Thyroid cancer: a lethal endocrine neoplasm

Journal Article · Mon Jul 15 00:00:00 EDT 1991 · Annals of Internal Medicine; (United States)

DOI:https://doi.org/10.7326/0003-4819-115-2-133· OSTI ID:5459413

Robbins, J; Merino, M J; Boice, Jr, J D; Ron, E; Ain, K B; Alexander, H R; Norton, J A; Reynolds, J

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.

• OSTI ID: 5459413
• Journal Information: Annals of Internal Medicine; (United States), Journal Name: Annals of Internal Medicine; (United States) Vol. 115:2; ISSN 0003-4819; ISSN AIMEA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMALS
BIOLOGICAL MARKERS
BODY
CALCITONIN
DISEASES
DOCUMENT TYPES
ENDOCRINE GLANDS
GLANDS
GLOBULINS
HORMONES
MAMMALS
MAN
MEDICINE
METASTASES
MORTALITY
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PEPTIDE HORMONES
PEPTIDES
POLYPEPTIDES
PRIMATES
PROTEINS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
REVIEWS
RISK ASSESSMENT
THERAPY
THYROGLOBULIN
THYROID
VERTEBRATES