Thyroid Cancer 101: Why with thyroid cancer awareness week you should not get thyroid cancer screening.
Dr.Guttler’s comments on this thyroid cancer awareness week article.
1.Thyroid cancer has actually seen an increase in frequency of about 4% every year throughout the last 10 years.
2. The increase in thyroid cancer detection is likely due to more sophisticated imaging techniques.
3. If you have no risk factors Do Not Get a screening thyroid ultrasound.
4. New approaches to thyroid cancer can save you a surgery and radiation therapy for certain low risk or small thyroid cancers.
5. 2000 patients die of thyroid cancer a year but most live a normal life and only the aggressive cancers have the possible bad outcome.
4. Radiation and family history of first degree relative with thyroid cancer are major risk factors which requires cast finding with a thyroid ultrasound looking for nodules.
5. There are no blood tests for thyroid cancer as it is a structural disease only picked up by examination or ultrasound.
6. With 500,000 biopsies a year in the USA and over 100,000 indeterminate results leading to 50,000 operations on benign nodules it is important you do not have one an screening thyroid ultrasound without a risk factor history. This leads to unnecessary biopsy and possible unnecessary surgery.
7. I am sorry but these awareness week promotions for different diseases can result in patients being scared about thyroid cancer when the have no risk factors and want an ultrasound to be sure they are OK.
8. With just 5 % of all patients with thyroid nodules have thyroid cancer, we should not be encouraging patients to screen for thyroid cancer without risk factors by thyroid cancer week promotion by the national cancer societies.
9. Over 10,000 cases of thyroid cancer a year are now going to be downgraded to benign. Follicular variant of papillary cancer without invasion is now call non-invasive follicular tumor with papillary looking cells or NIFT-P.
10. Finally small micro-papillary thyroid cancer <1.5 cm without lymph node or capsule invasion can be treated without immediate surgery and followed for years looking for a small increase in size. If there is no change they may never have surgery. This is called Active Surveillance.
11. Best advice is to stay away from any physician recommending a screening ultrasound.
12. If you are told you need surgery for an indeterminate thyroid biopsy get an out of network opinion and molecular marker tests before you consider surgery.
13. All patients with a diagnosis of thyroid cancer need a expert out of network second opinion before even considering surgery. Thyroid cancer is not an emergency needed rapid surgery. You have time to get opinions.
14. Alternative therapy is available for small thyroid cancers in the center of the thyroid lobe. Ethanol and radiofrequency have been used to ablate the cancer in the lobe without causing the need for surgery or lifetime thyroid hormone therapy.
Call me at 310-393-8860 or email to firstname.lastname@example.org for details about a second opinion consultation.
Richard Guttler MD,FACE,ECNU
Clinical Thyroid and Interventional Thyroidologist
National Thyroid Cancer Awareness Month
Given recent innovation in cancer research and public awareness, most cancers are declining in frequency. Unfortunately, thyroid cancer is not following this trend. Thyroid cancer has actually seen an increase in frequency of about 4% every year throughout the last 10 years. In addition, this increase is most significant in the United States. Part of the increase in thyroid cancer detection is likely due to more sophisticated imaging techniques, but there is speculation of other changes, including increases in radiation and changes in diet. For this reason, it is important to bring awareness to thyroid cancer, its risk factors and the path towards improvement.
Thyroid cancer is a devastating disease with interesting idiosyncrasies which are not yet fully understood. It is estimated that nearly 54,000 people will be diagnosed with thyroid cancer in the U.S. this year. It is likely that over 2,000 people will die from the disease. Women are three times more likely to develop thyroid cancer, but men are more likely to die from the disease upon developing it. Thyroid cancer is the most common cancer in women ages 20 to 34. More information is needed to better understand these statistics, but it is clear that young women need to be aware of their risk for this disease.
There are various risk factors for thyroid cancer which converge on two major themes. The first is iodine. Iodine is necessary for thyroid hormone production and it appears that a deficiency in this element does increase risk of developing cancer. Simultaneously, an excess has been shown to negatively impact thyroid function and lead to cancer. Finding the appropriate balance is important. The second major risk factor is radiation. Radiation from previous cancer treatment, as well as nuclear radiation, is strongly associated with thyroid cancer risk. Breast and colon cancer both too increase thyroid cancer risk. Family history of thyroid cancer is an additional risk factor.
Thyroid cancer produces many symptoms, such as swelling or lumps in the lower front of the neck, pain in the neck and sometimes moving up to the ears, difficulty breathing or swallowing, and a constant cough not due to a viral or bacterial infection. If any of these symptoms appear it is critical to go to a medical professional for a Neck Check or other screening. Regardless of symptoms, always ask your medical professional for a Neck Check during routine visits so they can detect a thyroid nodule if present.
Thyroid cancer currently has many promising immunotherapy-based treatments on the horizon. This is in response to new research which has exposed the genetic underpinnings of the disease. Many researchers are hopeful that major breakthroughs in thyroid cancer treatment will come in the near future. Increasing funding into this research will help the possibility for better treatment become a reality.