Is thyroid cancer rise linked to new sofas?
JUlIET SHAND thought nothing of it when she developed a deep, gravelly voice, and laughed along with husband Matt when he joked that she sounded like Rod Stewart.
‘I’d always had a deeper voice than most women so I didn’t think it was anything sinister,’ says Juliet, 44, a recruitment manager, who lives in Wouldham, Kent, with Matt, 45, a computer engineer and their children Joe, 18 and Eloise, 14.
‘I’d developed problems swallowing food — but it seemed to come and go, so I put it down to not chewing it properly,’ she says.
‘I was good at explaining away any symptoms as I hated going to the doctor. This went on for months.’
By April last year she had joint pain and was feeling tired, so did visit her GP. A set of blood tests came back normal. ‘ luckily my GP examined my neck and although he didn’t tell me at the time, he felt a lump,’ recalls Juliet. ‘He referred me for an ultrasound of my thyroid gland.
‘My grandmother had a goitre, a non- cancerous enlarged thyroid gland, so I thought I probably had a similar problem and it could all be sorted out with a prescription.’
But five months later Juliet was dealing with the news that she had cancer of the thyroid, the butterflyshaped gland at the front of the throat that produces hormones for metabolism and energy.
Ironically it’s the same cancer Rod Stewart was diagnosed with in 2000. Cases of this type of cancer have shot up 139 per cent since the Nineties, according to Cancer Research UK. One controversial theory is that chemicals used in fireproofing may be partly to blame.
A study published in April by Duke University in the U.S. found an association between flame retardants used to treat sofas and mattresses and a higher rate of thyroid cancer. Researchers analysed dust samples from homes of patients with thyroid cancer, comparing them to a control group.
The dust from cancer patients’ houses had higher levels of two flame retardant chemicals. Homeowners living with the highest levels of the retardant decabromodiphenyl ether were twice as likely to have thyroid cancer as those with low concentrations.
UK scientists say the study is small and does not prove flame retardants cause cancer. ‘ Even the author said the numbers were so small as not to be statistically significant,’ says Carl Alexander, health information officer at Cancer Research UK.
‘No causal link between these chemicals and cancer has been found. The levels of exposure to these chemicals is not high enough to cause any harm.’
A more convincing reason for the ‘explosion’ in thyroid cancer cases is that smaller tumours are now being picked up thanks to better imaging, says Dr Kristien Boelaert, a consultant endocrinologist at the Institute of Metabolism and Systems Research at the University of Birmingham.
HALF of those diagnosed with the disease don’t have any symptoms, such as a hoarse voice, difficulty swallowing or a lump in the neck when they are diagnosed. Instead, their cancer is detected during a routine scan for something else.
‘It’s estimated that about 30 per cent of the population have microcarcinomas — tiny tumours — of less than 1cm in diameter of the thyroid,’ says Dr Boelaert. ‘These may never get big enough to cause any problems.’
The problem is imaging alone can’t predict how the tumours may behave in the future and some grow bigger and spread. This raises questions about whether some people are undergoing treatments which bring their own risks of sideeffects for a cancer that might never cause any symptoms.
A study published in 2016 in the New England Journal of Medicine by the International Agency for Research on Cancer found hundreds of thousands of cases of thyroid cancer diagnosed in high-income countries were unlikely to cause death.
But because ‘we have no way of predicting whether they are indolent or aggressive’, the practice is to treat all thyroid cancers, irrespective of their size, explains Sabapathy Balasubramanian, a consultant surgeon at Sheffield Teaching Hospital and author of a recent review into thyroid cancer published in the journal Thyroid.
‘It’s one of the dilemmas of modern medicine — the more we look for things sometimes, the more trouble we find.
‘My view is that we should be doing fewer scans as there is no evidence that they improve survival in thyroid cancer.’
Yet for some, thyroid cancer can be life- threatening, he says. Researchers are trying to find a way to predict how tumours will behave to avoid needless treatment.
Juliet was sent for a biopsy as her ultrasound showed nodules on her thyroid gland. ‘ It sounded routine so I didn’t panic as cancer had not been mentioned,’ she says. She went to get the results in November last year on her own, having assured Matt there was no need for him to come with her. ‘When I got in the consulting room I saw a box of tissues on the consultant’s desk and a leaflet about cancer. It dawned on me that I could be about to get some very bad news,’ Juliet says. ‘The biopsy had revealed cancerous cells. I was told I needed surgery to remove nodules on my thyroid. ‘The cancer was stage T2, so there was a possibility it had spread to other parts of my body. I managed to stay calm and ask about the treatment, but I was in shock.’ She sobbed in the hospital car park and called Matt asking him to meet her at home with the children so she could break the news. She calls it ‘the hardest conversation I’ve ever had’.
SHE started researching the condition. ‘That’s when I realised all my vague symptoms had this underlying cause.
‘I was later told that thyroid cancer had a high five-year survival rate of 91 per cent for women and 82 per cent for men, but that didn’t reassure me.’
Two weeks later, she had an operation to remove her thyroid gland after her surgeon decided that there were too many nodules to remove individually.
After surgery, Juliet was put on a daily dose of levothyroxine to replace hormones produced by the thyroid gland, which she will take for the rest of her life.
In March, she was given radioiodine treatment, an internal radiotherapy designed to destroy any remaining thyroid cancer cells. Patients drink radioactive iodine and are kept in isolation for a few days.
‘ I’m just grateful my GP ordered that scan and my cancer was found before it had the chance to spread,’ says Juliet. ‘I could easily have ignored my symptoms. I would urge anyone who notices a change to their voice — not to ignore it.’