What makes this disease even more ominous, like most cancers, is the lack of any early symptoms.

Dan Ramphalla regrets not seeking medical attention sooner.

“I was very ignorant and never thought I’d be sick with a killer disease. I found about thyroid cancer late and if I had earlier, I might have been able to fight it,” said the 49-year-old.

Ramphalla ignored early signs due to shyness and having to open up to others. He said that after a lump had developed, he hid from other people in the fear of being ridiculed.

“There was a pain at the front of my neck which would sometimes go up into my ears. At this stage, I didn’t think of seeing a doctor despite the pain and the lump which was growing. My voice also became hoarse,” said Ramphalla.

Understanding the thyroid gland

The thyroid gland is a butterfly-shaped organ, located at the base of the neck, just below the voice box, or larynx.  Its function is the production, storage and release of thyroid hormones into the bloodstream. Thyroid hormones influence metabolism, growth and development, and body temperature. The main hormones are thyroxine (T4) and triiodothyronine (T3).


Thyroid cancer occurs when a cancerous tumour is found in the thyroid gland. Cancer begins in cells when cell growth is abnormal, and which then leads to abnormal tissue formation. The abnormal tissue in the thyroid gland is referred to as a nodule which then can develop into either a benign nodule or a cancerous tumour. Most thyroid nodules are benign.

Thyroid cancer in SA

According to the Cancer Association of South Africa (CANSA), about 50% of people over the age of 40 have a thyroid nodule, most of which are benign. Only 7-15% of thyroid nodules are malignant.

The Global Cancer Observatory (GLOBOCAN) ranked thyroid cancer as the 20th most prevalent cancer in South Africa in 2020. Just over 1 300 new cases were reported (1 305) and 146 deaths. Breast cancer remains no 1 with 15 491 cases and close to 4 700 deaths.

Beacon of support

There is help at hand for people like Ramphalla who often feel alone.

Ocesa, a non-profit organisation for cancer education in South Africa, offers support to people who have had cancer experience, feelings of unwanted loneliness and a loss of control and hope.

Cancer education is vital to each and every individual in our society, as prevention and being informed about cancer is better than going through such a traumatic experience.

What to look out for

Knowing what to look out for can help individuals who avoid seeking medical advice or treatment due to COVID-19 fears.

Symptoms include:

  • A lump (nodule) that can be felt through the skin on your neck
  • Changes to your voice, including increasing hoarseness
  • Difficulty swallowing
  • Pain in your neck and throat
  • Swollen lymph nodes in your neck

According to Ocesa: “Thyroid cancer can occur at any age, but the risk peaks earlier for women (who are most often in their 40s or 50s when diagnosed) than for men (who are usually in their 60s or 70s). Having a first-degree relative (parent, brother, sister, or child) with thyroid cancer, even without a known inherited syndrome in the family, increases your risk of thyroid cancer.”

The organisation lists three main options for treatment of thyroid cancer: surgical or thyroid hormone treatment and radioactive iodine therapy.

For now, Ramphalla is taking each day as it comes and continues to take his daily thyroid hormone (levothyroxine) pills to replace the missing thyroid hormone.

“It is not wise to ignore medical treatment. I recommend visiting your doctor at least once a month once diagnosed,” he added. – Health-e News