UC HEALTH LINE: Lumps in Neck May Be Sign of Hidden Cancer

Cincinnati—University of Cincinnati (UC) physicians say lumps in the head and neck region could mean more than swollen glands—they could be the sign of cancer.

“If people don’t have obvious symptoms, they tend to dismiss lumps as swollen glands. Lumps could be due to allergies or a cold, but if they persist more than a few weeks then they need to be investigated,” says Jeffrey Sussman, MD, a surgeon who specializes in thyroid cancer and parathyroid disorders. “The first step is often to be evaluated by your primary care physician.

“A lump in the lower central neck could be thyroid cancer,” he adds, “and can be easily diagnosed by examination and inserting a small needle into the mass.”

The thyroid is just one part of the human endocrine system, a complex arrangement of glands that exist throughout the body to produce the hormones that help control bodily functions.

Located beneath the larynx (voice box), the thyroid helps regulate growth and metabolism. Four pea-sized organs, known as the parathyroid glands, surround the thyroid and produce a hormone that helps the body use and store calcium and maintain it at normal levels in the blood.

According to the American Cancer Society, more than 32,000 new endocrine cancer cases, 30,000 of them thyroid cancer, were diagnosed in 2006. Endocrine cancer growth rates vary—ranging from very slow growing to very aggressive—so the five-year survival rate varies between 50 and 80 percent.

Sussman and colleague David Fischer, MD, recently launched an endocrine surgery clinic in honor of the late James Fidler, MD. Housed at both University Hospital and University Pointe, the clinic focuses on specialized treatment for thyroid and parathyroid conditions as well as endocrine tumors of the pancreas and adrenal glands.

“As with most cancers, early detection leads to less radical treatments and better outcomes,” says Sussman.

There are four types of thyroid cancer, but papillary cancer, the most common, is often slow growing and can occur in younger patients.

You may be at increased risk for thyroid cancer if you have any of the following risk factors:

• You have been exposed to radiation or radiation treatments to the head and neck, particularly during infancy or childhood.

• You have a family history of enlarged thyroid (goiter) or thyroid disease

• You are female

Sussman says abnormal parathyroid glands can lead to high blood calcium levels.  The problem can be picked up on routine blood tests and may cause a variety of different symptoms including kidney stones, osteopenia, memory loss, abdominal pain or fatigue,  Very high levels of hypercalcemia (excessive calcium in the blood) is also associated with parathyroid cancer.

“When the parathyroid gland becomes overactive, it can produce too much parathyroid hormone and allow higher than normal calcium levels into the blood,” explains Sussman, “Extra parathyroid hormone can also sap calcium from the bones, which can lead to bone pain and kidney trouble.”

Physicians use different imaging tests to evaluate the thyroid and parathyroid glands. If tumors are detected, surgery can cure the disease. In some cases, surgery is followed by radiation to fully eradicate the disease.

More information on thyroid and parathyroid diseases is available at www.netwellness.org, a collaborative health-information Web site staffed by Ohio physicians, nurses and allied health professionals.

For appointments with Sussman, call (513) 584-8900 or with Fischer, call (513) 475-8787.