 Myself Dr. Pushpendra Gulia, consultant surgical oncology at Manipal Hospital, Dwarka. Today I'll be talking about cancers of the thyroid gland. First of all, let me tell you, thyroid is a very small gland. It's an endocrine organ, which is present in front of your neck, covered by the skin and the muscles. And it secretes various hormones which are very helpful for your metabolism and other hormonal activities in the body. Thyroid cancer incidence is increasing in India, more common in South India as compared to the Northern India, and the cause is clearly unknown. Most of this rising incidence has been attributed to the over diagnosis. Over diagnosis, why am I saying this over diagnosis? Reason being, smaller and smaller tumors are being diagnosed by the investigation which are not invented for thyroid disease. Ultrason, CT, MRI or PET CT, which are being done for other diseases. They are incidentally detecting small thyroid nodules, which may not have appeared in the patient's lifetime if we would have left them like that only. But once there is a diagnosis, along with improved facility of the cytopathology for the diagnosis of thyroid cancer, more and more diagnosis are being made. And more so in the younger population. So coming on to the risk factors, which we can say again, increases the chances of developing thyroid cancer. Most of all in the female sex. Reason being, because of the hormonal changes which happens every month, this can be attributed for the increased incidence in the females. That to the ratio of around 4 is to 1, 4 female is to 1 male. More so around less than 45 years of age. Another are the exposure of the ionizing radiation that may be because of some disease and radiation therapy has been given or it may be environmental and occupational exposure. Others are like you know obesity, smoking and all these are more prevalent in the high income countries. That's why it is a disease of the high income countries. In India, if I talk about the incidence, it is less than 1% of all the cancers in India are thyroid cancers. So coming on to the various types of thyroid cancer which we can discuss here and I would like to tell you about. There are two most common one is differentiated and one is undifferentiated thyroid cancers. Differentiated can be papillotic arsidoma, it can be a folliculic arsidoma or it can be a mix of the papillodin follicular and it can be a hearthalic arsidoma. In the undifferentiated one, it is anoplastic arsidoma. And another category of the thyroid tumors is the metrolidic arsidoma which is entirely different from all of these other. So coming on to the diagnosis, first and foremost is the cytological diagnosis which is being done by fine needle aspiration cytology. A high-resolution ultrasound if need arises in MRI. Along with that, sometimes for the metrolic arsidoma and then a plastic might need a PET CT, Leodopa PET CT or a Dotonok PET CT. After the diagnosis, once we make a diagnosis of the thyroid cancer, now we should proceed for the treatment and I'll just be giving you an overview of the treatment. First of all, the differentiated thyroid cancers like papillodin follicular, surgical excision, maybe hemithiratectomy, maybe total thyridectomy, with or without lymph node dissection is the primary curative modality for the treatment of any thyroid cancer. Chemotherapy and radiotherapy, they are not very much effective except in anoplastic carcinoma they are being used. For the differentiated thyroid carcinoma, if I talk about the prognosis, they have a very good prognosis. In patients who are less than 45 years of age, the prognosis is even better. In females, the prognosis is even better. All other cancers, they have stage 1, 2, 3, 4, but in differentiated thyroid cancers, we have stage 1 and 2 in females or males who are less than 45 years of age. And the prognosis for these patients is approximately around more than 90% 5 years survival, which is very good considering other thyroid cancers and the other cancers in the head and neck. Now for the medullary carcinoma, which comprises approximately 3% of all the thyroid cancers, primary treatment modality is surgery only and followed by maybe sometimes maybe chemotherapy and nowadays we are having targeted therapy also being developed for that. Last but not the least is the anoplastic carcinoma thyroid, which is like having a very poor prognosis and there is no treatment available right now, only treatment is the palliative thing. Recently it is mostly presented in advanced stages. So surgery that can be done by an open method and nowadays robotic and endoscopic thyroid actinies are being done more and more commonly at the centers of excellence like Manipal hospitals. Here at Manipal hospitals, we have all the facilities including the surgery, open surgery, modalities, robotic surgery. We have all the nuclear medicine facilities for the diagnoses and for the treatment. So this was just about the brief overview of the thyroid cancer. Thank you.