Medullary thyroid cancer may literally be 'a pain in the neck'

It can be difficult to detect the presence of medullary thyroid cancer (MTC), but new research suggests that individuals with neck pain are more likely than those without it to have an advanced case of the disease.

A study published in the Journal of Cancer determined that 22 percent of participants diagnosed with MTC presented with frontal neck pain, compared to 6 percent of those with papillary thyroid cancer, the more common thyroid cancer.

The finding contradicts the received wisdom about MTC, which many health authorities - like the Columbia University Department of Surgery (CUDS) - say usually first appears as a painless lump on the throat.

MTC accounts for between 2 and 3 percent of annual thyroid carcinoma diagnoses in the U.S., according to the National Cancer Institute (NCI). In contrast, papillary tumors of the thyroid comprise more than 70 percent of these diagnoses.

Medullary thyroid tumors have poor prognoses, which is one reason the study's authors investigated whether neck pain could indicate the presence of the disease. The NCI states that the five-year survival rate for MTC is 83 percent, compared to 90 percent for papillary thyroid cancer.

At 10 years beyond the diagnosis of a medullary thyroid carcinoma, survival drops to 65 percent, according to the National Institutes of Health.

The CUDS also notes that MTC's metastasis in the lymph nodes or at distant sites in the body drastically decreases a patient's life expectancy. For individuals whose MTC has spread to the lymph nodes, liver, lungs or bones, the 10-year survival rate is 25 percent, the department estimates.

In light of this fact, the authors of the new study also analyzed the stage of cancer at which individuals with MTC began experiencing neck pain.

The team determined that compared to those without frontal neck pain, MTC patients with it were more than twice as likely to have a stage III or IV MTC, in which the tumor had spread to the lymph nodes or beyond.

Researchers concluded that MTC patients with frontal neck pain should always undergo a thyroidectomy, as well as a thorough neck dissection to determine if the disease has spread to the lymph nodes.