Thyroid Cancer 101: Looks like Papillary thyroid Cancer but it is Not Cancer.
The Scarlet Letter Big C Tattoo to the Blue Letter b tattoo.
Dr.Guttler’s comments: 31 rules to live by to avoid lifetime thyroid cancer diagnosis.
1.Thyroid Cancer Look-Alike is called Noninvasive follicular thyroid neoplasm with papillary-like nuclear features or NIFTP.
2.Expert international panel of doctors has decided that a type of tumor that was classified as a cancer is not a cancer at all.
3.Downgraded cancer to benign thousands of patients will be spared removal of their thyroid, treatment with radioactive iodine and regular checkups for the rest of their lives.
4. All to protect against a tumor that was never a threat.
5. The change is expected to affect about 10,000 of the nearly 65,000 thyroid cancer patients a year in the United States.
6. The reclassified tumor is a nodule in the thyroid that is completely surrounded by a capsule of fibrous tissue.
7.Its cell nucleus looks like a papillary cancer but the cells have not broken out of their capsule.
8. Surgery to remove the entire thyroid followed by treatment with radioactive iodine is unnecessary and harmful.
8. Once called it “encapsulated follicular variant of papillary thyroid carcinoma.
9.Now call it is “noninvasive follicular thyroid neoplasm with papillary-like nuclear features,” or NIFTP. 10. The word “carcinoma” is gone.
11.If it’s not a cancer, let’s not call it a cancer.
12.Calling lesions cancer when they are not leads to unnecessary and harmful treatment.
14.At major medical centers, many patients with encapsulated thyroid tumors are already being treated less aggressively.
15.That is not the norm in the rest of the country and the rest of the world.
16.But surgeons in the USA still remove the entire thyroid gland and treat with radioactive iodine.
17.What does that mean for you if you are told that a needle biopsy of your thyroid nodule was positive for papillary thyroid cancer?
18.After the surgery if it is the type called follicular variant of papillary thyroid cancer do not go directly to radioiodine therapy.
19.Have the slides reviewed by expert thyroidologist and his pathologists.
20.If it is one of the declassified lesions that is now called benign follicular adenoma with papillary cell features, NIFT-P you are done.
21.If they did just a lobe you do not need the completion lobectomy.
22.With one lobe and no other lesions or thyroiditis you may not need thyroid hormone therapy.
23.However, after a total you will need thyroid replacement for life.
24.You will not have thyroid cancer on your medical records and will not thyroid cancer follow up, cancer markers or neck ultrasounds.
25. Small micro-papillary thyroid cancers that fit the criteria as very very unlikely to “act” like cancers and spread to lymph nodes can be followed by a technique of Active Surveillance.
26.Active Surveillance for Small papillary thyroid microcarcinoma is finally here in the USA.
27. Prior to surgery but after your ultrasound and needle biopsy confirms you have a small papillary microcancer endocrine neck ultrasound images are needed to determine the size and location and blood flow of the microcarcinoma and if there are suspicious lateral neck lymph nodes to biopsy.
Small NIFT-P in a good location for Active Surveillance.
30.This patient is ideal candidate for non-surgical surveillance.
31. The Thyroid Cancer Care Collaborative ( TCCC) is a portable record keeping system that can manage a mobile patient population undergoing active surveillance.
Call me at 310-393-8860 or email to thyroid.manager@proton mail.com BEFORE surgery!
You may not have cancer after all even though the biopsy said you had cancer.
You may not need any surgery if you have a micro-cancer and could be treated by Active Surveillance.
If you don’t want surgery but do not like the fact a cancer is in your neck no matter how “harmless it may be you have to other options. Ablation of the small cancer by ethanol ablation, or radiofrequency ablation.
Both are available at my center after detailed evaluation.