Thyroid cancer: a lethal endocrine neoplasm
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), Vol. 115:2; ISSN 0003-4819
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
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-)