Are doctors treating more thyroid cancer patients than necessary?

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Are doctors treating more thyroid cancer patients than necessary?

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PHILADELPHIA -- Nearly a million Americans live with thyroid cancer and doctors will diagnose more than 50,000 new cases this year. Fortunately, the survival rate for this kind of cancer is one of the best. Five years after diagnosis, more than 98 percent of patients are survivors.

Now a team of researchers led by Alliric Willis, MD, a thyroid surgeon in the Department of Surgery in the Sidney Kimmel Medical College at Thomas Jefferson University and researcher with the Sidney Kimmel Cancer Center - Jefferson Health, finds nearly a quarter of low-risk thyroid cancer patients receive more treatment than necessary. The practice carries potential long-term risk to the patient and added financial costs. The discovery could help to shift how doctors treat thyroid cancer patients.

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"Just as a patient can be at risk of under treatment, a patient can be at risk of over treatment," says Dr. Willis, who published the work in the journal Surgical Oncology. "Our research really shines light on the fact that we are not treating all patients the same."

The thyroid is a butterfly-shaped gland that sits over the airway in the neck. The gland makes hormones that help to control heart rate, blood pressure, body temperature and how the body uses energy. When cells grow out of control in the thyroid, cancer develops.

Typical treatment for thyroid cancers that have not spread to other parts of the body begins with surgical removal of the gland. After completing surgery, patients can then go on to receive a second therapy known as radioactive iodine ablation. Radioactive iodine ablation is therapy taken as a pill. Because iodine is preferentially taken up by the thyroid gland, which relies on iodine to produce hormones, the radiation dose becomes concentrated there. The high amount of radioactivity in the iodine kills off any lingering cancer cells. Historically, patients have had fantastic results with radioactive iodine ablation treatment, Dr. Willis says. But the therapy does not come without costs.

Experts estimate the financial cost of radioactive iodine ablation exceeds $9 million dollars per year across the country. Additionally, for several days to weeks after surgery, patients who receive the radioactive iodine treatment must stay away from small children and pets. "They're virtually in isolation because the radioactivity will be on their clothing and on their sheets," Dr. Willis says. The dose of radioactivity in the treatment is so high that airport security has picked up radioactivity from patients as well as their spouses.
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