Learn about this rare type of aggressive thyroid cancer. Treatment typically involves surgical removal of the thyroid gland.
Hurthle (HEERT-luh) cell cancer is a rare cancer that affects the thyroid gland.
The thyroid is a butterfly-shaped gland in the base of the neck. It secretes hormones that are essential for regulating the body's metabolism.
Hurthle cell cancer is also called Hurthle cell carcinoma or oxyphilic cell carcinoma. This is one of several types of cancers that affect the thyroid.
This type of cancer can be more aggressive than other types of thyroid cancer. Surgery to remove the thyroid gland is the most common treatment.
The thyroid gland is located at the base of the neck, just below the Adam's apple.
Hurthle cell cancer doesn't always cause symptoms, and it's sometimes detected during a physical examination or an imaging test done for some other reason.
When they do occur, signs and symptoms may include:
These signs and symptoms don't necessarily mean that you have Hurthle cell cancer. They may be indications of other medical conditions — such as inflammation of the thyroid gland or an enlargement of the thyroid (goiter).
Make an appointment with your health care provider if you have any signs or symptoms that worry you.
It's not clear what causes Hurthle cell cancer.
This cancer begins when cells in the thyroid develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The DNA changes, which doctors call mutations, tell the thyroid cells to grow and multiply quickly. The cells develop the ability to continue living when other cells would naturally die. The accumulating cells form a mass called a tumor that can invade and destroy healthy tissue nearby and spread (metastasize) to other parts of the body.
Factors that increase the risk of developing thyroid cancer include:
Possible complications of Hurthle cell cancer include:
Tests and procedures used to diagnose Hurthle cell cancer include:
Examining the vocal cords (laryngoscopy). In a procedure called laryngoscopy, your provider can visually examine your vocal cords by using a light and a tiny mirror to look into the back of your throat. Or your provider may use fiber-optic laryngoscopy. This involves inserting a thin, flexible tube with a tiny camera and light through your nose or mouth and into the back of your throat. Then your provider can watch the motion of your vocal cords as you speak.
This procedure might be recommended if there's a risk that the cancer cells have spread to the vocal cords, such as if you have voice changes that are concerning.
During needle biopsy, a long, thin needle is inserted through the skin and into the suspicious area. Cells are removed and analyzed to see if they are cancerous.
Treatment for Hurthle cell cancer usually involves surgery to remove the thyroid. Other treatments may be recommended, depending on your situation.
Total or near-total removal of the thyroid (thyroidectomy) is the most common treatment for Hurthle cell cancer.
During thyroidectomy, the surgeon removes all or nearly all of the thyroid gland and leaves tiny edges of thyroid tissue near small adjacent glands (parathyroid glands) to lessen the chance of injuring them. The parathyroid glands regulate the body's calcium level.
Surrounding lymph nodes may be removed if there's suspicion that the cancer has spread to them.
Risks associated with thyroidectomy include:
After surgery, your health care provider will prescribe the hormone levothyroxine (Synthroid, Unithroid, others) to replace the hormone produced by the thyroid. You'll need to take this hormone for the rest of your life.
Radioactive iodine therapy involves swallowing a capsule that contains a radioactive liquid.
Radioactive iodine therapy may be recommended after surgery because it can help destroy any remaining thyroid tissue, which can contain traces of cancer. Radioactive iodine therapy may also be used if Hurthle cell cancer has spread to other parts of the body.
Temporary side effects of radioiodine therapy can include:
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. During radiation therapy, you're positioned on a table and a machine moves around you, delivering the radiation to specific points on your body.
Radiation therapy may be an option if cancer cells remain after surgery and radioactive iodine treatment or if Hurthle cell cancer spreads.
Side effects may include:
Targeted drug treatments use medications that attack specific weaknesses within cancer cells. Targeted therapy may be an option if your Hurthle cell cancer returns after other treatments or if it spreads to distant parts of your body.
Side effects depend on the particular drug, but may include:
Targeted drug therapy is an active area of cancer research. Doctors are studying many new targeted therapy drugs for use in people with thyroid cancer.
The parathyroid glands lie behind the thyroid. They produce parathyroid hormone, which plays a role in regulating the body's blood level of calcium and phosphorus.
A diagnosis of Hurthle cell cancer can be challenging. Many people feel stressed and anxious. With time you'll find strategies to cope. Until then, here are some ideas that might help:
Start by making an appointment with your health care provider if you have signs and symptoms that worry you.
If Hurthle cell cancer is suspected, you may be referred to a doctor who specializes in treating thyroid disorders (endocrinologist) or a doctor who specializes in treating cancer (oncologist).
Because appointments can be brief, it's often helpful to arrive well prepared. Here's some information to help you get ready and what to expect from your provider.
Your provider is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked: