Thyroid Cancer Treatments

Over the last 40 years thyroid cancer rates have increased.  The rate of the most common form of thyroid cancer, papillary thyroid cancer, was 4.8 per 100,000 people in the US and 14.9 per 100,000 in 2012.  These cases are more often found today when imaging of the neck or chest is done for other reasons and a mass is found in the thyroid.

A 2017 study followed 291 patients with papillary thyroid cancers of less than 1.5 centimeters.  They received ultrasounds every 6 months for two years rather then surgery and ultrasound yearly thereafter.  The patients on average were followed for 25 months and received 4 follow-up ultrasounds where only 11 (3.8%) of the 291 saw their tumors grow more than 3 millimeters during the study period.  Tumor volume did increase by 50% in 35 patients (12.1%) and decreased in volume by 50% in 19 patients (6.5%).  Those that were younger than 50 had a 5X greater likelihood of tumor growth than those older than 50.  There have been similar results found in Japanese studies.

The traditional treatment for thyroid cancers less than 1 centimeter involved removal of one of the two lobes of the thyroid.  Those greater than 1 centimeter required removal of the entire thyroid, and the patient was then required to take thyroid hormone for the rest of his or her life.

Data tells us that the older patients with small papillary thyroid cancer can postpone surgery and rely on ultrasounds twice a year for a while.  I feel this “wait and see” time may be an excellent time to check with your alternative health care physician and research the advantages of trying to build your immune system. Remember, the immune system is our first and last defense system. If you’re a 70 year old with a papillary thyroid cancer of 1 centimeter, just monitoring the cancer could help you avoid unnecessary surgery.  If you are 70 with a 2 centimeter lesion, surgery to remove the thyroid is appropriate.

If you are a younger patient, this does not always remain true.  A 35 year old with a 1.2 centimeter papillary thyroid cancer, postponing surgery can be risky because of the higher likelihood that the cancer will increase in size.

Even though the rates of thyroid cancer is increasing in our population, it is important for us to continue studies on the most appropriate treatment.  This information has been provided through an article composed by Robert Ashley, M.D., who is an internist and assistant professor of medicine at the University of California, Los Angeles.

Dr Fredda Branyon