Sai (name changed), a teacher by trade, enjoyed his work. The 45-year-old was eager to share his enthusiasm for physics with young children. His job as a teacher demanded that he speak loudly in front of a large group of 50-60 students. It was critical that he speak loudly and clearly so that students in the back of the classroom could hear him. Thus, he found it very inconvenient when his voice became hoarse and he had to strain more and more each day to communicate with his students. Sai attributed the change in his voice to strain and began using a voice amplifier in class to rest his throat.
After a few weeks, he noticed a lump in his neck, in addition to the hoarseness in his voice, which showed no signs of improvement. On the advice of a friend, he decided to see an oncologist and ended up with Dr. Shiva Kimar Uppala of OncoIndia in Bengaluru.
Dr. Shiva Kumar performed extensive testing and determined that Sai had stage 3 papillary thyroid cancer. "The thyroid gland is a small gland in the front of the neck that produces hormones that are essential for body functions. Thyroid cancer is defined as any cancer that begins in the thyroid," explains Dr. Shiva Kumar. It is a type of cancer that is classified as head and neck cancer and is more common in women.
Thyroidectomy followed by radioactive iodine treatment is the most effective treatment for thyroid cancer. Thyroidectomy is the surgical removal of the thyroid gland. It always carries the risk of causing nerve damage to the voice box, which could result in hoarseness or other voice changes. "Because Sai worked in a profession that required his voice to be preserved, we used special equipment that alerted us if we got too close to the nerves that led to the voice box. This minimized damage to the voice box while also protecting the parathyroid glands, which regulate calcium levels in the blood," explains Dr. Shiva Kumar.
Following surgery and radiotherapy, Sai will need to take supplements to replace thyroid hormones that his body will no longer produce. "We usually give a higher dose of thyroid supplement than the body requires to prevent cancer recurrence. This is known as thyroid hormone suppression therapy, and it is required to keep serum thyrotropin (TSH) levels low in order to avoid stimulating any remaining thyroid cancer cells," explains Dr. Shiva Kumar.
Back in his classroom, Sai is careful not to strain his voice too much and continues to use the voice amplifier. He is grateful to Dr. Shiva Kumar and the OncoIndia team for preserving his voice, allowing him to continue teaching. He is most grateful for the love and support he has received from his family, friends, and students.
