What Is Thyroid Cancer?
Thyroid cancer in Singapore is the second most common cancer in women under 39 years old. The thyroid gland is a butterfly-shaped gland located at the base on the neck. Hormones that regulate our weight, heart rate, and body temperature are produced by it. When there is an abnormal growth of tissue in the thyroid gland, it results in the development of a nodule. Nodules can be benign (non-cancerous) or malignant (cancerous). A careful diagnosis is needed to ascertain if the nodule is benign (in most cases) or malignant.
Types Of Thyroid Cancer
Papillary Thyroid Cancer
Being about 75% of all thyroid cancer cases, papillary thyroid cancer is the most common kind of thyroid cancer. These are slow growing typically, but have a tendency to spread to the lymph nodes in the neck. Most cases of papillary thyroid cancer can be successfully treated.
Subtypes of papillary thyroid cancer do exist. Certain less common ones such as follicular variant, tall cell, insular, and diffuse sclerosing tend to be more aggressive (faster grow and spread).
Follicular Thyroid Cancer
The second most common type of thyroid cancer is follicular thyroid cancer. This type is responsible for about 15% of all cases. Follicular thyroid cancer spreads typically via the bloodstream to the lungs and bones, and other parts of the body.
Medullary Thyroid Cancer
Medullary thyroid cancer is a less common form of thyroid cancer (about 5% of cases). Compared to papillary and follicular thyroid cancers, the outcome of treatment for medullary thyroid cancer is not as good. Nonetheless, successful treatment is still possible for many paitents.
Anaplastic Thyroid Cancer
Anaplastic thyroid cancer is a rare form of thyroid cancer (about 2% of cases). These are usually very aggressive – growing and spread rapidly to other parts of the body.
Thyroid Cancer Singapore Statistics
Incidence Rates For Thyroid Cancer In Singapore – More Common In Females
Thyroid cancer in Singapore is more common in women than men. Data published in the Singapore Cancer Registry Annual Report 2019 shows that it is the 8th most common cancer diagnosed in women in Singapore for the period 2015-2019. Most cases of thyroid cancer occur in patients under 60 years old. In females, the incidence rate of thyroid cancer is higher for Indians (4.8% of all cancers diagnosed in 2015-2019), followed by Malays (4.4%) and Chinese (3.7%)
Thyroid Cancer Impacts Younger Males Too
While thyroid cancer is not within the top 10 most common cancer for males overall, in younger males, the incidence rates are significant. For males in the 30-39 year old bracket in particular, thyroid cancer was 7.1% of all cancers diagnosed.
Causes Of Thyroid Cancer & Risk Factors
It is not known exactly what causes thyroid cancer, or the growth of thyroid nodules. What is known are the risk factors that can increase the chances of contracting the disease:
- Being exposed to high levels of radiation, especially to the head and neck area – e.g. as a result of radiation therapy.
- A family history of thyroid nodules.
- Being female, as females are more prone to contracting thyroid cancer than males.
- Inflammatory thyroid disorders, including goitre (enlargement of the thyroid gland), hypothyroidism, and Hashimoto’s thyroiditis (which is an autoimmune condition that causes hypothyroidism).
- Inherited genetic conditions such as familial medullary thyroid cancer, multiple endocrine neoplasia, Cowden’s syndrome and familial adenomatous polyposis.
Symptoms Of Thyroid Cancer
Thyroid cancer symptoms depend on the type of cancer. There may not be any symptoms early in the early stages. As the cancer grows however, it may cause the following general symptoms:
- Difficulty in swallowing or in breathing (in severe cases).
- Hoarseness of and/or changes in the voice.
- A lump in the neck (which moves when swallowing).
Screening & Prevention
To diagnose thyroid cancer, doctors may perform the following:
- Physical examination: Examine the neck to feel for thyroid nodules or other physical changes in the thyroid. You may also be asked regarding risk factors like exposure to radiation or if you have a family history of thyroid tumour.
- Blood test: Your blood may be tested for the levels of the thyroid hormones and thyroid-stimulating hormone (TSH). This is to see if your thyroid is functioning normally.
- Fine-needle Aspiration Cytology (FNAC): When a lump is detected in the neck, the doctor may recommend a biopsy to investigate the lump. During FNAC biopsy, the doctor uses a small needle to remove a sample of cells from the lump to test for cancer.
- Ultrasound scan: An ultrasound scan may be used to evaluate thyroid nodules and look for signs that may indicate that the thyroid nodule is cancerous. Also, the doctor may use it to look for enlarged lymph nodes in the neck.
- Computer Tomographic (CT) scan: A CT scan may be used to help the doctor determine whether the cancer has spread beyond the thyroid.
Learn More: Medical Imaging In Singapore >>
Just as there is no known definitive causes of thyroid cancer, there is unfortunately no known preventive measure that guarantees avoidance of thyroid cancer. What we can do it to reduce the risk factors that contribute to the likelihood of contracting the disease. These include:
- Avoiding exposure to radiation around the neck area (including those from medical procedures), particularly for young children. It is not clear how much imaging tests like X-Rays and CT scans might raise the risk of thyroid cancer to children, as the radiation levels are not that high. While any increased risk is likely to be small, children should nonetheless not undergo these tests unless absolutely required, to be on the safe side. If carried out, they should be done using the lowest level of radiation that can still provide a sufficiently clear picture.
- People with inherited genetic conditions that increase the risk of medullary thyroid cancer can consult with a genetic counsellor.
Thyroid Cancer Treatments
Treatment for thyroid cancer varies based on factors such as cancer staging, patient health, and personal preferences.
- Surgical removal of the thyroid: This is a common approach, often supplemented with chemotherapy or radiation therapy. Thyroidectomy, the removal of the entire thyroid, is typically performed through a neck incision or via robotic methods for less visible scarring. For smaller, slow-growing cancers, a thyroid lobectomy—removal of one thyroid lobe—may be recommended. Surgeons may also remove nearby lymph nodes if necessary.
- Thyroid hormone therapy: Patients who undergo thyroid removal will need lifelong thyroid hormone therapy to replace missing hormones and inhibit cancer cell growth.
- Radioactive iodine treatment: Post-surgery, radioactive iodine treatment is used to destroy any remaining cancer cells and target secondary tumors. This treatment is administered orally and mainly absorbed by thyroid cells, limiting harm to healthy tissues.
- Radiation therapy is considered when surgery or radioactive iodine treatment is ineffective or unfeasible.
- Targeted therapy: In cases where cancer has spread and is unresponsive to radioactive iodine, targeted therapy using drugs that attack specific cancer traits, like genetic mutations or blood vessel growth, can be employed to stop cancer progression. This multi-faceted approach tailors treatment to individual needs and maximizes effectiveness.
Learn More: Thyroid Surgery In Singapore >>
Cost Of Thyroid Cancer Treatment
Estimated Cost Of Thyroid Cancer Surgery In Singapore (Updated Jan 2025)
The cost of thyroid cancer surgery in Singapore may vary widely based on the factors mentioned above. According to the Ministry of Health’s fee benchmarks, on average, patients can expect to pay around:
Neck, partial removal of thyroid gland (TOSP Code: SJ802T)
Public Hospital
- Day Surgery (Subsidised) – S$2,596
- Day Surgery (Unsubsidised) – S$8,676
- Ward B2 (Subsidised) – S$2,556
- Ward C (Subsidised) – S$2,153
- Ward A (Unsubsidised) – S$8,414
- Ward B1 (Unsubsidised) – S$8,222
Private Hospital
- Inpatient – S$26,624
Neck, total or near complete removal of thyroid gland (TOSP Code: SJ803T)
Public Hospital
- Ward B2 (Subsidised) – S$3,621
- Ward C (Subsidised) – S$2,425
- Ward A (Unsubsidised) – S$14,571
- Ward B1 (Unsubsidised) – S$12,492
Private Hospital
- Inpatient – S$32,016
Check with the Ministry of Health for the updated benchmark fees. For an accurate cost breakdown tailored to your specific case, it is advisable to consult with the hospital or clinic directly.
Insurance And MediSave
Health insurance can significantly reduce the out-of-pocket expenses for thyroid cancer surgery. Most insurance plans in Singapore cover thyroid cancer surgery under their surgical benefits. It is essential to review your policy to understand the extent of coverage and any exclusions.
Additionally, Singaporean citizens and Permanent Residents can use their MediSave funds to pay for thyroid cancer surgery. MediSave withdrawal limits apply, and you may need to supplement with cash or insurance for higher-cost procedures.
Survival Rates
The silver lining is that thyroid cancer is not within the top 10 causes of death for cancer patients in Singapore. It is one of the cancers with the highest survival rate. The survival rate for thyroid cancer in Singapore for females is high, at 89% (five-year age-standardised relative survival rate).
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FAQs
How does thyroid cancer affect thyroid hormone levels and what are the implications?
Thyroid cancer can influence hormone levels by disrupting the thyroid’s ability to produce thyroid hormones, which are critical for regulating metabolism, heart rate, and body temperature. If the cancer or its treatment necessitates the removal of the thyroid (thyroidectomy), patients will no longer produce these hormones naturally and will need lifelong thyroid hormone replacement therapy. Inadequate thyroid hormone levels can lead to symptoms like fatigue, weight gain, and depression, while excessive hormone levels may cause weight loss, anxiety, and heart palpitations. Regular monitoring and dosage adjustments are essential to maintain hormone balance and overall well-being.
What are the potential long-term effects of thyroid cancer treatments on quality of life?
The long-term effects of thyroid cancer treatments, such as surgery, radioactive iodine therapy, and hormone replacement, can vary. Some patients may experience chronic fatigue, changes in weight, and fluctuations in mood due to hormone imbalances. Scarring from surgery, particularly if a traditional approach is used, can impact self-esteem and body image. There may also be impacts on vocal quality if the vocal cords are affected during surgery. However, many patients adjust well to hormone replacement therapy and lead normal, healthy lives. Ongoing medical follow-ups and supportive care can help manage any lingering side effects and improve quality of life.
How do doctors determine if thyroid cancer has spread to other parts of the body?
Doctors use several methods to determine if thyroid cancer has metastasised. Imaging tests, such as ultrasound, CT scans, MRI, and PET scans, help visualize the extent of cancer spread to lymph nodes or other organs. A fine-needle aspiration biopsy may be used to test suspicious lymph nodes or masses for cancerous cells. Blood tests measuring thyroglobulin levels (a protein produced by thyroid tissue) can also indicate the presence of remaining or spreading cancer. Additionally, radioactive iodine scans can help detect cancerous thyroid cells that have spread beyond the thyroid gland. These comprehensive assessments guide treatment decisions and help monitor the effectiveness of therapies
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.