Lorraine Roberts loves nothing more than tending to her garden and walking the trails around her home, nestled in the woods of Virginia’s Roanoke valley. At 78, she was healthy and enjoying life. But then her life suddenly turned upside down: She started coughing up blood. Doctors suspected lung cancer, but it was aggressive thyroid cancer.
So aggressive, it almost strangled her.
Lorraine had long assumed thyroid cancer was one of the "better" cancers.
She shares, "My sister had thyroid cancer about 30 years ago. But it was a pretty simple thing for her. Mine was more serious because I had a tumor growing on my windpipe. And it was going to strangle me."
Aggressive thyroid cancers make up about 15% of thyroid cancers. So it's important to know what it is, how to spot it, and where to turn for treatment. We use Lorraine’s story as our guide.
What Does the Thyroid Do?
Our thyroid is among a group of glands (endocrine system) that control hormones. The thyroid makes hormones that help regulate our body's heart rate, blood pressure, temperature, and metabolism (how we convert food into energy).
How Can Thyroid Cancer Strangle Someone?
A small butterfly-shaped gland, the thyroid sits in the front of the neck. Its 2 wings (lobes) wrap around the windpipe (trachea).
Thyroid cancer begins in the thyroid gland. It comes in all shapes and sizes. In some cases, you can just watch a small, slow growing tumor. When treatment is needed, it usually involves surgery to remove part or all of the gland.
Invasive or aggressive thyroid cancers cancers can grow quickly. Some can eventually cut off the airway.
Papillary Thyroid Cancer Normally Not Aggressive
Strangely, Lorraine didn't have anaplastic thyroid cancer, which is the most aggressive type. She had papillary thyroid cancer — the most common type of thyroid cancer and usually not aggressive.
"With most thyroid cancers, the prognosis is great. But Ms. Roberts had a life-threatening type of thyroid cancer," says UVA Health otolaryngologist David Shonka, MD, who specializes in head and neck surgery.
He adds, "Without surgery, her tumor would likely grow large enough so she wouldn't be able to breathe. Or she would have problems breathing because of bleeding from the tumor into the lungs."
Lorraine's Symptoms of Aggressive Thyroid Cancer
Healthy her whole life, Lorraine’s first signs of aggressive thyroid cancer came out of the blue. She began:
- Coughing up blood
- Having trouble swallowing
- Sounding hoarse
- Always needing to clear her throat
At First, a Scary Thyroid Cancer Prognosis
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After some tests, Lorraine got terrible news from her local healthcare providers. "They told me I had about three months to live," she shares.
First told surgery wasn’t an option, she began radiation therapy and chemotherapy to try to shrink the tumor. But then she met with an endocrinologist in Roanoke.
Suhail Dar, MD, knew Lorraine needed the expertise of UVA Health otolaryngologists in Charlottesville. "Dr. Dar is familiar with Dr. Shonka's work and reputation. I credit him with putting me on the right track and making the connection for me."
Lorraine Learns Surgery Can Save Her Life
When Lorraine met Shonka the next week, she knew right away she was in good hands. Shonka does many thyroid cancer surgeries. Lorraine’s was particularly challenging.
Shonka needed to remove her thyroid and 2 inches of her windpipe, while protecting the nerves that control breathing and speaking. These nerves sit close to the thyroid and windpipe. When a segment of the windpipe is removed, it must be put back together. During this part of the surgery, Shonka teamed up with fellow otolaryngologist James Daniero, MD. He specializes in airway reconstruction.
"It's a complex and technically challenging surgery," Shonka says. "You have to remove the cancer entirely. Then you have to put everything back together in a way that allows the patient to have a good voice and to be able to breathe well."
She Sails Through a Big Surgery
Lorraine’s surgery went beautifully, Shonka says.
She is able to breathe well. And the small nerves that move her vocal cords were preserved and are working perfectly. Tests over the past 2 years have shown no signs of cancer. In church, she’s noticed her singing voice is only slightly different. Most importantly, she’s back to enjoying country life.
Shonka shares, "Ms. Roberts is tough and came through surgery really nicely. She’s done incredibly well since then."
He adds, "At UVA Health, we have a great team, including our residents and nurses. We can address the most complex thyroid cancers with excellent outcomes."