Latest Advances in Thyroid Cancer Treatment


Sarah Lewis, PharmD

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Endocrinologist’s appointment

It’s an amazing time for cancer research. Cancer is still a scary word, but researchers have made tremendous progress in understanding and treating it. And this includes progress in treating thyroid cancer.

Thyroid cancer usually doesn’t cause signs or symptoms early in the disease. Most often, doctors find a lump during a physical exam or symptoms appear once the tumor is large. Symptoms can include hoarseness, a lump in the neck, and trouble breathing or swallowing. The good news is treatment for thyroid cancer is successful in most cases. And advances in thyroid cancer treatment have resulted in higher cure rates, lower recurrence rates, and longer survival.

New surgical techniques help reduce scarring.

Surgery to remove part or all of the thyroid gland is a common treatment for thyroid cancer. It’s also one of the most effective treatments.

Until recently, surgery (thyroidectomy) for thyroid cancer resulted in a scar on the neck. This is cosmetically bothersome for some people. Surgeons have developed new techniques that reduce or eliminate scarring on the neck and shorten recovery times. This includes endoscopic surgery that leaves smaller scars. There is also a new robotic-assisted surgery that reaches the thyroid gland through an incision in the armpit. This new surgery may not be available at all cancer centers yet. And it’s only right for some people. Talk with your doctor about your options.

Researchers are fine-tuning the use of radioactive iodine.

Radioactive iodine destroys thyroid gland cells, including the cancerous cells. It’s a standard treatment for some types of thyroid cancer.

Researchers have been working to fine-tune the dosing. They are also trying to identify which cancers are more likely to recur or come back after surgery. Using radioactive iodine after surgery may decrease the risk of recurrence for these cancers. On the other hand, some cancers have a very low risk of recurrence even without radioactive iodine. Identifying these cancers saves people from having to use a treatment they may not need.

New drugs may help radioactive iodine work better.

Researchers are studying drugs that may increase radioactive iodine’s effectiveness. One drug—selumetinib—may boost radioactive iodine’s absorption into the thyroid gland. This would help treat advanced cancers. Another drug for advanced cancer—sunitinib (Sutent)—may help when people take it after radioactive iodine therapy.

Chemotherapy may treat anaplastic thyroid cancer.

Thyroid cancer does not usually respond to chemotherapy. But researchers are looking at its effectiveness in treating a specific type—anaplastic thyroid cancer. Combination chemotherapy with newer drugs may be of value in treating this type of thyroid cancer.

Targeted therapies attack genetic markers in some thyroid cancers.

Targeted therapies work by targeting genetic markers. Some of these new drugs target specific proteins expressed by mutated genes, such as the BRAF gene. Others disrupt new blood vessel growth to the tumor, which cuts off the cancer’s ability to grow. Targeted therapies are useful for cancers with specific DNA mutations. They may also be useful for cancers that stop responding to radioactive iodine.

Genetic testing can prevent an inherited form of thyroid cancer.

Familial medullary thyroid cancer is an inherited form of thyroid cancer. People with this form of thyroid cancer may develop additional non-thyroid cancers. Researchers have identified a gene—the REF gene—that is responsible. Genetic testing can identify family members with the abnormal gene. For these people, doctors can remove the thyroid and prevent the cancer while monitoring closely for other tumors. Thyroid hormone replacement medicines allow people to live normally without a thyroid gland.