http://www.cancerwise.org/January_2005/display.cfm?id=E12BEB3D-F4DC-4B64-8CBE441BF105CE87&method=displayFull&color=green
Q&A: What to Know About Thyroid Cancer
Thyroid cancer is a rare disease that is successfully treated in the majority of cases.
Answering questions about thyroid cancer is Steven Sherman, M.D., chair, Department of Endocrine Neoplasia and Hormonal Disorders at M. D. Anderson and director of the National Thyroid Cancer Treatment Cooperative Study Group.
What is the thyroid?
A butterfly-shaped gland located in the neck that generates hormones that control the body’s heart rate, blood pressure, temperature and metabolism among many other effects.
How often is thyroid cancer diagnosed?
Thyroid cancer:
Was expected to be diagnosed in 24,000 people in the United States in 2004
Is the eighth most common malignancy diagnosed in women
Currently has 300,000 people in the United States who have finished treatment or are living with the disease (since it is a slow-growing cancer)
How many cases were treated at M. D. Anderson this year?
2,000.
What are the symptoms?
Enlargement on the thyroid gland or neck swelling
Hoarseness
Cough or cough with blood
Difficulty swallowing
No symptoms at all for many people
How treatable is thyroid cancer?
Most thyroid cancers are not fatal. Patients are treated with surgery to remove part or all of the thyroid and sometimes with radiation and chemotherapy. (More details)
A rare form of the disease, called anaplastic carcinoma, which is usually fatal, makes up only 2% to 3% of all thyroid cancers. It is such an aggressive type of cancer that it is difficult to completely eradicate: 90% of patients die within six months. This type clearly requires clinical trials and better therapies.
How often does the cancer return?
Recurrence depends on the stage of the disease. During a 10-year period after diagnosis, chances of recurrence are:
10% with stage I
20% with stage II
30% with stage III
Many recurrences are treatable, particularly if the cancer can be removed with surgery.
What are the four types of thyroid cancer?
Papillary is the most common and least aggressive type of thyroid cancer, and most commonly affects women of child-bearing age. It can be triggered by exposure to radiation, an example being the 1986 Chernobyl nuclear power plant explosion.
Follicular accounts for about 20% of all thyroid cancer cases and has a greater rate of recurrence and metastasis.
Medullary can run in families; however, 80% of thyroid cancer cases are not inherited.
Anaplastic is the rarest and most malignant form of thyroid cancer. It spreads quickly to structures such as the trachea, causing compression and breathing difficulties.
Is tracheotomy part of treatment?
A tracheotomy is not a common way to treat thyroid cancer. We do everything we can to avoid it. A tracheotomy is the surgical procedure in which a hole, called a tracheostomy, is made to the outside lower portion of the neck to allow a patient to breathe.
It is only required if the tumor is:
Compressing the airway
Invading the airway
Paralyzing the vocal chords, causing the airway to be covered
Are there any preventive measures for thyroid cancer?
Not really. However, if a patient tests positive for the medullary thyroid cancer gene, we ask that his or her children be tested. If a child has the gene, we can take the thyroid out before the cancer develops. This is important because more than 90% of people who carry the gene develop the cancer.
One type of medullary cancer (MEN-2B) can develop in the first few months of life. Typically, it is rare to see cancer before age five, so we recommend children have the thyroid removed before age five. They would then take a thyroid hormone pill every day to replace the function of the thyroid.
A patient’s parents also should consider testing. A patient with the medullary cancer gene could have a parent who doesn’t realize he has the gene and cancer. Thyroid cancer can be slow-growing and usually does not cause death, so the parent might have it and not know it.
What is the status of thyroid cancer clinical trials at M. D. Anderson?
In the last five years we have opened three times as many clinical trials compared to the previous 25 years.
In the last year, we also have had an increase, from about 5% to 20%, in the number of patients whose thyroid cancer has spread outside the neck. As a result we have taken the lead in organizing a number of clinical trials.
For information on thyroid cancer clinical trials, call the Department of Endocrine Neoplasia and Hormonal Disorders at (713) 792-2841.
http://www.cancerwise.org/January_2005/display.cfm?id=E12BEB3D-F4DC-4B64-8CBE441BF105CE87&method=displayFull&color=green
_______________________________________________________________
Thyroid Welcome Message (Instructions) Always Available
Anyone can obtain a fresh, new copy of the Thyroid Welcome
message at any time (24/7) by sending an e-mail message
saying only "get Thyroid Welcome" (remove quotes) to our
sleepless robot at <[log in to unmask]>. Its free.
_______________________________________________________________
|