take medication 1 to 3 times a day for a long period. So many doctors recommend a permanent treatment.

Radioactive iodine (RAI) is the most commonly recommended permanent treatment for teens with Graves disease today. It is usually given at a hospital, but doesn't require a hospital stay. RAI is considered safe for teens when given in the standard amount. It is taken in capsules or mixed with a glass of water. The thyroid gland quickly absorbs the RAI from the bloodstream and, within a few months, the gland shrinks and symptoms gradually disappear. RAI has been used to treat Graves disease successfully for more than 50 years.

The other permanent treatment for Graves disease is surgery to remove most of the thyroid gland (thyroidectomy). The operation is performed in a hospital under general anesthesia, meaning the person is asleep and feels nothing during the surgery. A small incision (cut) in the lower central part of the neck usually leaves a thin scar.

After surgery, there typically is swelling in the area of the incision. People sometimes have a sore throat and some trouble swallowing following surgery, although they should be able to eat and drink normally. These symptoms usually disappear within a few days.

After treatment for hyperthyroidism, hormone production often slows down to hypothyroid (underactive) levels, so the person needs to take a thyroid hormone replacement tablet each day. This treatment is a lot easier to manage than taking pills to control the hyperthyroidism — fewer blood tests, doctor visits, and medication adjustments are necessary.

As the body adjusts to the hormone replacement tablets, a doctor may increase or reduce the dosage until the levels of thyroid hormone in a person's blood are normal. Once the doctor finds the proper dosage, people usually feel well and free of symptoms. However, the doctor will continue to check hormone levels to make sure the dosage is right, especially for growing teens whose levels might change over just a few months.

What Is Thyroid Disease?

Thyroid disease occurs when the thyroid gland doesn't supply the proper amount of hormones needed by the body. If the thyroid is overactive, it releases too much thyroid hormone into the bloodstream, resulting in hyperthyroidism. ("Hyper" is from the Greek, meaning "over" or "above.") Hyperthyroidism causes the body to use up energy more quickly than it should, and chemical activity (like metabolism) in the cells speeds up.

An underactive thyroid produces too little thyroid hormone, resulting in hypothyroidism. ("Hypo" means "under" or "below.") When the amount of hormone released into the bloodstream is below normal, the body uses up energy more slowly, and chemical activity (metabolism) in the cells slows down.

Although they are two different conditions, in both hypothyroidism and hyperthyroidism the thyroid can become larger than normal. An enlarged thyroid gland is a lump that can be felt under the skin at the front of the neck. When it is large enough to see easily, it's called a goiter.

People who don't get enough iodine in their diets also can get an enlarged thyroid, but this is rare in the United States because foods here usually supply enough iodine.

What is thyroid cancer?

The thyroid glandThe thyroid gland is below the thyroid cartilage (Adam’s apple) in the front part of the neck. In most people, the thyroid cannot be seen or felt. It is butterfly shaped, with 2 lobes — the right lobe and the left lobe — joined by a narrow isthmus (see picture below).The thyroid gland has 2 main types of cells:

• Follicular cells use iodine from the blood to make thyroid hormones, which help regulate a person’s metabolism. Having too much thyroid hormone (a condition called hyperthyroidism) can cause a rapid or irregular heartbeat, trouble sleeping, nervousness, hunger, weight loss, and a feeling of being too warm. Having too little hormone (called hypothyroidism) causes a person to slow down, feel tired, and gain weight. The amount of thyroid hormone released by the thyroid is regulated by the pituitary gland at the base of the brain, which makes a substance called thyroid-stimulating hormone (TSH).

• C cells (also called parafollicular cells) make calcitonin, a hormone that helps control how the body uses calcium.

Other, less common cells in the thyroid gland include immune system cells (lymphocytes) and supportive (stromal) cells.Different cancers develop from each kind of cell. The differences are important because they affect how serious the cancer is and what type of treatment is needed.Many types of growths and tumors can develop in the thyroid gland. Most of these are benign (non-cancerous) but others are malignant (cancerous), which means they can spread into nearby tissues and to other parts of the body. Benign thyroid enlargement and nodulesChanges in the thyroid gland’s size and shape can often be felt or even seen by patients or by their doctor.The medical term for an abnormally large thyroid gland is goiter. Some goiters are diffuse, meaning that the whole gland is large. Other goiters are nodular, meaning that the gland is large and has one or more nodules (bumps) in it. There are many reasons the thyroid gland might be larger than usual, and most of the time it is not cancer. Both diffuse and nodular goiters are usually caused by an imbalance in certain hormones. For example, not getting enough iodine in the diet can cause changes in hormone levels and lead to a goiter.Lumps or bumps in the thyroid gland are called thyroid nodules. Most thyroid nodules are benign, but about 1 in 20 is cancerous (see the next section). Sometimes these nodules make too much thyroid hormone and cause hyperthyroidism.People can develop thyroid nodules at any age, but they occur most commonly in older adults. Fewer than 1 in 10 adults have thyroid nodules that can be felt by a doctor. But when the thyroid is looked at using ultrasound, many more people are found to have nodules that are too small to feel.Most nodules are cysts filled with fluid or with a stored form of thyroid hormone called colloid.Solid nodules have little fluid or colloid. These nodules are more likely to be cancerous than are fluid-filled nodules. Still, most solid nodules are not cancer. Some types of solid nodules, such as hyperplastic nodules and adenomas, have too many cells, but the cells are not cancer cells.Benign thyroid nodules sometimes can be left alone (not treated) as long as they’re not growing or causing symptoms. Others may require some form of treatment. Malignant (cancerous) thyroid tumorsThere are several types of thyroid cancer. Differentiated thyroid cancersMost thyroid cancers are differentiated cancers. In these cancers, the cells look a lot like normal thyroid tissue when seen under a microscope. These cancers develop from thyroid follicular cells.Papillary carcinoma: About 8 out of 10 thyroid cancers are papillary carcinomas (also called papillary cancers orpapillary adenocarcinomas). Papillary carcinomas tend to grow very slowly and usually develop in only one lobe of the thyroid gland. Even though they grow slowly, papillary carcinomas often spread to the lymph nodes in the neck. Still, these cancers can often be treated successfully and are rarely fatal.There are several subtypes of papillary carcinoma. Of these, the follicular subtype (also called mixed papillary-follicular variant) occurs most often. The usual form of papillary carcinoma and the follicular subtype have the same good outlook (prognosis) when found early, and they are treated the same way. Other subtypes of papillary carcinoma (columnar, tall cell, insular, and diffuse sclerosing) are not as common and tend to grow and spread more quickly.Follicular carcinoma: Follicular carcinoma, also called follicular cancer or follicular adenocarcinoma, is the next most common type, making up about 1 out of 10 thyroid cancers. It is more common in countries where people don’t get enough iodine in their diet. These cancers usually do not spread to lymph nodes, but they can spread to other parts of the body, such as the lungs or bones. The outlook (prognosis) for follicular carcinoma is not quite as good as that of papillary carcinoma, although it is still very good in most cases.Hürthle (Hurthle) cell carcinoma, also known as oxyphil cell carcinoma, is actually a variant of follicular carcinoma. It accounts for about 3% of thyroid cancers. The prognosis may not be as good as that of typical follicular carcinoma because this type is harder to find and treat. This is because it is less likely to absorb radioactive iodine, which is used both for treatment and to look for the spread of differentiated thyroid cancer. Other types of thyroid cancersThese thyroid cancers occur less often than differentiated thyroid cancers.Medullary thyroid carcinoma: Medullary thyroid carcinoma (MTC) accounts for about 4% of thyroid cancers. It develops from the C cells of the thyroid gland, which normally make calcitonin, a hormone that helps control the amount of calcium in blood. Sometimes this cancer can spread to lymph nodes, the lungs, or liver even before a thyroid nodule is discovered.Medullary thyroid cancers often release too much calcitonin and a protein called carcinoembryonic antigen (CEA) into the blood. These substances can be detected with blood tests.Because MTC does not absorb or take up radioactive iodine (used for treatment and to find metastases of differentiated thyroid cancer), the prognosis (outlook) is not quite as good as that for differentiated thyroid cancers. There are 2 types of MTC:

• Sporadic MTC, which accounts for about 8 out of 10 cases of MTC, is not inherited (meaning it does not run in families). It occurs mostly in older adults and affects only one thyroid lobe.

• Familial MTC is inherited and can occur in each generation of a family. These cancers often develop during childhood or early adulthood and can spread early. Patients usually have cancer in several areas of both lobes. Familial MTC is often linked with an increased risk of other types of tumors. This is described in more detail in the section “What are the risk factors for thyroid cancer?”

Anaplastic carcinoma: Anaplastic carcinoma (also called undifferentiated carcinoma) is a rare form of thyroid cancer, making up about 2% of all thyroid cancers. It is thought to sometimes develop from an existing papillary or follicular cancer. This cancer is called undifferentiated because the cancer cells do not look very much like normal thyroid cells under the microscope. This cancer often spreads quickly into the neck and to other parts of the body, and is very hard to treat.Thyroid lymphoma: Lymphoma is very uncommon in the thyroid gland. Lymphomas are cancers that develop from lymphocytes, the main cell type of the immune system. Most lymphocytes are found in lymph nodes, which are pea-sized collections of immune cells scattered throughout the body (including the thyroid gland). Lymphomas are discussed in our separate document, .Thyroid sarcoma: These rare cancers start in the supporting cells of the thyroid. They are often aggressive and hard to treat. Sarcomas are discussed in our separate document,  Parathyroid cancerBehind, but attached to, the thyroid gland are 4 tiny glands called the parathyroids. The parathyroid glands help regulate the body’s calcium levels. Cancers of the parathyroid glands are very rare — there are probably fewer than 100 cases each year in the United States.Parathyroid cancers are often found because they cause high blood calcium levels. This makes a person tired, weak, and drowsy. It can also makes you urinate (pee) a lot, causing dehydration, which can make the weakness and drowsiness worse. Other symptoms include bone pain and fractures, pain from kidney stones, depression, and constipation.Larger parathyroid cancers may also be found as a nodule near the thyroid. No matter how large the nodule is, the only treatment is to remove it surgically. Unfortunately, parathyroid cancer is much harder to cure than thyroid cancer.The remainder of this document only discusses thyroid cancer.Last Medical Review: 02/24/2014Last Revised: 03/20/2014

What causes hemorrhoids?

Hemorrhoids are swollen veins in the anal canal. This common problem can be painful, but it's usually not serious.

Veins can swell inside the anal canal to form internal hemorrhoids. Or they can swell near the opening of the anusto form external hemorrhoids. You can have both types at the same time. The symptoms and treatment depend on which type you have.

Many people have hemorrhoids  at some time.

Too much pressure on the veins in the pelvic and rectal area causes hemorrhoids.

Normally, tissue inside the anus fills with blood to help control bowel movements. If you strain or sit on the toilet a long time to move stool, the increased pressure causes the veins in this tissue to swell and stretch. This can cause hemorrhoids.

Diarrhea or constipation also may lead to straining and can increase pressure on veins in the anal canal.

Pregnant women can get hemorrhoids during the last 6 months of pregnancy. This is because of increased pressure on the blood vessels in the pelvic area. Straining to push the baby out during labor can make hemorrhoids worse.

Being overweight can also lead to hemorrhoids.

The most common symptoms of both internal and external hemorrhoids include:

• Bleeding during bowel movements. You might see streaks of bright red blood on toilet paper after you strain to have a bowel movement.
• Itching.
• Rectal pain. It may be painful to clean the anal area.

With internal hemorrhoids, you may see bright red streaks of blood on toilet paper or bright red blood in the toilet bowl after you have a normal bowel movement. You may see blood on the surface of the stool.

Internal hemorrhoids often are small, swollen veins in the wall of the anal canal. But they can be large, sagging veins that bulge out of the anus all the time. They can be painful if they bulge out and are squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off. If hemorrhoids bulge out, you also may see mucus on the toilet paper or stool.

External hemorrhoids can get irritated and clot under the skin, causing a hard painful lump. This is called a thrombosed, or clotted, hemorrhoid.

Your doctor can tell if you have hemorrhoids by asking about your past health and doing a physical exam.

You may not need many tests at first, especially if you are younger than 50 and your doctor thinks that your rectal bleeding is caused by hemorrhoids. Your doctor may just examine your rectum  with a gloved finger. Or your doctor may use a short, lighted scope to look inside the rectum.

Rectal bleeding can be a sign of a more serious problem, such as colon, rectal, oranal cancer. So if the first exam does not show a clear cause of your problems, your doctor may use a lighted scope (sigmoidoscope) to look at the lower third of your colon. Or your doctor may use another kind of scope (colonoscope) to look at the entire colon to check for other causes of bleeding.

pancreas surgery - Pancreatic Cancer

pancreas surgery

Pancreatic Cancer

What is pancreatic cancer?

Pancreatic cancer is a type of cancer that originates in the tissue of the pancreas.

What does the pancreas do?

The pancreas is a dual-function organ. The pancreas is about 6 inches long and is located deep in your belly between your stomach and backbone and is surrounded by the liver, intestine, and other organs.The pancreas is a digestive gland that makes a mixture of specific types of enzymes (known collectively as ‘pancreatic juice’) to digest proteins, starch and carbohydrates, fats and other nutrients. The pancreatic juice also assists with nutrient absorption and digestion ion the small intestine. Additionally, the pancreas has another major function, which is making insulin.  Insulin is a signal (a hormone) that is released into the blood stream and goes to cells of the body to tell them that nutrients are on the way. This very important organ also produces many other important hormones that are both critical to directing the body’s tasks as well as communicating messages from one part of the body to another.

What are some pancreatic cancer symptoms?

Early cancer of the pancreas often doesn’t cause symptoms. When the cancer grows larger, you may notice one or more of these common symptoms:

• Dark urine, pale stools, and yellow skin and eyes from jaundice
• Pain in the upper part of your belly
• Pain in the middle part of your back that doesn’t go away when you shift your position
• Nausea and vomiting
• Stools that float in the toilet

Advanced pancreatic cancer may cause these general symptoms:

• Weakness or feeling very tired
• Loss of appetite or feelings of fullness
• Weight loss for no known reason

One reason pancreatic cancer is so deadly is because the symptoms are frequently vague and largely ignored.  Often times it is too late once the cancer suffer realizes something is wrong. By that time the pancreatic cancer has often traveled to other parts of the body – making it nearly impossible to stop.

These symptoms may be caused by pancreatic cancer or by other health problems. People with these symptoms should tell their doctor so that problems can be diagnosed and treated as early as possible.

Pancreatic Cancer Statistics (in the U.S. as of 2013):[1]

• An estimated 45,220 diagnosed in 2013
• An estimated 38,460 deaths in 2013

The Kanzius Noninvasive Radiowave Cancer Treatment

and Pancreatic Cancer Research

Currently, research is being conducted to treat pancreatic cancer with the Kanzius Noninvasive Radiowave Cancer Treatment, as well as the following eight other types of cancer: liver cancer, breast cancer, colon cancer, leukemia, lung cancer, melanoma, osteosarcoma, and prostate cancer. This treatment, which utilizes three simple elements - controlled radiowaves, antibodies and metallic nanoparticles - has shown to be incredibly successful in treating pancreatic cancer. In studies conducted by lead Kanzius researcher, Dr. Steven Curley, human pancreatic cancer cells have been destroyed in vivo (in small labratory animals). After the cancer cells were targeted with antibody-coated microscopic metallic particles and exposed to a controlled radiowave, the pancreatic cancer cells (even the large ones) were killed with no injury to the surrounding tissue and with no side effects or illness in the subjects. Radiowaves used in this research are generated by the patented Kanzius RF Machine. To obtain a copy of this journal article published in Cancer Research Journal, . 

Pancreatic cancer is one of the most deadly and least curable cancers. With the Kanzius Noninvasive Radiowave Cancer Treatment, more lives can be saved from this awful disease. Additional articles validating the treatment of pancreatic cancer with the Noninvasive Radiowave Cancer Treatment from the Kanzius research teams at The University of Texas MD Anderson Cancer Center, the University of Pittsburgh Medical Center and the University of California, Davis have been published and are available for your reading. 

Are you interested in learning more about this cancer research? As your interest in the Kanzius Noninvasive Radiowave Cancer Treatment increases, gather more knowledge about the continued research from published journal articles.