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Title: Thyroid cancer: a lethal endocrine neoplasm

Abstract

This conference focuses on the controversies about managing thyroid cancer, emphasizing the possibility that the treatment of patients with potentially fatal thyroid cancer may be improved. Although the mortality rate from thyroid cancer is low, it is the highest among cancers affecting the endocrine glands (excluding the ovary). Exposure to radiation during childhood in the 1930s and 1940s increased the incidence of but not the mortality from thyroid cancer, because these tumors are mainly papillary cancers developing in young adults. These rates may change as the exposed cohort ages. Risk factors that increase mortality include older patient age and the growth characteristics of the tumor at diagnosis, the presence of distant metastases, and cell type (for example, the tall-cell variants of papillary cancer, follicular cancer (to be distinguished from the more benign follicular variant of papillary cancer), medullary cancer, and anaplastic cancer). Local metastases in lymph nodes do not seem to increase the risk for death from papillary cancer, but they do increase the risk for death from follicular and medullary cancer. In the latter, mortality is decreased by the early detection and treatment of patients with the familial multiple endocrine neoplasia syndrome 2a. There are excellent tumor markers formore » differentiated cancer of the parafollicular and of the follicular cells. Measuring the calcitonin level allows early diagnosis of familial medullary cancer, whereas measuring the thyroglobulin level, although useful only after total thyroidectomy, allows early recognition of recurrence or metastases of papillary or follicular cancer. Initial surgery, protocols for follow-up, and the use of radioiodine for the ablation of any residual thyroid and the treatment of metastatic cancer are discussed.128 references.« less

Authors:
; ; ; ; ; ; ;
Publication Date:
OSTI Identifier:
5459413
Resource Type:
Journal Article
Journal Name:
Annals of Internal Medicine; (United States)
Additional Journal Information:
Journal Volume: 115:2; Journal ID: ISSN 0003-4819
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; THYROID; NEOPLASMS; BIOLOGICAL MARKERS; CALCITONIN; MAN; METASTASES; MORTALITY; PATIENTS; RADIOINDUCTION; RADIOTHERAPY; REVIEWS; RISK ASSESSMENT; THYROGLOBULIN; ANIMALS; BODY; DISEASES; DOCUMENT TYPES; ENDOCRINE GLANDS; GLANDS; GLOBULINS; HORMONES; MAMMALS; MEDICINE; NUCLEAR MEDICINE; ORGANIC COMPOUNDS; ORGANS; PEPTIDE HORMONES; PEPTIDES; POLYPEPTIDES; PRIMATES; PROTEINS; RADIOLOGY; THERAPY; VERTEBRATES; 560151* - Radiation Effects on Animals- Man; 550603 - Medicine- External Radiation in Therapy- (1980-)

Citation Formats

Robbins, J, Merino, M J, Boice, Jr, J D, Ron, E, Ain, K B, Alexander, H R, Norton, J A, and Reynolds, J. Thyroid cancer: a lethal endocrine neoplasm. United States: N. p., 1991. Web. doi:10.7326/0003-4819-115-2-133.
Robbins, J, Merino, M J, Boice, Jr, J D, Ron, E, Ain, K B, Alexander, H R, Norton, J A, & Reynolds, J. Thyroid cancer: a lethal endocrine neoplasm. United States. https://doi.org/10.7326/0003-4819-115-2-133
Robbins, J, Merino, M J, Boice, Jr, J D, Ron, E, Ain, K B, Alexander, H R, Norton, J A, and Reynolds, J. 1991. "Thyroid cancer: a lethal endocrine neoplasm". United States. https://doi.org/10.7326/0003-4819-115-2-133.
@article{osti_5459413,
title = {Thyroid cancer: a lethal endocrine neoplasm},
author = {Robbins, J and Merino, M J and Boice, Jr, J D and Ron, E and Ain, K B and Alexander, H R and Norton, J A and Reynolds, J},
abstractNote = {This conference focuses on the controversies about managing thyroid cancer, emphasizing the possibility that the treatment of patients with potentially fatal thyroid cancer may be improved. Although the mortality rate from thyroid cancer is low, it is the highest among cancers affecting the endocrine glands (excluding the ovary). Exposure to radiation during childhood in the 1930s and 1940s increased the incidence of but not the mortality from thyroid cancer, because these tumors are mainly papillary cancers developing in young adults. These rates may change as the exposed cohort ages. Risk factors that increase mortality include older patient age and the growth characteristics of the tumor at diagnosis, the presence of distant metastases, and cell type (for example, the tall-cell variants of papillary cancer, follicular cancer (to be distinguished from the more benign follicular variant of papillary cancer), medullary cancer, and anaplastic cancer). Local metastases in lymph nodes do not seem to increase the risk for death from papillary cancer, but they do increase the risk for death from follicular and medullary cancer. In the latter, mortality is decreased by the early detection and treatment of patients with the familial multiple endocrine neoplasia syndrome 2a. There are excellent tumor markers for differentiated cancer of the parafollicular and of the follicular cells. Measuring the calcitonin level allows early diagnosis of familial medullary cancer, whereas measuring the thyroglobulin level, although useful only after total thyroidectomy, allows early recognition of recurrence or metastases of papillary or follicular cancer. Initial surgery, protocols for follow-up, and the use of radioiodine for the ablation of any residual thyroid and the treatment of metastatic cancer are discussed.128 references.},
doi = {10.7326/0003-4819-115-2-133},
url = {https://www.osti.gov/biblio/5459413}, journal = {Annals of Internal Medicine; (United States)},
issn = {0003-4819},
number = ,
volume = 115:2,
place = {United States},
year = {Mon Jul 15 00:00:00 EDT 1991},
month = {Mon Jul 15 00:00:00 EDT 1991}
}