The thyroid gland, shaped like a butterfly, sits just below the skin and several thin muscle layers in the lower part of the neck. It's attached to the deeper neck structures (trachea and voice box) and elevates when we swallow. The thyroid gland secretes hormones that control a variety of systems all through out life including our metabolism, growth and development. Each year about 30,000 Americans are diagnosed with thyroid cancer. It is about 2 to 4 times more common in women than in men, and is most prevalent between ages 25 and 65. Thyroid cancer prognosis can occur during a routine physical exam. Your doctor may ask you about your medical history and can recommend screening tests for thyroid cancer before any symptoms appear. Thyroid cancer symptoms usually begin as a lump or swelling in the neck, called a nodule. Thyroid nodules are very common (12% of general population) and most are benign. All nodules, however, need to be carefully evaluated as a very high percentage of nodules are cancerous (10-15%). If you have a lump or nodule in your thyroid, your doctor may order a CT scan or an ultrasound to get a better look at your thyroid. If your doctor thinks that the lump or nodule could be cancerous, he or she will do a biopsy of the thyroid gland which involves removing a piece of your thyroid, often through a needle. This test is a simple procedure that can be done in your doctor's office. Tests which may be done before, during, or after any thyroid cancer treatment may include specific blood tests, CT scans, chest X-rays, thyroid ultrasounds, or radioactive iodine scans, which help determine whether the cancer has spread to other parts of the body. In rare cases, when thyroid cancer has significantly spread, an MRI or a PET scan may be done. Most thyroid cancers are very treatable and carry a high cure rate, especially when discovered early. Treatment of thyroid cancer requires a close collaboration between endocrinologists and thyroid surgeons. The treatment plan by our team of doctors is always decided through this collaboration. The first and most effective step in treatment of thyroid cancer is usually surgery. Thyroid cancer surgery involves removal of a portion (hemi-thyroidectomy) or the entire thyroid gland (total thyroidectomy). The newest advances in the field of surgery (endoscopes and endoscopic instruments) allow for minimally invasive thyroidectomy (Endoscopic Assisted Thyroidectomy, E.A.T.?) (as small as 2.5 cm or close to an inch), rather than the standard technique using a large incision and greater tissue trauma. This is a revolutionary way of surgically treating the thyroid, and because it involves a much smaller incision, it enables patients to go home the same day, with less scarring and quicker recovery time.
Sarcoidosis is an inflammatory disease that starts in your lungs, but in time it can affect virtually any organ in your body, including your liver, skin, heart, nervous system and eyes. Sarcoidosis can attack any organ and often affects more than one. However, more than 90 percent of patients with sarcoidosis will have pulmonary involvement. Pulmonary sarcoidosis can cause loss of lung volume (the amount of air the lungs can hold) and abnormal lung stiffness.
Causes
The cause of sarcoidosis is unknown. Because the lungs and thoracic lymph nodes (the lymph nodes located in the chest) are the most frequently involved organs, some physicians and researchers suspect that sarcoidosis may be caused by something that enters the body through the lungs, that is, something that is inhaled such as a virus or bacteria, or an unidentified environmental toxin.
Possible causes of sarcoidosis include:
* Hypersensitivity to environmental factors * Genetics * Extreme immune response to infection
The incidence varies widely according to race and sex.
It is more common in African Americans than Caucasians. Females are usually affected more frequently than males. Onset of the disease typically occurs between the ages of 20 and 40. Sarcoidosis is very rare in young children.
Symptoms
As with many diseases, sarcoidosis is often present without causing any symptoms. However, when symptoms do appear they do so abruptly (acute sarcoidosis), or gradually over a number of years (chronic sarcoidosis). About 25% of people who have sarcoidosis have eye symptoms. These symptoms can make it hard to see, but they rarely cause blindness. Eye symptoms usually include dry eyes, but they can also include swelling of the tear gland that makes the eyes water.
Treatment
Pulmonary function tests evaluate how well the lungs are functioning (i.e., how well the lungs expand and how much oxygen they are capable of handling). Sarcoidosis patients who have granulomas or fibrosis in their lungs generally do not perform as well as they should on these tests.
Because the cause sarcoidosis is unknown, it is difficult to treat. The symptoms of sarcoidosis result from inflamed granuloma tissue and can be relieved, to some extent, by drugs that stop the swelling ? in particular, corticosteroids. The dose and duration of corticosteroid treatment varies considerably from case to case. The most common corticosteroid is prednisone.
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