September is Thyroid Cancer Awareness Month

Dr. Gregg Shepard

September is Thyroid cancer awareness month.  While thyroid cancer is still relatively rare in the world, and many people can have successful treatment and a long life with thyroid cancer, it is becoming more common.  There are over 600,000 people in the US with thyroid cancer, and this number has more than tripled over the last few decades.  There are a variety of types of thyroid cancer, and it can affect all types of people.  Anaplastic thyroid cancer is an aggressive and often life threatening type that can be devastating for people such as medical students with families, athletes early in careers, parents or grandparents of young children, or anyone in otherwise good health.  Follicular and papillary thyroid cancer are “differentiated” types that are often discovered before becoming life threatening, and may progress very slowly when discovered.  These differentiated types of thyroid cancer, which can affect either men or women, have features in common with prostate cancer in men.  Both can be diagnosed easily by simple tests and very accurate biopsy methods.  Both are increasing in numbers in this country.  Both are sometimes able to be observed without treatment, and both are sometimes treated with hormone manipulation.  In addition to the better known methods of surgery and chemotherapy treatment, thyroid cancer can be treated with radioactive doses of iodine.  Iodine is an element that is used by the normal thyroid more than in any other body part.  By giving iodine that creates radiation on a microscopic scale, the treatment is concentrated around the cancer.  Advanced or complicated thyroid cancer is best treated by a team of different types of specialists including endocrinology, surgery, and radiation oncology.


Recent research published in the New England Journal of Medicine suggests that thyroid cancer is increasing due to our ability to diagnose smaller, less significant cancers.  Some of these cancers might not need immediate treatment.  Treatment such as surgery could be delayed for a few years, in hopes that it could be done at more convenient time, or perhaps would never be needed.  This is exciting news and will be a good option for a few patients. Doctors are becoming more familiar with this type of approach to smaller and lower risk cancers.  In the last few years, well done research has suggested that some women with breast cancer do not need radiation to help the chance of being cured, and some men with small or less aggressive prostate cancer might not ever need treatment or develop symptoms requiring treatment.  This research should be reviewed by a specialist with any patient considering this approach to decide if that is an option.  People with thyroid cancer, or people who have concerns about thyroid health for any reason should consult promptly with a trusted doctor and sometimes see a specialist.  The research was covered by an NBC article providing a good summary:


Several additional new treatments have become available for advanced and serious thyroid cancers, usually supervised and provided by medical oncologists. These are all considered targeted therapy because they target cancers on a molecular level more specifically.  Lenvatinib and sorafenib are oral medications taken every day that treat follicular or papillary thyroid cancer in patients who previously had radioactive iodine or other treatments.  These treatments shrink or halt the growth of cancer in more than half of cases for more than a year.  They have some side effects that are usually rather mild, and are easy for patients to take at home.  Vandetanib is an oral medication that treats a type called medullary thyroid cancer.  Because of some potentially serious side effects, this medication requires prescribing doctors to have special registration with the FDA, but it can be a lifeline for patients without other options for this deadly type of thyroid cancer.


We have more to learn about thyroid cancer, and advances have been difficult due to the rarity of these types of cancer.  Doctors and nurses treating thyroid cancer are grateful to patients who participate in clinical trials to help discover new treatments.