Thyroid Cancer 2017: Gone is One Size Fits All: Surgery, Radioiodine and High Dose Thyroid Hormone is for a few not all.
Even though most thyroid nodules do not contain cancer, the overall number of nodules being detected every year has made thyroid cancer the fastest growing cancer diagnosis in the United States.
In the past, most patients were treated the same way, regardless of the unique attributes of the patient or their cancer; almost everyone had the entire thyroid gland removed, then received radioactive iodine and high doses of thyroid hormone replacement.
Recently, however, there have been significant changes to the way thyroid nodules and cancers are managed, with an emphasis on minimizing the side effects of surgery and radioiodine treatment without compromising the patient’s long-term survival.
As the number of thyroid nodules being detected has increased, a more selective use of biopsy (tissue sampling with a small needle) of these nodules have been recommended. The focus is no longer solely on the size of the nodule to determine when a biopsy should be performed, but also on the appearance of the nodule on ultrasound.
In cases where the biopsy results are uncertain, new molecular (genetic) testing can be performed on the tissue. This allows patients to better understand their risk of cancer and aids in management decisions.
The treatment of well-differentiated thyroid cancer is also becoming more personalized. Whereas all thyroid cancer patients in the past had their entire thyroid glands removed, new guidelines published by the American Thyroid Association in 2016 outline situations in which less extensive surgery may be considered. Additionally, more selective use of radiation therapy after surgery is also advocated.
Read my cancer road maps on my blog and get outside opinions before you rush into surgery with a slow growing thyroid cancer.
Call Matt at 310-393-8860 or firstname.lastname@example.org for details.
Thyroid cancer surgery is elective and not an emergency.There is no rush. Don’t be oushed into an early surgery without the complete evaluation before.
Richard Guttler MD,FACE,ECNU