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Hearing the word cancer is a life-altering event, even if it is only mentioned as a possibility. When it comes to the thyroid, the process of diagnosing cancer can be time consuming and difficult. If your doctor believes that your thyroid issues could be the result of a malignant or cancerous tumor, you will have to begin the process required for a complete diagnosis. While this may seem overwhelming, understanding what to expect, can help you know what to expect throughout the diagnosis process. This article aims to provide general information only and is not a substitute for thorough management by a doctor.

Symptoms of thyroid cancer

The first step in determining the potential cause of thyroid problems is to identify the symptoms. While many cancers of the thyroid produce no recognisable symptoms, many others do.

Thyroid cancer symptoms can include:

  • Lymph nodes in the neck that are enlarged
  • Difficulty with swallowing
  • One or more lumps in the front neck area
  • Changes in your voice
  • Chronic coughing that does not go away with treatment
  • Pain, stiffness, or discomfort in the neck

Your doctor will rely on you to be honest and open about the symptoms you are having. He or she will also perform a physical examination of your neck, to see if there are any areas of swelling or growths that you may not be aware of. Your doctor will also check any lumps that are present to determine how they feel and whether they cause pain.

Thyroid blood tests

Your doctor will usually request that you have blood tests done during the diagnosis process. These tests are used to measure the TSH level or thyroid-stimulating hormone. If these numbers are higher or lower than normal, it may be due to the thyroid not functioning properly. In some cases, other tests will be performed to check calcitonin and thyroglobulin and other hormone levels depending on the type of cancer the doctor suspects that you may have.

Imaging Tests

Imaging tests are another important part of thyroid cancer diagnosis. There are several types of medical imaging studies that may be needed.

Ultrasound imaging

This imaging test emits sound waves that bounce off the glands, lymph nodes, and other structures in your neck. When these sound waves bounce back, they create images or pictures that allow the doctor to see if there are any other nodules or lumps present in the thyroid that are unable to be felt. This test will allow your doctor to gain a better understanding of the shape and size of the nodules, as well as whether they are solid masses or filled with fluid. If your nodules are fluid-filled, this is a good indication that the growths are non-cancerous.

CT neck

The CT scan is an x-ray test that provides detailed cross-sectional images of your body. A neck CT scan can help determine the location and size of thyroid cancers and whether they have spread to nearby areas. The CT is complementary to an Ultrasound. CT scanning can show if the thyroid nodule has extended locally, for instance into the chest. This is also called retrosternal extension. A CT may also provide clear imaging of neck lymph nodes and also tracheal – wind pipe compression. A CT scan can also be used to look for spread into distant organs such as the lungs.

Thyroid nuclear imaging – Radioiodine scan

This test requires you to ingest radioactive iodine just before the testing begins. This substance will attach to the thyroid cells and any nodules that are present. The images produced by this scan allow your doctor to see if there are hot or cold nodules. Cold nodules generally absorb less of the radioactive iodine, while hot ones absorb much more. Nodules that are considered hot, meaning they soak up the radioactive iodine, are generally not cancer.

Thyroid Biopsy

If your doctor has performed all of the other tests, and there are any abnormal results, the next step is a biopsy. This procedure may be done with a needle to remove a tissue sample, or you may have to undergo surgery to remove your thyroid or a portion of it. These samples are then sent to the lab for the final diagnosis.

For more information about thyroid cytology click here.

The diagnostic process for thyroid cancer can be overwhelming. However, when you know why your doctor is making the decisions for tests and imaging, it can help you better understand the process.

If you have questions or concerns about thyroid lumps see your local doctor, who will arrange for you to see a thyroid surgeon.

Reference

http://www.medicinenet.com/thyroid_cancer

 

The post The Diagnosis of Thyroid Cancer appeared first on Thyroid Clinic Sydney.

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Melasma is a skin condition where brown patches develop on the skin. It more commonly affects the face, and other parts of the body where the skin is exposed to the sun (i.e. the arms, chest and neck). On the face, melasma affects the forehead, cheeks, chin and the nasal bridge. Other than the appearance of patches on the skin, there are no other signs or symptoms of melasma. Melasma can affect the more superficial part of the skin (called the epidermis) or the deeper layer of the skin (the dermis). In some people, there is a mixture of both dermis and epidermis involvement, and this is called mixed melasma.

Causes

Melasma predominantly affects women; however, it is possible for men to be affected by melasma. The exact cause of melasma is unknown, but it is believed to be due to over-activity of the cells in the skin that make melanin (the pigment that gives skin its colour). These specialised cells are called melanocytes. Melasma is more common in people with darker coloured skin, possibly because the melanocytes in people with dark skin are more active than in people with lighter skin tones. There is also a genetic component to melasma, as people who have had a family member with melasma are more likely to experience melasma themselves.

It is common for an event to trigger the start of melasma. Some triggers for melasma that have been reported include:

  • Hormonal changes & pregnancy
  • Sun exposure
  • Thyroid Disease
  • Some make-up and cosmetic products
  • Certain medications (contraceptive pills, anti-epileptic medications)

Hormones

One theory on the cause of melasma is that oestrogen and progesterone, the two female sex hormones, cause the melanocytes to become over-active and produce more melanin when there is exposure to the sun. This theory explains why melasma is much more common in women than in men. It also explains why women can develop melasma during pregnancy, because the levels of oestrogen and progesterone are much higher during pregnancy. Melasma brought on by pregnancy is called chloasma.

Another hormone that has been implicated in melasma is called Melanocyte Stimulating Hormone (MSH). MSH is also higher in pregnancy than normal and may contribute to chloasma. MSH is made by a tiny gland in the brain, called the pituitary gland. MSH stimulates the melanocytes to make more melanin and make the skin appear darker.

Sun exposure

The sun contains ultraviolet (UV) rays that also act to stimulate the melanocytes to make more melanin. This is the most common trigger for melasma, and small amounts of sun exposure can cause melasma to re-appear after it has faded. Due to the importance of sun exposure in the condition, melasma is much more common in the summer months.

Ethnicities

Certain ethnic groups are more likely to suffer from melasma than others, primarily due to the pigmentation characteristics of the skin. People of the following backgrounds are at an increased risk:

  • Latin/Hispanic
  • North African
  • Indian
  • African-American
  • Middle Eastern
  • Mediterranean
  • Asian

Prevention of Melasma

One of the most important things to do in terms of preventing melasma is to take precautions surrounding exposure to the sun. This is especially important for people who have a known family history of melasma. Wearing high SPF sunscreen, wearing a hat, sunglasses and long clothing are important in order to limit the amount of exposure of the skin to the sun’s UV rays. Another prevention measure that may be taken by women who have a family history of melasma is to use non-hormonal contraceptive methods. Hormonal options, such as the contraceptive pill, can increase the likelihood of developing melasma.

Diagnosis

Skilled doctors can diagnose melasma on the pattern of pigmentation on the face alone. Use of a specialised lamp (a black light/Wood’s lamp) can also help to make a diagnosis of melasma. In some cases, a biopsy may be ordered, where a small sample of tissue is taken and analysed under a microscope to confirm the diagnosis.

 

Treatment

Whilst some treatment options for melasma exist, the treatments are not always effective in all patients. Sunscreen and sun precaution measures are the most important starting point in the treatment of melasma. A few creams can be used to help lighten the pigmentation, although they do not always return the darkened patches to the original skin tone.

Hydroquinone is one agent contained in some ointments that can help lighten the colour of the patches in the skin. It can also be incorporated into a sunscreen in some preparations. Sometimes a side effect of this treatment is that the patches of skin may actually become darker; and if this is the case, the treatment should be stopped. It can also cause irritation of the skin, so is a good idea to test a tiny amount of cream on a small, unaffected area first. This formulation is applied twice a day for about 3 months or so.

Another agent that is used in ointments is called tretinoin. This cream also helps to lighten the patches of affected skin. It can cause skin irritation, so it should also be tested before applying to the skin, and should not be used over extensive periods.

If the skin does not respond to these treatments, there are a few more options for melasma. One is a chemical peel, where a chemical solution is applied to the skin causing the upper layers of dead skin to peel off. It may help people with moderate or severe melasma that has not responded to bleaching treatments. There are also a few laser treatment options, but these are seldom recommended because it is common to relapse after undergoing treatment.

In people with chloasma, the majority of cases will resolve spontaneously within a year. Some cases will improve, and not resolve completely. In subsequent pregnancies, melasma may become more obvious.

If you have any questions or concerns about melasma facial pigmentation contact your local doctor, who will arrange for you to see a dermatologist. Contact Us Today!

 

The post Melasma Facial Pigmentation appeared first on Dermatology Sydney.

By

Melasma is a skin condition where brown patches develop on the skin. It more commonly affects the face, and other parts of the body where the skin is exposed to the sun (i.e. the arms, chest and neck). On the face, melasma affects the forehead, cheeks, chin and the nasal bridge. Other than the appearance of patches on the skin, there are no other signs or symptoms of melasma. Melasma can affect the more superficial part of the skin (called the epidermis) or the deeper layer of the skin (the dermis). In some people, there is a mixture of both dermis and epidermis involvement, and this is called mixed melasma.

Causes

Melasma predominantly affects women; however, it is possible for men to be affected by melasma. The exact cause of melasma is unknown, but it is believed to be due to over-activity of the cells in the skin that make melanin (the pigment that gives skin its colour). These specialised cells are called melanocytes. Melasma is more common in people with darker coloured skin, possibly because the melanocytes in people with dark skin are more active than in people with lighter skin tones. There is also a genetic component to melasma, as people who have had a family member with melasma are more likely to experience melasma themselves.

It is common for an event to trigger the start of melasma. Some triggers for melasma that have been reported include:

  • Hormonal changes & pregnancy
  • Sun exposure
  • Thyroid Disease
  • Some make-up and cosmetic products
  • Certain medications (contraceptive pills, anti-epileptic medications)

Hormones

One theory on the cause of melasma is that oestrogen and progesterone, the two female sex hormones, cause the melanocytes to become over-active and produce more melanin when there is exposure to the sun. This theory explains why melasma is much more common in women than in men. It also explains why women can develop melasma during pregnancy, because the levels of oestrogen and progesterone are much higher during pregnancy. Melasma brought on by pregnancy is called chloasma.

Another hormone that has been implicated in melasma is called Melanocyte Stimulating Hormone (MSH). MSH is also higher in pregnancy than normal and may contribute to chloasma. MSH is made by a tiny gland in the brain, called the pituitary gland. MSH stimulates the melanocytes to make more melanin and make the skin appear darker.

Sun exposure

The sun contains ultraviolet (UV) rays that also act to stimulate the melanocytes to make more melanin. This is the most common trigger for melasma, and small amounts of sun exposure can cause melasma to re-appear after it has faded. Due to the importance of sun exposure in the condition, melasma is much more common in the summer months.

Ethnicities

Certain ethnic groups are more likely to suffer from melasma than others, primarily due to the pigmentation characteristics of the skin. People of the following backgrounds are at an increased risk:

  • Latin/Hispanic
  • North African
  • Indian
  • African-American
  • Middle Eastern
  • Mediterranean
  • Asian

Prevention of Melasma

One of the most important things to do in terms of preventing melasma is to take precautions surrounding exposure to the sun. This is especially important for people who have a known family history of melasma. Wearing high SPF sunscreen, wearing a hat, sunglasses and long clothing are important in order to limit the amount of exposure of the skin to the sun’s UV rays. Another prevention measure that may be taken by women who have a family history of melasma is to use non-hormonal contraceptive methods. Hormonal options, such as the contraceptive pill, can increase the likelihood of developing melasma.

Diagnosis

Skilled doctors can diagnose melasma on the pattern of pigmentation on the face alone. Use of a specialised lamp (a black light/Wood’s lamp) can also help to make a diagnosis of melasma. In some cases, a biopsy may be ordered, where a small sample of tissue is taken and analysed under a microscope to confirm the diagnosis.

 

Treatment

Whilst some treatment options for melasma exist, the treatments are not always effective in all patients. Sunscreen and sun precaution measures are the most important starting point in the treatment of melasma. A few creams can be used to help lighten the pigmentation, although they do not always return the darkened patches to the original skin tone.

Hydroquinone is one agent contained in some ointments that can help lighten the colour of the patches in the skin. It can also be incorporated into a sunscreen in some preparations. Sometimes a side effect of this treatment is that the patches of skin may actually become darker; and if this is the case, the treatment should be stopped. It can also cause irritation of the skin, so is a good idea to test a tiny amount of cream on a small, unaffected area first. This formulation is applied twice a day for about 3 months or so.

Another agent that is used in ointments is called tretinoin. This cream also helps to lighten the patches of affected skin. It can cause skin irritation, so it should also be tested before applying to the skin, and should not be used over extensive periods.

If the skin does not respond to these treatments, there are a few more options for melasma. One is a chemical peel, where a chemical solution is applied to the skin causing the upper layers of dead skin to peel off. It may help people with moderate or severe melasma that has not responded to bleaching treatments. There are also a few laser treatment options, but these are seldom recommended because it is common to relapse after undergoing treatment.

In people with chloasma, the majority of cases will resolve spontaneously within a year. Some cases will improve, and not resolve completely. In subsequent pregnancies, melasma may become more obvious.

If you have any questions or concerns about melasma facial pigmentation contact your local doctor, who will arrange for you to see a dermatologist. Contact Us Today!

 

The post Melasma Facial Pigmentation appeared first on Dermatology Sydney.

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Ear infection in children

Children get ear infections more frequently than adults do. Popular belief is that this is because children are more exposed to germs and bacteria, or because their immune systems have not built up the same tolerances that adults have. In fact, for the most part, both these beliefs are incorrect.

Children are more prone to ear infections because their Eustachian tubes are much smaller and almost completely horizontal. As we grow and develop, the Eustachian tubes elongate and become more angled allowing fluid to drain from the ear more easily. Due to this, fluid can be trapped in the middle ear more easily, allowing bacteria to breed and grow.

If your child experiences ear infections, ear grommets can be the most reliable treatment to help prevent future ear infections and other pediatric ear conditions. However, it can be difficult to discern when the right time is to schedule your child to have ear grommets inserted in their ears.

Ear Grommets

Ear grommets are tiny tubes that allow fluid to drain from the middle ear. During this very minor, minimally invasive surgery, the doctor will insert the grommets (or tubes) into tiny incisions in the eardrums. There is no need to have them removed, as they will slowly work themselves out and fall out of the ears when the eardrums heal. By this time, the Eustachian tubes have developed, and fluid can drain on their own.

Chronic Ear Infections

If your child only gets ear infections every now and then, and they do not last for very long, grommet surgery may not be required. Unfortunately, many children will suffer from multiple, seemingly chronic ear infections. While they will eventually grow out of this phase, it can be difficult for parents to watch their child in so much pain, repeatedly.

If your child is getting ear infections frequently, talk to your pediatrician about ear grommets. The surgery takes so little recovery time that children are often back in school or daycare the next day after the procedure, and they often feel much better without ear infections to deal with.

Glue Ear

If your child’s middle ear is filling up with a thick, glue-like substance instead of fluid, this is called glue ear. In addition to excess waxy buildup, you will notice that your child has trouble hearing normal conversational tones and sounds that you would otherwise expect them to easily notice.

Glue ear is not painful, but, as we said above, it does affect your child’s hearing, and it can affect their sense of equilibrium, as well. If you notice that your child is having balance problems, in addition to difficulty hearing, it is probably time for a trip to the pediatrician.

Your doctor may recommend a period of watchful waiting before doing anything else. Glue ear sometimes goes away on its own if you do not want to perform any unnecessary medical procedures on your child. If it does not go away though, it is probably time for ear grommets.

What to Expect After the Procedure

If you decide that it is time to get ear grommets inserted in your child’s ears, you should know what to expect. As we said, the procedure has very little recovery time. However, your child may perceive that sounds are louder than they were before for a few days after. This is just an adjustment period and is nothing to worry about. Ask your doctor if you have any other concerns before or after the procedure.

Children’s ear infection and the role for ear grommet placement

Acute otitis media or middle ear infection is the most common childhood bacterial infection and may affect up to 75% of children by the age of 5 years. Otitis media with effusion, also know as glue ear, is the collection of fluid in the middle ear space. This occurs due to the negative pressure produced by dysfunction of the Eustachian tube – the passage between the back of the nose, called the nasopharynx and middle ear.

The consequences of childhood middle ear infection may include hearing loss, perforation of the tympanic membrane, delay in speech and language development, balance problems and poor school performance. Whilst chronic ear disease may affect all children, Aboriginal and Torres Strait Islander children are at particular risk. In Australia, insertion of ear tubes, also called ear grommets will usually be recommended when a child has repeated middle ear infections, or has hearing loss caused by glue ear.

Ear grommet placement is most commonly needed from the age of one to three years.

The benefits of ear grommet placement may include

  • Reduced risk of future ear infections.
  • Restored hearing loss caused by middle ear fluid.
  • Improvement in speech and language development.
  • Improvement in balance, behaviour and school performance.
  • Management of the complications of middle ear infection.

If you have concerns about your child’s hearing or problems with ear infection, contact your local doctor, who will arrange for you to see an Ear, Nose and Throat Surgeon.

For more information about ear grommet placement in children click here.

References

The post When a child needs ear grommets appeared first on ENT Clinic Sydney.

By


Ear infection in children

Children get ear infections more frequently than adults do. Popular belief is that this is because children are more exposed to germs and bacteria, or because their immune systems have not built up the same tolerances that adults have. In fact, for the most part, both these beliefs are incorrect.

Children are more prone to ear infections because their Eustachian tubes are much smaller and almost completely horizontal. As we grow and develop, the Eustachian tubes elongate and become more angled allowing fluid to drain from the ear more easily. Due to this, fluid can be trapped in the middle ear more easily, allowing bacteria to breed and grow.

If your child experiences ear infections, ear grommets can be the most reliable treatment to help prevent future ear infections and other pediatric ear conditions. However, it can be difficult to discern when the right time is to schedule your child to have ear grommets inserted in their ears.

Ear Grommets

Ear grommets are tiny tubes that allow fluid to drain from the middle ear. During this very minor, minimally invasive surgery, the doctor will insert the grommets (or tubes) into tiny incisions in the eardrums. There is no need to have them removed, as they will slowly work themselves out and fall out of the ears when the eardrums heal. By this time, the Eustachian tubes have developed, and fluid can drain on their own.

Chronic Ear Infections

If your child only gets ear infections every now and then, and they do not last for very long, grommet surgery may not be required. Unfortunately, many children will suffer from multiple, seemingly chronic ear infections. While they will eventually grow out of this phase, it can be difficult for parents to watch their child in so much pain, repeatedly.

If your child is getting ear infections frequently, talk to your pediatrician about ear grommets. The surgery takes so little recovery time that children are often back in school or daycare the next day after the procedure, and they often feel much better without ear infections to deal with.

Glue Ear

If your child’s middle ear is filling up with a thick, glue-like substance instead of fluid, this is called glue ear. In addition to excess waxy buildup, you will notice that your child has trouble hearing normal conversational tones and sounds that you would otherwise expect them to easily notice.

Glue ear is not painful, but, as we said above, it does affect your child’s hearing, and it can affect their sense of equilibrium, as well. If you notice that your child is having balance problems, in addition to difficulty hearing, it is probably time for a trip to the pediatrician.

Your doctor may recommend a period of watchful waiting before doing anything else. Glue ear sometimes goes away on its own if you do not want to perform any unnecessary medical procedures on your child. If it does not go away though, it is probably time for ear grommets.

What to Expect After the Procedure

If you decide that it is time to get ear grommets inserted in your child’s ears, you should know what to expect. As we said, the procedure has very little recovery time. However, your child may perceive that sounds are louder than they were before for a few days after. This is just an adjustment period and is nothing to worry about. Ask your doctor if you have any other concerns before or after the procedure.

Children’s ear infection and the role for ear grommet placement

Acute otitis media or middle ear infection is the most common childhood bacterial infection and may affect up to 75% of children by the age of 5 years. Otitis media with effusion, also know as glue ear, is the collection of fluid in the middle ear space. This occurs due to the negative pressure produced by dysfunction of the Eustachian tube – the passage between the back of the nose, called the nasopharynx and middle ear.

The consequences of childhood middle ear infection may include hearing loss, perforation of the tympanic membrane, delay in speech and language development, balance problems and poor school performance. Whilst chronic ear disease may affect all children, Aboriginal and Torres Strait Islander children are at particular risk. In Australia, insertion of ear tubes, also called ear grommets will usually be recommended when a child has repeated middle ear infections, or has hearing loss caused by glue ear.

Ear grommet placement is most commonly needed from the age of one to three years.

The benefits of ear grommet placement may include

  • Reduced risk of future ear infections.
  • Restored hearing loss caused by middle ear fluid.
  • Improvement in speech and language development.
  • Improvement in balance, behaviour and school performance.
  • Management of the complications of middle ear infection.

If you have concerns about your child’s hearing or problems with ear infection, contact your local doctor, who will arrange for you to see an Ear, Nose and Throat Surgeon.

For more information about ear grommet placement in children click here.

References

The post When a child needs ear grommets appeared first on ENT Clinic Sydney.

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