Active Thyroid Cancer Surveillance AS 101: How to keep your thyroid without surgery for micro-papillary cancers.
A study from Korea.
Oh et al
Thyroid 28(12) 2018 1587
- Tumor volume is a better index or growth then linear size increase.
- 370 patients had AS for micro-papillary cancer.
- 16% of 370 patients had delayed surgery.
- 38% of 60 patients due to due to anxiety of cancer in the neck.
- 33% of 60 had delayed surgery due to increased tumor size.
- 9 % of 60 had surgery due to appearance of tumor lymph nodes.
- 33% of 60 of the patients who had surgery had lymph node metastasis.
- The majority had surgery due to fear and anxiety of cancer.
- Smaller % due to tumor volume growth or lymph node metastatic disease.
What did we learn? Active surveillance is a good way to go with micro papillary cancer and most of the 370 patients still have not had surgery. This is an important improvement from old ways of surgery for all and radioiodine therapy. Bravo to the Japanese physicians who first reported watching this small cancers.
Before going to surgery with a very small papillary thyroid cancer get a second opinion on possible avoidance of immediate surgery and use active surveillance. If you are one of the anxious ones about continuing AS or the tumor grows slightly you can have a delayed surgery. However, with only 16% having surgery out of 370 patients you still have a good chance to avoid surgery.
The anxiety group have another alternative.Two minimal invasive treatments have ablated micro-papillary cancers without surgery. Ethanol PEI or radiofrequency RFA ablation.
Call me for an opinion before you have the surgery.310-393-8860 or firstname.lastname@example.org.