Benign Paroxysmal Positional Vertigo (BPPV) is a mechanical problem in the inner ear that causes brief but intense episodes of dizziness or spinning sensations (vertigo) triggered by specific head movements. The condition occurs when tiny calcium carbonate crystals called otoconia become dislodged from their normal location and migrate into the semicircular canals of your inner ear, where they don’t belong. These displaced crystals interfere with the normal fluid movement that your inner ear uses to sense head motion, sending false signals to your brain about your body’s position. BPPV affects the population, with higher prevalence among older adults. While the term “benign” indicates the condition isn’t life-threatening, the sudden and unpredictable nature of vertigo attacks can impact your safety, independence, and psychological well-being.
Thyroid Cancer Treatment in Singapore
Discovering a thyroid nodule or receiving a thyroid cancer diagnosis can be overwhelming, but understanding your condition and treatment options is an important step in your healthcare journey. Thyroid cancer can have favourable outcomes when detected and treated appropriately. In Singapore, modern diagnostic techniques and comprehensive treatment approaches are available for managing thyroid cancer. Endocrinologists and surgical teams can provide thyroid cancer treatment plans tailored to each patient’s specific diagnosis and circumstances.
*Individual results and treatment outcomes may vary.*
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
What is Thyroid Cancer?
Types of Thyroid Cancer
Papillary Thyroid Cancer
Papillary thyroid cancer is the most common type of thyroid cancer and grows slowly from follicular cells. This type may spread to lymph nodes but less commonly to distant organs. Treatment outcomes can vary depending on individual factors such as stage at diagnosis and patient characteristics.
Follicular Thyroid Cancer
Follicular thyroid cancer also originates from follicular cells but tends to spread through blood vessels rather than lymph nodes. This type may spread to distant organs, such as the lungs and bones, particularly in older patients. Early detection may help improve treatment outcomes.
Medullary Thyroid Cancer
Medullary thyroid cancer develops from C cells that produce calcitonin hormone and represents a small percentage of thyroid cancer cases. Some medullary thyroid cancers are hereditary, which may require genetic testing for family members. This type requires specialised treatment approaches and careful monitoring.
Anaplastic Thyroid Cancer
The rarest and most aggressive form, anaplastic thyroid cancer, is uncommon. It grows rapidly and requires immediate, intensive treatment. This type typically affects older adults and requires coordinated care from multiple specialists.
Thyroid Lymphoma
Primary thyroid lymphoma is extremely rare, developing from immune system cells within the thyroid. It often occurs in patients with pre-existing autoimmune thyroid disease and requires different treatment protocols than other thyroid cancers.
Causes & Risk Factors
Causes
The exact cause of thyroid cancer remains unknown in most cases. However, genetic mutations in thyroid cells may lead to uncontrolled growth and tumour formation. These mutations may be inherited or acquired during a person’s lifetime. Some cases may result from radiation exposure, while others develop spontaneously without identifiable triggers.
Risk Factors
- Radiation exposure: Previous radiation therapy to the head, neck, or chest, particularly during childhood
- Gender and age: Women may be more likely to develop thyroid cancer, though men may have more aggressive forms
- Family history: Inherited genetic syndromes like familial medullary thyroid cancer or familial adenomatous polyposis
- Pre-existing thyroid conditions: Benign thyroid nodules or goitre may slightly increase risk
- Iodine intake: Both very high and very low dietary iodine levels may influence thyroid cancer development
- Previous thyroid disease: History of benign thyroid conditions or autoimmune thyroid disorders
- Genetic syndromes: Cowden syndrome, Werner syndrome, and Carney complex may increase thyroid cancer risk
*Individual risk factors and their impact may vary. Consult with a healthcare professional for a personalised assessment.*
Signs & Symptoms
Early Stages
- Painless lump or swelling in the neck
- Slight neck discomfort or pressure sensation
- Changes in voice quality noticed by others
- Mild difficulty swallowing certain foods
Advanced Stage
- Visible neck mass or asymmetry
- Persistent hoarseness or voice changes
- Difficulty swallowing or breathing
- Constant cough not related to cold or allergies
- Neck or throat pain radiating to the ears
- Enlarged lymph nodes in the neck
Late Stage
- Multiple enlarged neck masses
- Severe breathing difficulties
- Inability to swallow solid foods
- Weight loss and fatigue
- Bone pain if cancer has spread
Thyroid cancers may grow slowly and might not cause symptoms initially. Some are discovered during routine neck examinations or imaging for other conditions.
Experiencing these symptoms? Consider consulting a healthcare professional for proper evaluation.
Schedule a consultation with an Endocrinologist for assessment and management options.
When to See a Doctor
Seek medical evaluation if you notice a lump in your neck, especially if it grows or is accompanied by voice changes, difficulty swallowing, or breathing problems. Any neck mass that persists for more than two weeks may warrant professional assessment. Patients with a family history of thyroid cancer or genetic syndromes should discuss screening options with their healthcare provider.
During your consultation, the healthcare professional will perform a neck examination, review your medical history, and discuss risk factors. The doctor will examine your thyroid and neck lymph nodes, assess your voice quality, and may perform an ultrasound during the visit. Blood tests checking thyroid function and tumour markers may be ordered. Based on findings, the healthcare professional will explain whether further testing might be needed and outline potential next steps in your evaluation.
Diagnosis & Testing Methods
Accurate diagnosis of thyroid cancer requires multiple assessment methods to determine the type, stage, and extent of disease. The diagnostic process typically begins with a thorough clinical evaluation followed by imaging studies and tissue sampling.
Ultrasound examination
Ultrasound examination provides detailed images of thyroid nodules, revealing their size, composition, and suspicious features. Modern ultrasound can detect small nodules and assess lymph node involvement. This procedure requires no preparation.
Fine needle aspiration (FNA) biopsy
Fine needle aspiration (FNA) biopsy is a standard method for thyroid nodule evaluation. Using ultrasound guidance, a thin needle extracts cells from suspicious nodules for microscopic examination. The procedure involves minimal discomfort.
Blood tests
Blood tests measure thyroid hormone levels (TSH, T3, T4) and specific tumour markers. Calcitonin and CEA levels may help diagnose medullary thyroid cancer, whilst thyroglobulin can serve as a marker for differentiated thyroid cancers. Genetic testing may be recommended for hereditary cases.
Advanced imaging
Advanced imaging including CT scans, MRI, or PET scans, may be ordered to evaluate potential cancer spread beyond the thyroid. These tests can help determine surgical planning and treatment strategies. Radioiodine scanning assesses how thyroid tissue absorbs iodine, which may guide radioactive iodine therapy decisions.
*Individual results and timelines may vary. These diagnostic procedures are administered as part of a comprehensive evaluation supervised by a healthcare professional.*
Treatment Options Overview
Total Thyroidectomy
Complete removal of the thyroid gland is a treatment option for thyroid cancers. The procedure removes thyroid tissue through a horizontal neck incision. Surgeons may use nerve monitoring technology to help protect the recurrent laryngeal nerves that control vocal cord function. Recovery may require a hospital stay, with return to activities varying by individual case.
Lymph Node Dissection
When cancer spreads to the neck lymph nodes, surgical removal may be considered. Central neck dissection removes lymph nodes near the thyroid, whilst lateral neck dissection addresses spread to the side neck regions. The extent of lymph node surgery depends on imaging findings and surgical assessment.
Radioactive Iodine Therapy
- Post-Surgical Treatment: Radioactive iodine (RAI) treatment aims to destroy remaining thyroid tissue after surgery. Patients receive a radioactive iodine capsule that targets thyroid cells. Treatment requires temporary isolation for radiation safety. Preparation involves following a low-iodine diet and hormone management to optimise treatment conditions.
- Treatment Approach: RAI doses vary based on cancer characteristics and individual factors. Treatment protocols are individualised based on patient assessment. Multiple treatments may be considered for certain cases. Regular follow-up monitoring assesses treatment response.
Thyroid Hormone Supplementation
After thyroidectomy, daily levothyroxine replaces thyroid hormones and may help suppress TSH levels. Dosing requires adjustment based on regular blood tests. Hormone levels may stabilise over time with treatment. Ongoing monitoring aims to maintain an appropriate hormone balance.
Radiation Therapy
External radiation targets neck areas when surgery isn’t suitable or for certain cancer types. Treatment may involve daily sessions over several weeks. Modern techniques like intensity-modulated radiation therapy aim to minimise the impact on surrounding tissues. Side effects may include skin irritation, swallowing difficulties, and fatigue during treatment.
Tyrosine Kinase Inhibitors
For certain thyroid cancers, targeted drugs may block specific proteins involved in cancer growth. Medications like lenvatinib and sorafenib are treatment options that may help slow disease progression. Treatment continues based on individual response and tolerance. Regular monitoring assesses treatment response and manages potential effects.
Chemotherapy
Traditional chemotherapy may be considered for certain thyroid cancer types or cases where other treatments are not suitable. Combination drug regimens target cancer cells. Treatment protocols depend on cancer type and individual patient factors.
*Individual results and treatment responses may vary.*
Every patient’s condition is unique.
Our endocrinologist will assess your specific situation and discuss treatment options that may be suitable for you.
Complications if Left Untreated
Untreated thyroid cancer may progressively enlarge, potentially compressing neck structures and affecting breathing and swallowing function. Local growth can affect the voice box, which may result in hoarseness or voice changes. The oesophagus and trachea may become affected, potentially requiring medical interventions.
Metastatic spread can occur when cancer cells travel to distant organs. The lungs represent a site for distant metastases, which may cause breathing difficulties and reduced oxygen levels. Bone metastases can lead to pain, fractures, and mobility problems. Brain involvement, though rare, may cause neurological symptoms.
Advanced thyroid cancer can impact quality of life through pain, breathing difficulties, and difficulty eating normally. Patients may require feeding tubes or tracheostomy procedures. The condition can affect both patients and families. Early detection and treatment aim to help prevent these complications and preserve normal function.
*Individual outcomes may vary. This information is provided for educational purposes and should not replace consultation with a healthcare professional.*
Prevention
Most thyroid cancers cannot be prevented, but certain measures may help reduce risk. Limiting unnecessary radiation exposure, particularly during childhood, may help prevent radiation-induced thyroid cancer. Medical imaging should use the lowest radiation dose possible, and thyroid shielding during dental X-rays may provide additional protection.
For individuals with hereditary thyroid cancer syndromes, genetic counselling can guide risk assessment and screening protocols. Some high-risk patients may consider prophylactic thyroidectomy (preventive thyroid removal) to help prevent cancer development. Regular screening may enable early detection when treatment can be more effective.
Maintaining adequate iodine intake through iodised salt supports thyroid health. Some studies suggest that a diet rich in vegetables and fruits may offer protective benefits. Regular neck self-examinations may help detect new lumps early. Annual check-ups with thyroid function tests may benefit those with risk factors or family history.
*Individual results and preventive outcomes may vary. Consult with a healthcare professional for personalised risk assessment and screening recommendations.*
Medisave & Insurance Shield Plan approved
Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.
Frequently Asked Questions (FAQ)
What is the survival rate for thyroid cancer in Singapore?
Thyroid cancer generally has favourable outcomes when diagnosed early. Papillary and follicular thyroid cancers typically have positive prognoses. Outcomes depend on cancer type, stage at diagnosis, patient age, and treatment response. Regular follow-up and appropriate treatment can help improve long-term outcomes.
*Individual results and timelines may vary.*
Will I need to take medication for life after thyroid surgery?
If you undergo total thyroidectomy (complete thyroid removal), you may require daily thyroid hormone replacement medication (levothyroxine) for life. This medication replaces the hormones your thyroid would normally produce and helps prevent cancer recurrence by suppressing TSH levels. Patients who have a partial thyroidectomy may not need hormone replacement if the remaining thyroid tissue functions adequately. Regular blood tests help monitor proper hormone levels.
*This treatment is administered as part of a comprehensive plan supervised by a healthcare professional.*
How long does recovery from thyroid surgery take?
Recovery from thyroid surgery varies by individual. Patients typically stay in the hospital for a short period after thyroid surgery and may return to light activities within a week. Healing of the surgical site generally takes several weeks, with many people resuming normal activities, including work, during this period. Voice changes or weakness may persist for several weeks but often resolve. Return to strenuous activities typically occurs within several weeks.
*Individual results and timelines may vary.*
Can thyroid cancer come back after treatment?
Thyroid cancer can recur, though the risk varies by cancer type and initial stage. Recurrences can happen within the first few years but may also occur later. Regular monitoring through blood tests, ultrasounds, and physical examinations helps detect any recurrence early when treatment options remain available. Adhering to prescribed hormone suppression therapy may help reduce recurrence risk.
*Individual results and timelines may vary.*
What follow-up care is needed after thyroid cancer treatment?
Follow-up care includes regular blood tests measuring thyroglobulin and TSH levels, neck ultrasounds, and physical examinations. The frequency of monitoring may decrease over time for low-risk patients, but continues long-term. Radioiodine scans may be performed periodically for higher-risk cases. Consistent follow-up enables monitoring for recurrence and adjustment of hormone therapy as needed.
*This treatment is administered as part of a comprehensive plan supervised by a healthcare professional.*
Conclusion
Thyroid cancer, while serious, may respond to treatment when detected early and managed appropriately. Modern diagnostic techniques and comprehensive treatment options available in Singapore can offer positive outcomes for patients. Understanding your specific type of thyroid cancer, treatment options, and follow-up requirements may help you make informed decisions about your care. With proper treatment and monitoring, patients with thyroid cancer may return to normal, healthy lives. *Individual results and timelines may vary.*
Take the First Step Towards Better Health
Living with thyroid cancer can be challenging, but you don’t have to face it alone. Our endocrinologist has experience diagnosing and treating thyroid cancer using evidence-based approaches.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
Make an Enquiry
Fill up the form and our friendly clinic staff will get back to you promptly.
Our Location
A Specialist Clinic for Sinus, Snoring & ENT
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Hospital
Singapore 329563
Mon – Fri: 9:00 am – 5:00 pm
Sat: 8:30 am – 12:00 pm