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Thyroid Cancer


A butterfly-shaped gland located in the neck, the thyroid plays an important role in a person’s well-being. Like the pituitary gland, it is part of the endocrine system, which regulates specific body functions. The thyroid generates hormones that control the body’s heart rate, blood pressure, temperature and metabolism.

Thyroid cancer develops when cells of the thyroid grow uncontrollably. Fortunately, most thyroid tumors are benign (non-cancerous).

 

Cancer of the thyroid is uncommon, accounting for about 1% of all cancers diagnosed. However, it has become the 8th most commonly diagnosed cancer in women. Fortunately for those with the disease, there’s hope. Early detection, accurate diagnosis, precise treatment and scheduled follow-up can result in a healthy future.

 

Types
 

Types of thyroid cancer include:

  • Papillary thyroid cancer
  • Follicular thyroid cancer
  • Medullary thyroid cancer
  • Anaplastic thyroid cancer

In the early stages of thyroid cancer, no symptoms are present. As the cancer develops, symptoms may include:

  • Lump in the front of the neck
  • Voice changes or hoarseness
  • Swollen lymph nodes
  • Trouble breathing or swallowing
  • Recurring or constant pain in the throat and/or neck

The above symptoms are often due to benign, non-cancerous conditions such as goiter or infection. However, due to their possible severity, it is recommended that anyone with these symptoms see a doctor to be diagnosed as soon as possible.

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Clinical trials
Ensayo de fase 1a/2a, abierto y multicéntrico, para investigar la seguridad, tolerabilidad y actividad antitumoral de dosis repetidas de Sym015, una mezcla de anticuerpos monoclonales dirigida frente al receptor MET, en pacientes con tumores malignos sólidos en fase avanzada
Estudio fase IIIB, prospectivo, randomizado, abierto que evalúa la eficacia y seguridad de Heparina/Edoxaban versus Dalteparina en tromboembolismo venoso asociado con cáncer.
Tumores sólidos. Antiemesis Estudio fase III, multicéntrico, aleatorizado, doble ciego, con control activo para evaluar la seguridad y eficacia de Rolapitant en la prevención de náuseas y vómitos por la quimioterapia (NVIQ) en pacientes que reciben quimioterapia altamente emética (QAE). A phase III, multicenter, randomized, double blind, placebo controlled study of the safety and efficacy of Rolapitant for the treatment of Chemotherapy-induced nausea and vomiting in subjects receiving highly Emetogenic Chemotherapy (HEC)
Ensayo clínico en fase I de determinación de dosis del antiangiogénico multidiana Dovitinib (TKI258) más paclitaxel en pacientes con tumores sólidos.

It is difficult for doctors to determine why one person develops a thyroid cancer and another does not. However, research has provided evidence showing that people with certain risk factors are more likely to develop the disease. The following risk factors have been associated with an increased chance of developing thyroid cancer.

 

Radiation: Individuals exposed to radiation are more likely to develop papillary or follicular thyroid cancer.

 

Family history of medullary thyroid cancer: Medullary thyroid cancermay be passed down from parent to child through a change on the RET gene. Nearly everyone with this changed gene develops the disease, which may occur alone or with other cancers such as multiple endocrine neoplasia (MEN) disorder.

 

Family/personal history of goiters or colon growths: Some people with a family history &/or personal history of multiple thyroid nodules are at greater risk of developing papillary thyroid cancer.

Gender: Females are three times more likely than males to develop thyroid cancer.

 

Age: Thyroid cancer most commonly occurs in people over the age of 45. Anaplastic thyroid cancer mainly occurs in people over the age of 60.

 

Iodine: Scientists are still researching iodine as a potential risk for developing thyroid cancer. Studies have suggested that a diet too low in iodine (a substance found in shellfish, iodized salt) may increase the risk of developing follicular thyroid cancer. Other studies have shown that a diet too rich in iodine may increase the risk of papillary thyroid cancer. More research is necessary to determine whether or not iodine is a risk factor for thyroid cancer.

 

The more risk factors a person has, the greater one’s chance of developing thyroid cancer. However, many people with known risk factors for thyroid cancer do not develop the disease. People with a family history of the disease or those who think they may be at risk should discuss this concern with their doctor. Your doctor may be able to suggest genetic blood tests and other ways to reduce you and your family’s risk of developing thyroid cancer.

 

Screening Guidelines
 

Most early thyroid cancers are discovered when patients ask their doctors about lumps or nodules they have noticed. If you believe you have symptoms such as a lump or other abnormal growth on your neck, it is recommended that you see a doctor as soon as possible to have it examined. Some cancer professionals recommend that people perform a self examination of their necks twice yearly to search for any lumps.

People with a family history of medullary thyroid carcinoma (MTC) with or without type 2 multiple endocrine neoplasia (MEN 2) may be at very high risk for developing this cancer. Most doctors recommend genetic testing for these people when they are young to see if they carry the gene for MTC.

Diagnostic Tests
To better understand the symptoms that may suggest thyroid cancer, your doctor may ask a series of questions regarding personal and family medical history. One or more of the following tests may also be performed:

  • Physical exam: Your doctor feels your thyroid for lumps (nodules). Your doctor also checks your neck and nearby lymph nodes for growths or swelling.
  • Blood tests: Your doctor may check for abnormal levels of thyroid-stimulating hormone (TSH) in the blood. Too much or too little TSH means the thyroid is not working well.
  • Ultrasound
  • Thyroid scan
  • Biopsy: Biopsy is the only sure way to diagnose thyroid cancer

Staging
 

Staging of thyroid cancer consists of analyzing the size of the nodule, whether the cancer has spread, and if so, to what other parts of the body. Thyroid cancer spreads most often to the lymph nodes, lungs, and bones. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of cancer cells and the same name as the original cancer. Doctors call the new tumor "distant" or metastatic disease.

 

Staging may involve one or more of these tests:

  • Ultrasound
  • CT scan
  • MRI
  • Chest X-ray
  • Whole body scan

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis, but you will have time to talk with your doctor about treatment choices and get a second opinion.

The choice of treatment depends on:

  • Type of thyroid cancer (papillary, follicular, medullary, or anaplastic)
  • Size of the nodule
  • Patient’s age
  • Stage of cancer

Surgery
 

Most people with thyroid cancer have surgery. The surgeon may remove all or part of the thyroid. The following are possible types of surgeries to treat thyroid cancer:

 

Total thyroidectomy: Complete removal of the entire thyroid through an incision in the neck.

 

Lobectomy: Some people with follicular or papillary thyroid cancermay have only part of the thyroid removed. The surgeon removes one lobe and the isthmus. Some people who have a lobectomy later have a second surgery to remove the rest of the thyroid. 

 

Less often, the remaining thyroid tissue is destroyed by radioactive iodine therapy.

Thyroid Hormone Treatment -
Radioactive Iodine Therapy -
External Radiation Therapy -
Chemotherapy -