Question 1

What is Medullary Thyroid Cancer?

Accepted Answer

Medullary thyroid cancer (MTC) is a rare form of thyroid cancer that originates in the parafollicular C-cells of the thyroid gland. It is caused by mutations in the RET proto-oncogene, which leads to abnormal cell growth and the secretion of calcitonin and carcinoembryonic antigen (CEA). The Carcinoembryonic Antigen (CEA) test is the most important blood test for monitoring treatment effectiveness and detecting cancer recurrence in MTC patients.

Question 2

What causes medullary thyroid cancer?

Accepted Answer

Medullary thyroid cancer is caused by mutations in the RET proto-oncogene, which leads to uncontrolled growth of parafollicular C-cells in the thyroid gland. These mutations can be inherited (familial MTC) or occur spontaneously (sporadic MTC). About 25% of cases are hereditary and associated with genetic syndromes like Multiple Endocrine Neoplasia type 2 (MEN2), while the remaining 75% occur randomly without a family history. The mutated cells produce excessive amounts of calcitonin and carcinoembryonic antigen (CEA), which serve as tumor markers for diagnosis and monitoring.

Question 3

What is the best test for medullary thyroid cancer?

Accepted Answer

The Carcinoembryonic Antigen (CEA) test is the most important blood test for monitoring medullary thyroid cancer because it detects elevated CEA levels that indicate active disease or recurrence. CEA levels typically decrease with successful treatment and rise when cancer returns or progresses, making it essential for tracking treatment effectiveness. While calcitonin is the primary tumor marker for initial diagnosis, CEA provides complementary information and is particularly valuable for long-term monitoring. Regular CEA testing helps your healthcare team detect cancer recurrence early and make timely treatment adjustments to improve outcomes.

Question 4

When should I get tested for medullary thyroid cancer?

Accepted Answer

You should get tested if you have a family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndromes, notice a lump or nodule in your neck, experience persistent hoarseness or difficulty swallowing, or have unexplained diarrhea (a common symptom of MTC). If you have already been diagnosed with medullary thyroid cancer, regular CEA testing is essential to monitor your treatment response and detect potential recurrence. Your doctor will typically recommend testing every 3-6 months after treatment, with frequency adjusted based on your individual risk factors and treatment plan.

Question 5

What are the symptoms of medullary thyroid cancer?

Accepted Answer

Symptoms of medullary thyroid cancer include a noticeable lump or nodule in the front of the neck, persistent hoarseness or voice changes, difficulty swallowing or breathing, chronic diarrhea (due to hormone secretion by cancer cells), and swollen lymph nodes in the neck. Many people have no symptoms in the early stages, and the cancer is discovered during routine thyroid examinations or genetic screening for family members of affected individuals. As the tumor grows, you might experience neck pain or persistent cough unrelated to a cold or infection.

Question 6

Who is at risk for medullary thyroid cancer?

Accepted Answer

People with a family history of medullary thyroid cancer or inherited genetic syndromes like Multiple Endocrine Neoplasia type 2A or 2B (MEN2A, MEN2B) are at highest risk. First-degree relatives of patients with hereditary MTC should undergo genetic testing for RET mutations. The cancer can develop at any age but is most commonly diagnosed in people between 40-60 years old. Individuals with sporadic MTC (no family history) have no identifiable risk factors, though the condition appears slightly more common in women than men.

Question 7

What happens if medullary thyroid cancer is left untreated?

Accepted Answer

Untreated medullary thyroid cancer can spread beyond the thyroid gland to nearby lymph nodes, and eventually metastasize to distant organs including the lungs, liver, and bones. As the tumor grows, it can compress or invade surrounding structures in the neck, causing severe difficulty breathing and swallowing. The cancer produces hormones that can cause debilitating chronic diarrhea and other metabolic complications. Early detection and treatment significantly improve survival rates, which is why regular monitoring with CEA blood tests is crucial for anyone with MTC or at risk for developing it.

Question 8

Can medullary thyroid cancer be diagnosed with a blood test?

Accepted Answer

Blood tests measuring calcitonin and CEA levels are essential tools for diagnosing and monitoring medullary thyroid cancer, though a definitive diagnosis requires a fine needle aspiration biopsy of the thyroid nodule. Elevated calcitonin levels strongly suggest MTC and prompt further investigation. The Carcinoembryonic Antigen (CEA) test is particularly valuable for monitoring treatment response and detecting recurrence after surgery or therapy. Genetic blood tests for RET mutations can identify inherited forms of MTC in family members before symptoms develop, allowing for preventive treatment.

Question 9

How is medullary thyroid cancer treated?

Accepted Answer

The primary treatment for medullary thyroid cancer is surgical removal of the thyroid gland (total thyroidectomy) along with affected lymph nodes in the neck. Unlike other thyroid cancers, MTC does not respond to radioactive iodine therapy because C-cells do not absorb iodine. For advanced or metastatic disease, targeted therapy drugs like vandetanib or cabozantinib that block cancer cell growth may be used. After treatment, you will need lifelong thyroid hormone replacement therapy and regular monitoring with blood tests like CEA to detect any recurrence early.

Question 10

How can I prevent medullary thyroid cancer?

Accepted Answer

For hereditary medullary thyroid cancer, prevention involves genetic testing of family members to identify RET mutations, followed by prophylactic thyroidectomy (preventive removal of the thyroid) in mutation carriers, often during childhood. This preventive surgery can eliminate the risk of developing MTC in people with inherited mutations. For sporadic MTC, there are no known prevention strategies since the cause is unknown. Regular medical checkups and promptly reporting any neck lumps or concerning symptoms to your doctor can lead to earlier detection and better treatment outcomes.

Question 11

What can I do at home to manage medullary thyroid cancer?

Accepted Answer

After treatment, take your thyroid hormone replacement medication exactly as prescribed and never miss doses to maintain proper metabolism. Keep a symptom journal tracking any new neck lumps, changes in voice, or digestive issues to report at follow-up appointments. Eat a balanced diet rich in calcium and vitamin D to support bone health, especially if you have had parathyroid glands removed during surgery. Schedule and attend all follow-up appointments for blood tests like CEA monitoring, as early detection of recurrence significantly improves treatment success. Connect with support groups for thyroid cancer patients to share experiences and coping strategies.

Question 12

How’s this work?

Accepted Answer

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Question 13

How do I know which test to get?

Accepted Answer

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Question 14

When will my lab results be available?

Accepted Answer

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Question 15

Is it possible to make changes to my lab order if I made a mistake with the name, date of birth, or any other details?

Accepted Answer

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Question 16

Do you accept health insurance?

Accepted Answer

Only HSA & FSA is accepted.
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Question 17

Can I cancel my order?

Accepted Answer

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Question 18

How can I find a lab location near me?

Accepted Answer

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Medullary Thyroid Cancer Blood Test

What is Medullary Thyroid Cancer?

What causes medullary thyroid cancer?

What is the best test for medullary thyroid cancer?

When should I get tested for medullary thyroid cancer?

References

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