Thyroid cancer is a common type of cancer that affects the thyroid gland, a small butterfly-shaped gland located at the base of the neck. The thyroid gland produces hormones that regulate metabolism, growth, and development. In Singapore, thyroid cancer is one of the most commonly diagnosed cancers in women.
There are several treatment options available for thyroid cancer in Singapore, including surgery, radioactive iodine therapy, external beam radiation therapy, and chemotherapy. The choice of treatment depends on the type and stage of the cancer, as well as the patient’s overall health.
Surgery is the primary treatment for thyroid cancer in Singapore. The goal of surgery is to remove the cancerous thyroid gland and any nearby lymph nodes that may contain cancer cells.
The type of surgery performed depends on the size and location of the tumour. In some cases, a partial thyroidectomy may be performed, where only a portion of the thyroid gland is removed. In more advanced cases, a total thyroidectomy may be necessary, where the entire thyroid gland is removed.
During surgery, the patient is placed under general anesthesia, and an incision is made in the neck to access the thyroid gland. The surgeon carefully removes the cancerous tissue while trying to preserve the surrounding healthy tissue as much as possible. If cancer has spread to nearby lymph nodes, those may also be removed during the surgery.
After surgery, the patient will need to take thyroid hormone replacement medication for the rest of their life. This medication replaces the hormones that were previously produced by the thyroid gland and helps regulate metabolism and other bodily functions.
Radiation therapy is a type of cancer treatment that uses high-energy radiation beams to kill cancer cells. There are two main types of radiation therapy used in the treatment of thyroid cancer in Singapore: external beam radiation therapy and radioactive iodine therapy.
Radiation therapy is a common treatment option for thyroid cancer. The choice of radiation therapy depends on the type and stage of the cancer and the patient’s overall health.
Chemotherapy is not typically used as a first-line treatment for thyroid cancer. This is because most types of thyroid cancer are not very responsive to chemotherapy.
However, in some cases where the cancer has spread to other parts of the body or is not responding to other treatments, chemotherapy may be used. Chemotherapy involves the use of drugs that target and kill rapidly dividing cancer cells.
Chemotherapy is usually given as an infusion into a vein or as a pill that is taken orally. The treatment is typically administered in cycles, with a period of rest in between cycles to allow the body to recover.
Targeted therapy is a type of cancer treatment that uses drugs to target specific proteins or genes that help cancer cells grow and divide. In Singapore, targeted therapy is becoming an increasingly important treatment option for certain types of advanced thyroid cancers.
One of the main targeted therapy drugs used in the treatment of thyroid cancer is tyrosine kinase inhibitors (TKIs). TKIs are drugs that target specific proteins on the surface of cancer cells, inhibiting their growth and division.
TKIs are typically used to treat advanced or metastatic thyroid cancer that has spread to other parts of the body and is no longer responding to other treatments. TKIs are taken orally, usually once or twice a day, and are generally well-tolerated with fewer side effects compared to chemotherapy.
Immunotherapy is a type of cancer treatment that helps the patient’s own immune system to identify and attack cancer cells. In Singapore, immunotherapy is not currently a standard treatment option for thyroid cancer, but it is being studied in clinical trials for certain types of advanced thyroid cancers.
One type of immunotherapy being studied for thyroid cancer is immune checkpoint inhibitors. These drugs work by blocking proteins on cancer cells that prevent the immune system from attacking them. By blocking these proteins, immune checkpoint inhibitors can help the immune system recognize and attack cancer cells.
Clinical trials of immune checkpoint inhibitors have shown promising results in some patients with advanced thyroid cancer. However, not all patients respond to these drugs, and some may experience serious side effects, such as inflammation of the lungs, liver, or colon.
Another type of immunotherapy being studied for thyroid cancer is adoptive cell transfer therapy. This involves removing T cells from the patient’s blood, genetically modifying them to recognize and attack cancer cells, and then infusing the modified T cells back into the patient’s bloodstream. This approach is still in the early stages of development and is not widely available.
Surgery is a common treatment option for thyroid cancer in Singapore. While it is generally safe and effective, there are still some potential side effects associated with the procedure. The specific side effects that a patient may experience depend on the extent of the surgery, and other factors such as their overall health and medical history.
Some common side effects of thyroid cancer surgery may include:
Radiation therapy is a common treatment option for thyroid cancer in Singapore, but it can also have side effects. Here are some potential side effects of radiation therapy for thyroid cancer:
Chemotherapy is not a common treatment option for thyroid cancer, but it may be used in certain cases.
Here are some potential side effects of chemotherapy for thyroid cancer:
Targeted therapy is a type of cancer treatment that uses drugs to target specific molecules involved in the growth and spread of cancer cells. While targeted therapy drugs may have fewer side effects than traditional chemotherapy, they can still cause some side effects. Here are some potential side effects of targeted therapy for thyroid cancer:
Immunotherapy is a type of cancer treatment that uses the body’s immune system to fight cancer cells. While immunotherapy can be a promising treatment for some patients with advanced thyroid cancer, it can also cause some side effects. Here are some potential side effects of immunotherapy for thyroid cancer:
It is important to remember that thyroid cancer can be treated successfully if caught early. If you have any concerns about your thyroid or notice any changes, do not hesitate to see a healthcare professional for evaluation.
If you suspect that you or your loved one have thyroid cancer, it is advisable to get the support you need. Early detection and diagnosis of thyroid cancer is key to treating the disease.
Regardless of what stage your thyroid cancer may be at, you should schedule an appointment to see an oncologist specialising in thyroid cancer as soon as possible. With the speed of developments in thyroid cancer diagnosis and treatment, novel emerging treatment options could be explored by your medical oncologist.
Our cancer specialists at OncoCare specialise in treating late stage and advanced stages of thyroid cancer, as well as earlier stages of the disease.
Senior Medical Oncologist
Dr Tan Chee Seng | OncoCare Cancer Centre
MBBS (Singapore) – MRCP (United Kingdom)
Dr Tan Chee Seng is a Senior Medical Oncologist at OncoCare Cancer Centre. Prior to this he was a Consultant with the Haematology-Oncology Department of National University Cancer Institute of Singapore (NCIS), National University Hospital (NUH) and Visiting Consultant at Ng Teng Fong General Hospital (NTFGH).
He obtained his undergraduate medical degree from School of Medicine, National University of Singapore and his post-graduate qualification from Royal College of Physicians, United Kingdom. He completed his advanced specialist training in Medical Oncology from National University Hospital. He was later awarded with the prestigious Academic Medicine Development Award (AMDA) fellowship to subspecialize in personalization of lung cancer therapies at Addenbrooke’s Hospital, Cambridge University, United Kingdom.
His main clinical interests are in lung/thoracic and head/neck cancers. He was principal investigator or co-investigators for several international multi-center cancer clinical trials including novel chemotherapy agents, targeted therapies, tyrosine kinase inhibitors, antibody-drug conjugates, immunotherapy agents and etc. Dr Tan has also authored or co-authored publications in peer-reviewed international journals including Lancet Oncology, Clinical Cancer Research, Molecular Cancer, Lung Cancer, Oncotarget, Target Oncology, Journal of Cancer Research and Clinical Oncology, Journal of Translational Medicine, Journal of Oncology Practice and etc.
He had been invited to speak or to chair in local and regional oncology meetings. He also routinely held public talks and to local GP to inform them of the latest innovative treatments for cancers. Dr Tan was also the recipient of several grants including National Medical Research Council (NMRC) Clinician Investigator Salary Support Programme and Investigational Medicine Unit (IMU) Bridging Funds.
He is a member of several professional bodies including American Society of Clinical Oncology (ASCO), European Society of Medical Oncology (ESMO), International Association for the Study of Lung Cancer (IASLC) and was an executive committee member of the Singapore Society of Oncology.
He was actively involved in both undergraduate and post graduate teachings at the Yong Loo Lin School of Medicine (YLLSOM) and National University Hospital (NUH) respectively. He was previously appointed as the Assistant Professor for Faculty of Medicine, YLLSOM and Undergraduate Education Director (Medical Oncology). He was also a core faculty member of Medical Oncology Senior Residency of NUH. He was invited to be examiner for YLLSOM final year MBBS examinations.
Dr Tan is fluent in English, Mandarin and Malay/Bahasa. He is able to speak some Cantonese and Hokkien. He has taken care of patients from many regional and overseas regions including Malaysia, Indonesia, Vietnam, Myanmar, China, Bangladesh, Sri Lanka and India.
Dr Tan has sub-specialty oncology interest in head/neck cancers (including thyroid cancer, nasopharyngeal carcinoma, NPC) and thoracic/lung (small cell and non-small cell lung cancers, mesothelioma).
• Graduated from the National University of Singapore in 2005.
• Obtained Membership of the Royal College of Physician (United Kingdom) in 2007.
• Awarded ASEAN Scholarship (1998-2000) and KUOK Foundation Scholarship (2000-2005).
• Awarded prestigious AMDA Academic Medicine Development Award (AMDA) (2014-2015) for fellowship training at Addenbrooke’s Hospital Cambridge University, United Kingdom on personalization of treatment for lung cancers.
• Clinical lecturer, Yong Loo Lin School of Medicine, National University of Singapore from 2012-2018.
• Director of Undergraduate (Medical Oncology), Yong Loo Lin School of Medicine, National University of Singapore from 2012-2018.
• Assistant Professor Yong Loo Lin School of Medicine, National University of Singapore from 2016-2018.
• Invited as examiner for Yong Loo Lin School of Medicine final year MBBS examinations.
• Authored or co-authored publications in peer-reviewed international journals including Lancet Oncology, Clinical Cancer Research, Molecular Cancer, Lung Cancer, Oncotarget, Target Oncology, Journal of Cancer Research and Clinical Oncology, Journal of Translational Medicine, Journal of Oncology Practice and etc.
• Recipient of several grants including National Medical Research Council (NMRC) Clinician Investigator Salary Support Programme and Investigational Medicine Unit (IMU) Bridging Funds.
• Member of several professional bodies including American Society of Clinical Oncology (ASCO), European Society of Medical Oncology (ESMO), International Association for the Study of Lung Cancer (IASLC) and was an executive committee member of the Singapore Society of Oncology.
• Sub-specialty oncology interest in thoracic/lung (small cell and non-small cell lung cancers, mesothelioma) and head/neck cancers (including nasopharyngeal carcinoma, NPC).
Senior Consultant, Medical Oncologist
Cancer Specialist, Expert in Oncology, Singapore (oncocare.sg)
MBBS (Singapore) – M.Med (Singapore) – MRCP (United Kingdom) – FAMS (Medical Oncology)
Dr Leong Swan Swan did her basic Medical studies in the National University of Singapore (NUS) and obtained her Master of Medicine (Internal Medicine), NUS and Membership of the Royal College of Physicians (United Kingdom) in 1995. She started her training in Medical Oncology in 1995, and was awarded HMDP for further training, with special focus on Thoracic Oncology under Dr Mark Green at Holling’s Cancer Centre in 1997. In 2000, she obtained Specialist Accreditation in Medical Oncology as well as European Society of Oncology (ESMO) certification.
Dr Leong has been working in the Department of Medical Oncology, Singapore General Hospital / National Cancer Centre since 1995. She has provided outstanding cancer care for a wide-spectrum of cancers including breast cancer, colorectal and stomach cancers, lung cancer, head & neck cancer, ovarian/uterine/cervical cancers, lymphomas and other solid tumours. Prior to leaving for private practice, Dr Leong was serving as Senior Consultant, managing different tumour types and was involved in the multi-disciplinary care tumour boards, establishing her as a key opinion cancer specialist doctor in lung as well as head and neck cancers. She was also Visiting Consultant at Changi General Hospital. She was Director of the Ambulatory Treatment Unit at National Cancer Centre and was the Chairperson of the Code Blue Team.
Dr Leong was also actively involved in teaching. She was a Clinical Lecturer for medical students, involved in undergraduate teaching as well as teaching for junior staff and nurses. She has also given many public lectures.
She has published widely in both local and International journals including Journal of Clinical Oncology, Chest, Cancer and has written book chapters for the staging and treatment of lung cancer. Recognised for her expertise in lung and other cancers, she has been a reviewer for several journals including Journal of Clinical Oncology, Respirology and Singapore Medical Journal.
Dr Leong’s subspecialty interest is in lung cancer, thyroid cancer and head & neck cancer. (Head and neck cancer is a cancer that starts in the lip, oral cavity (mouth), nasal cavity (inside the nose), paranasal sinuses, pharynx, and larynx.) She is fluent in English and Mandarin as well as Cantonese dialect.
· Graduated from the National University of Singapore.
· Obtained Master of Medicine (Internal Medicine) and Membership of the Royal College of Physicians (United Kingdom) in 1995.
· Awarded the Ministry of Health Manpower Development Programme (HMDP) Scholarship HMDP for further training, with special focus on Thoracic Oncology under Dr Mark Green at Holling’s Cancer Centre in 1997. In 2000, she obtained Specialist Accreditation in Medical Oncology as well as European Society of Oncology (ESMO) certification.
· She was the Director of the Ambulatory Treatment Unit at National Cancer Centre and was the Chairperson of the Code Blue Team.
· She has been actively involved in clinical and translational research for many years, in lung cancer and head and neck cancer. These have involved international trials of chemotherapy drugs currently in active use and newer targeted therapy drugs. She was principal investigator for more than 10 clinical trials for cancer drug development.
· Research work by Dr Leong has been published in both local and international reputable journals including Journal of Clinical Oncology, Chest, Cancer and has written book chapters for the staging and treatment of lung cancer. She has been a reviewer for several journals including Journal of Clinical Oncology, Respirology and Singapore Medical Journal.
· With respect to public service, Dr Leong was also actively involved in teaching. She was a Clinical Lecturer for medical students, involved in undergraduate teaching as well as teaching for junior staff and nurses. She has also given many public lectures.
· Accredited for Palliative Medicine.
Thyroid cancer is a type of cancer that affects the thyroid gland, which is a butterfly-shaped gland located in the neck that produces hormones that regulate the body’s metabolism. The thyroid gland is made up of different types of cells that can become cancerous.
Thyroid cancer can occur at any age, but it is most commonly diagnosed in people between the ages of 30 and 60. Women are also more likely than men to develop thyroid cancer.
There are different types of thyroid cancer, including:
According to the International Agency for Research on Cancer (IARC), in 2020, there were an estimated 586,000 new cases of thyroid cancer worldwide and 42,000 deaths from the disease.
In Singapore, thyroid cancer is the 7th most common cancer among women, with an incidence rate of 8.1 per 100,000 populations in 2018, according to the Singapore Cancer Registry. The incidence of thyroid cancer in Singapore has been increasing over the past few decades, with an average annual increase of 5.2% in women between 1973 and 2017, and 3.8% in men between 1993 and 2017. The mortality rate for thyroid cancer in Singapore is relatively low, with 1.1 deaths per 100,000 population in 2018.
It is worth noting that the incidence of thyroid cancer has been increasing globally over the past few decades, which is partly attributed to the increased use of diagnostic imaging tests such as ultrasound and CT scans, which can detect small thyroid nodules that may not have been detected in the past. However, the majority of thyroid cancers are still highly treatable, and the prognosis for most patients is excellent, with a 5-year survival rate of around 98%.
The signs and symptoms of thyroid cancer can vary depending on the type and stage of the cancer. Some people with thyroid cancer may not have any symptoms, and the cancer may be detected during a routine physical exam or through imaging tests.
There is currently no universally accepted screening test for thyroid cancer. In individuals without symptoms or risk factors, routine screening for thyroid cancer is not recommended. However, in some cases, a doctor may recommend a thyroid ultrasound or other imaging tests if a person has symptoms or risk factors, such as a family history of thyroid cancer or exposure to radiation.
In Singapore, the Health Promotion Board recommends that individuals aged 50 years and above should undergo a screening for thyroid disorders, including thyroid cancer, during their routine health check-ups. The screening may include a physical examination of the neck to check for any lumps or nodules, as well as a blood test to measure thyroid hormone levels.
It is important to note that thyroid nodules are common, and most of them are benign. Only a small percentage of thyroid nodules are cancerous, and not all cases of thyroid cancer can be detected through screening.
Thyroid cancer is typically diagnosed through a combination of physical examination, imaging tests, and biopsy. The diagnostic process may include the following steps:
Once a diagnosis of thyroid cancer has been made, additional tests may be done to determine the stage of the cancer and whether it has spread to other parts of the body. These tests may include chest X-ray, bone scan, or PET scan.
The exact cause of thyroid cancer is not known. However, certain risk factors may increase the likelihood of developing thyroid cancer. These include:
It is important to note that having one or more of these risk factors does not necessarily mean that a person will develop thyroid cancer, and many people with thyroid cancer have no identifiable risk factors.
There are several types of thyroid cancer, including:
It is important to note that each type of thyroid cancer may require different treatments, and the prognosis and likelihood of cure may vary depending on the type and stage of the cancer.
The staging of thyroid cancer refers to the extent to which the cancer has spread beyond the thyroid gland. The most commonly used staging system for thyroid cancer is the TNM system, which stands for Tumour, Nodes, Metastasis.
Here are the stages of thyroid cancer:
Each stage is further divided into subcategories based on the size and extent of the cancer, as well as the number and location of affected lymph nodes. The stage of cancer helps guide treatment decisions and can also provide information about the likely outcome of the disease.