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  • Overview of Thyroid Cancer

    Thyroid cancer is a malignancy that originates in the butterfly shaped gland located in the front of the neck. The thyroid is responsible for the regulation of blood pressure, heart rate, body temperature and weight.

    Types of Thyroid Cancer:

    Papillary thyroid cancer : papillary thyroid cancer is the most common type (70-80%) of thyroid cancers. Papillary thyroid cancer tends to grow slowly and often spreads to lymph nodes in the neck.

    Follicular thyroid cancer : follicular thyroid cancer (10-15% of thyroid cancers) tends to occur in older patients and often spreads to the lymph nodes in the neck. Follicular cancer sometimes also spreads to the lungs and bones.

    Medullary thyroid cancer : medullary thyroid cancer (5-10% of thyroid cancers) often has a familiar genetic origin. A test for a genetic mutation in the RET proto-oncogene can lead to an early diagnosis of medullary thyroid cancer and curative surgery to remove the thyroid.

    Anaplastic thyroid cancer : anaplastic thyroid cancer often presents as advanced and aggressive thyroid cancer that has spread to the lymph nodes of the neck, lungs or bones. Anaplastic thyroid cancer usually requires aggressive treatment, including tracheostomy, surgery, radiation, targeted drugs and chemotherapy.
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  • Treatment for Thyroid Cancer

    Thyroid cancer is commonly treated by one or a combination of treatments, including surgery, hormone treatment, radioactive iodine, targeted therapy, radiation therapy and/or chemotherapy.

    Surgery: surgery for the removal of the tumor and surrounding tissue is the main treatment for most people with thyroid cancers.

    Depending on the size of the nodule, common surgical options include:

    Lobectomy: surgery that removes the gland’s lobe with the cancerous nodule.
    Near-total thyroidectomy: surgery to remove most of the thyroid gland.
    Total thyroidectomy: surgery that removes the entire thyroid gland.

    The discovery of the genetic causes of familial (inherited) medullary thyroid cancer now makes it possible to identify family members carrying the abnormal RET gene and to remove the thyroid to prevent cancer from developing there.

    Hormone treatment: patients who are treated with surgery for papillary, follicular, and medullary thyroid cancers usually require thyroid hormone therapy to replace necessary hormones. Thyroid hormone replacement may include levothyroxine, Levothroid, Levoxyl, Synthroid, Tirosint, or Unithroid.

    Radioactive iodine (RAI) therapy: RAI Therapy (also called I-131) is a type of radiation therapy using radioactive iodine to find and destroy cancer cells that were not removed by surgery for patients with papillary and follicular thyroid cancer.

    Targeted therapies: targeted drugs known as tyrosine kinase inhibitors (TKIs) may help treat thyroid cancer cells with specific gene mutations, such as BRAF and RET/PTC.

    In many papillary thyroid cancers, the cells have changes in the BRAF gene, which help cancer cell growth. Drugs that target cells with BRAF gene changes include vemurafenib (Zelboraf®), dabrafenib, and selumetinib, sorafenib (Nexavar®), sunitinib (Sutent®), pazopanib (Votrient®), cabozantinib (Cometriq), motesanib (AMG 706), axitinib (Inlyta®), and vandetanib (Caprelsa®).

    New targeted drugs for medullary thyroid cancer (MTC) include Vandetanib and cabozantinib.

    Anti-angiogenesis drugs: Anti-angiogenesis drugs work by disrupting the ability of tumors to develop new blood vessels. Some of the TKIs, such as axitinib, motesanib, sunitinib, sorafenib, pazopanib, and cabozantinib, have anti-angiogenic properties. Other anti-angiogenesis drugs being studied for use against thyroid cancer include bevacizumab (Avastin®), lenalidomide (Revlimid®), and lenvatinib.

    Chemotherapy: combination therapy of the chemotherapy drug paclitaxel (Taxol®) with the targeted drug efatutazone may be a treatment option for patients with anaplastic thyroid cancer, as well as combination therapy of chemotherapy and radiation.

    For anaplastic thyroid cancer, clinical trials are studying combination chemotherapy. One study is comparing the results of either carboplatin (Paraplatin) and paclitaxel (Taxol) alone or with an experimental drug, combretastatin A4 phosphate (CA4P, fosbretabulin, Zybrestat).

  • Clinical Trials for Thyroid Cancer

    National Cancer Institute Clinical Trials for Thyroid Cancer
    http://www.cancer.gov/clinicaltrials/search/results?protocolsearchid=10591575

    American Thyroid Association
    http://www.thyroid.org/thyroid-trials/

    Center Watch Thyroid Cancer Trial Resource
    https://www.centerwatch.com/clinical-trials/listings/condition/641/thyroid-cancer

    Thyroid Cancer Clinical Trial Education
    http://www.cancer.net/cancer-types/thyroid-cancer/about-clinical-trials

  • Additional Educational Resources for Thyroid Cancer

    The American Thyroid Association
    www.thyroid.org

    The American Thyroid Association (ATA) is the leading organization focused on thyroid biology and the prevention and treatment of thyroid disorders through excellence and innovation in research, clinical care, education and public health. The ATA Web site features a variety of FAQs and brochures for patients.
    www.thyroid.org/patients/index.html

    National Cancer Institute
    www.cancer.gov

    EndocrineWeb is a comprehensive Web site for thyroid, parathyroid and other endocrine disorders intended for the education of patients and their families. All pages were written by physicians who treat these diseases.
    www.endocrineweb.com

  • Recent News for Thyroid Cancer

    2014 Thyroid Cancer Survivors’ Conference
    http://thyroid.about.com/od/Thyroid-Cancer-Treatments/fl/2014-Thyroid-Cancer-Survivors-Conference.htm

    Struggling Eisai files its thyroid cancer drug lenvatinib in U.S., EU
    August 18, 2014
    http://www.fiercebiotech.com/story/struggling-eisai-files-its-thyroid-cancer-drug-lenvatinib-us-eu/2014-08-18

    Molecular Testing Panel Increases Likelihood of Performing Correct Surgery for Thyroid Cancer Patients
    News Medical
    July31, 2014
    http://www.news-medical.net/news/20140726/Molecular-testing-panel-increases-likelihood-of-performing-correct-surgery-for-thyroid-cancer-patients.aspx

    EMA Approves Eisai’s Lenvatinib for Accelerated Assessment in Radioiodine-Refractory Differentiated Thyroid Cancer
    MarketWatch
    July 31, 2014
    http://www.marketwatch.com/story/ema-approves-eisais-lenvatinib-for-accelerated-assessment-in-radioiodine-refractory-differentiated-thyroid-cancer-2014-07-30

    CEL-SCI expands late-stage head and neck trial
    Nasdaq
    July, 2014
    http://www.nasdaq.com/article/celsci-expands-latestage-head-and-neck-cancer-trial-into-sri-lanka-20140717-00479

    Nexavar Approval Widens
    ThyCa: Thyroid Cancer
    July, 2014
    http://www.thyca.org/news/newsnotes0614#nexavar

  • Support Groups for Thyroid Cancer

    ThyCa: Thyroid Cancer Survivors’ Association, Inc.
    www.thyca.org

    Caring4Cancer
    www.caring4cancer.com/go/thyroid/wellbeing

    Imerman Angels: to connect directly with another survivor or caregiver through an organization that creates personal, one-on-one connections among patients, survivors, and caregivers.
    http://www.imermanangels.org

    Fighting Chance: free counseling service for cancer patients and caregivers.
    http://fightingchance.org/resourceGuide.shtml