Hashimoto's Patients Face Higher Risk of Thyroid Cancer
Researchers looked the use of thyroidectomy -- surgery to remove the thyroid gland -- as a treatment for Hashimoto's thyroiditis. In the study, 474 patients were evaluated: 133 (28%) had preoperative diagnosis of thyroid cancer (, 316 had benign thyroid nodules or goiter, and 25 had symptoms caused by thyroiditis. Among the patients, no one experienced death or permanent surgical complications. 32.1% had transient postoperative hypocalcemia, Less than 1% had transient recurrent nerve palsy, and less than 1% had a postoperative neck hematoma. The researchers concluded that thyroidectomy can be performed in patients with Hashimoto's thyroiditis with a low risk of permanent surgical complications. A surprising finding was that a total of fifty-three percent of the patients had thyroid cancer -- many more than the 28% who went into the surgery with a thyroid cancer diagnosis. Even when you exclude the patients who already knew they had thyroid cancer going into the surgery, the prevalence of thyroid cancer in the Hashimoto's patients as still 35.6%. According to the researchers, it is unclear why there is a link between Hashimoto's thyroiditis and cancer -- it may have to do with an immune response. Papillary thyroid cancer in Hashimoto's patients does, however, have a more favorable prognosis than in patients without Hashimoto's.
Shih, Ming-Lang et. al. "Thyroidectomy for Hashimoto's Thyroiditis: Complications and Associated Cancers," Thyroid. July 1, 2008, 18(7): 729-734. Full text PDF
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Comments
What would have been interesting to know is whether there are patients for whom they found out they had a cancer although they didn’t have preoperative diagnosis for it. I often heard (from doctors) that the preoperative diagnosis (thyroid punction) is not 100% reliable.
Besides: The title of this article is not consistent with its content.
I had Hashimotos and my nodules had grown to a point that I had trouble swallowing. My father’s mother had thyroid cancer but I was always told it was exceedingly rare to have Hashi and cancer. All of my FNAs came back normal. My doctor referred me to a surgeon to take the enlarged nodules out and in the midddle of surgery, they discovered pappillary carcinoma. A full report showed cancer in both sides of my thyroid So much for FNA!
Gosh, I have Hasi and did not realize I had any increased risk of Thyroid Cancer. What should I do to protect myself?
I have hashi’s and never had an FNA or any kind of scan (I assume b/c my endo didn’t find any nodules on exam) The prevalence of cancer in this study is very high even if you take out the cases they already knew about. Screening for cancer may have to be more aggressive in the Hashi’s population.
Great, another thing to worry about. I have Hashimoto, plus nodules and a goiter. I have been tested for cancer and they are negative. But are they really cancerous.
I have hashimotes as well and I was wondering if getting your thyroid removed , if it would help with the symptoms you experience with it? Is it better to keep your thyroid or get rid of it in this case?
I have Hashi’s & hyper & some nodules. We do a sonogram twice a year and if the nodules show any growth at all, then we do the FNA. However, when we do the FNA, it is guided with a sonogram and we have someone standing by with a microscope to check the samples to make sure they get a good sample.
Sure, what are the odds if they poke your nodule 6 times and get a good sample that they just missed getting a sample that showed any cancer?
You can’t stress about it. I’ve been on this merry go round for 8 years and we haven’t found any cancer yet. My doctor said there was a less than 10% chance of cancer.
That is why if there is any growth of the nodules they will test again for cancer to be safe.
I had my thyroid removed a year ago and then found out from the pathology report that I had Hashimotos and papillary carcinoma. Interesting……
I was diagnosed in early 1990 with Hashimotos and felt like I had great medical care. But I moved 4 years ago to a different state and my new doctor has not once mentioned cancer - or ever done an FNA and refuses to check T3 levels. My goiter is so large I have trouble swallowing. Time for a new doctor!
What is FNA testing?
FNA = Fine Needle Aspiration FNA Biopsy of the Thyroid
After 13 years with symtoms of Hashimotos, TSH, T4, T3 test all normal but with visable enlarged thyroid gland, I had FNA to discover Papillary Carcinoma. Thyroidectomy was performed and then Chronic Hashimoto was then found. This article I found interesting as I went to doctor for years complaining of symtoms until I had trouble swallowing then my doctor took action.
I had hashi and the cancer. when they started the FNA and ultrasounds the results never came back conclusive one way or the other so my endo recommended we remove the nodules. we removed 2/3 of my thyroid and then they realized i had cancer. i was given the option to get the rest removed but did not want to go through the surgery again. And Renee it doesn’t make a difference to the way you feel, except your body gets really “mad” at you for removing the gland and you feel like hell for a while after.
I have had hashi since 1995 and had few problems but since having a baby 15 months ago I’ve lost my voice half a dozen times and had trouble swallowing and the typical symptoms of thyroid problems. Was referred to an endo and told everything was post partum until it has been too long to be that anymore. Had an ultrasound and found nodules. He dicked around for over 4 weeks and said “Everything is fine.” we’ll just look at it in 6 months. In the meantime went to family doc and got a referral to a head and neck surgeon. I feel like I’m waiting for a time bomb to go off but would really like a diagnosis because after feeling so awful and not myself for the past year and half something confirmed would be great. Sometimes its hard when the endo says functionally the test say you are ok and you know that you aren’t. I love this site but after reading comments and the blog it just seems that the thyroid is a tricky bugger and a lot of mystery. I’ve made a commitment to myself and family that our health is non negotiatable!!!!
I have been diagnosed with Hashi since 1990. Going back for 10 years, though, I had classic symptons. My gen MD prescribed all my thyroid meds and listened to me when I suggested we add thyrolar to my meds. I lose my voice 2-6 times a year every year, my record time with no voice is 45 days. Does anyone know if there is a definite connection between Hashi and Laryngitis? On my 45 day stretch I even saw an ENT and stumped him because my vocal chords did not look like usual laryngitis afftected chords.
Thank you so much for this information. I was diagnosed with Hashi/Hypo 3 yrs ago and now I’m convinced I need more follow up re the cancer subject. The problem is, that I have the thickening on one side near my thyroid which affects my swallowing, too. I didn’t think I needed to do anything about it. Now I am alarmed at the possibility of getting cancer.
I’ve had hashi since I was 10 and I’ve been fighting an increasing sickness in the last few years. All my doctors say just live with it. Now that I’m reading this I’m a lot alarmed and think I’m getting a new doctor on Monday.
I have a multinodular goiter (no cancer) that is pressing on my windpipe. My doctors tell me that my thyroid is functioning normally, except a little enlarged. As for the nodules they all say thyroidectomy is the only answer. My mother had a goiter when I was a kid, and her doctor used suppressive therapy on hers and it worked like a charm. Her goiter shrank so quickly she had loose skin on her neck. I’m now told suppressive therapy is outdated. Has anyone had their nodules successfully treated without surgery?
I had hasi for over fifteen years c/o diff. with swallowing and pain for about 3 yrs. they kept increasing my synthroid. Finally I demanded for it to be removed . Although they said it could never be cancer. i finally had the surgery and can you believe there was cancer and 3 diffent types with margins involved. I am one year past had paralyzied vocal cords bilat and hypoparathroidism. I did the RAI and had bad effects from it. So I do say now can hashi be canerous?
Wow, this cancer connection is news to me. I thought only very old people in their 90’s got a squamous cell cancer from having Hashimoto’s for decades. Mine appeared about 10 years ago. My thyroid swelled big time after the first FNA and never went down. Have one nodule that grew a tiny bit over the years, and a new doctor thought it should be biopsied even tho it looked benign. My insurance denied the procedure. I didn’t think much about that until NOW. The side without the nodule actually looks bigger and harder. Why do they only want to biopsy the nodes?? I do know a swollen thyroid can damage the vocal chords so it makes sense that some people are having loss-of-voice problems now.
I have Hashimotos and this only confirms my decision to have my thyroid removed. It is covered in nodules and the biopsies are AWFUL!
my Endro says it will not take the Hashimotos away because it is made in the bone morrow; but at least I won’t have to worry about cancer, unless I already have it and don’t know it.
im 21 years old and i have had a lump in my throat (like an adams apple) since i was 13 years old, only then it wasnt noticeable. during and after the birth of my daughter the lump ballooned so i was referered to hospital where i have had 3 FNAs and 2 have come back one has come back benine the other came back as “cells of an unknown nature”. i am still waiting for the result of the third. the consultant has recommended surgery anyway where he said he will remove the nodules ( there are 2) and also half of my thyroid gland. i am incredibly anxious as i have never had an operation before can anyone help me if they have had this surgery? iv heard so many horror stories of people not waking up after anesthetic.
I was diagnosed 3 years ago with Hashi’s and papillary carcinoma. At the time they only removed half of the thyroid. I’m on replacement but still have nodules in my right side. Should I insist on taking the other side out? I can honestly say I’ve never felt the same since this started and I still have symptoms of Hashi’s. Anyone have any advise… Just want to feel normal again!