Hereditary Cancer Risk Assessment Basics

The goal of most hereditary cancer programs is to provide individual risk assessment that can be incorporated into the patient’s ongoing medical care. The programs usually evaluates families with multiple members with cancer (of the same or different type) for the purpose of assessing the likelihood of a hereditary cancer syndrome. Patients are usually referred by their physician based upon their personal medical and/or family histories.

Often several sessions are required. The initial session includes a review of the patient’s medical history as well as three generational family history. The counselor will review this information within the context of risk for a hereditary cancer syndrome. The benefits, risks and limitations of testing will be described in detail. Often testing options can be offered at an initial visit. However, sometimes it is necessary to collect medical records on affected family members in order to understand the risk that exists for the patient and family. 

Genetic testing will then be offered if appropriate. If the patient decides to proceed with testing a final appointment is scheduled to review the results in person. This visit includes interpretation of the results a discussion of how this information affects medical management and the impact on the extended family. 

Some important factors that would indicate this type of evaluation include:

• Cancer that developed at an early age, usually less than 50.
• Individuals with rare cancer i.e. male breast cancer.
• More than one primary cancer in an affected individual.
• Other physical signs such as colon polyps, moles, desmoids tumors, thyroid nodules, and fatty tumors.
• Different cancers in a family that are known to be genetically related such as breast and ovarian cancers.
• Several generations in the family affected by cancer.
• Clustering of cancers that are known to be genetically related (such as breast and ovarian, colon and uterine and breast and thyroid).
• Breast or ovarian cancer and Ashkenazi (eastern European) Jewish ancestry.
• An identified genetic mutation in the family.
• Known cancer syndrome in the family (for example Lynch syndrome, Cowden syndrome, MEN and others).

FOR MORE INFORMATION PLEASE TALK TO YOUR DOCTOR OR CLICK HERE 

Stage III through IV Medullary Thyroid Cancer Treatment

If you have Stage III or IV medullary thyroid carcinoma (MTC), you will probably be treated with total thyroidectomy. If your cancer has spread to the lymph nodes (tiny bean-shaped organs throughout the body that help fight infections), your doctor might recommend that you have a modified radical or radical neck dissection in addition to the thyroidectomy.

• Total thyroidectomy - The surgeon removes the entire thyroid, and sometimes nearby lymph nodes, through an incision in the neck. In some rare cases, the surgeon also takes out other tissues in the neck that have been affected by the cancer.
• Neck dissection - The surgeon removes lymph nodes in the front and side of the neck that may contain cancer. Neck dissection is sometimes the best way to prevent MTC from spreading or coming back after treatment (recurring).
• Modified radical - The surgeon removes all of the lymph nodes on one side of the neck from the lower edge of the jaw to the upper edge of the collarbone. However, the surgeon does not take out sections of muscle, nerve, and the large veins in the neck.
• Radical -  The surgeon removes all of the lymph nodes on one side of the neck from the lower edge of the jaw to the upper edge of the collarbone. The surgeon also takes out sections of muscle, nerve, and the large veins in the neck.

Regardless of the type of surgery you had, you will be treated with thyroid hormone after surgery.

• Thyroid hormone replacement - These pills can give your body the natural thyroid hormone it can no longer make on its own. The generic name of the hormone is levothyroxine sodium. It is sold as Synthroid^®, Levoxyl^®, Levothroid^®, Unithroid^®, and other brand names.

You will probably be treated with external beam radiation therapy, which uses high-energy x-rays or other types of radiation to kill cancer cells. It is often used in combination with chemotherapy.

• External beam radiation therapy (EBRT) - Radiation from a high-energy x-ray machine (linear accelerator) outside the body is focused on the cancer cells. Most people are treated with EBRT for a few minutes 5 days a week for a few weeks or months as an outpatient.

Your doctor might also recommend chemotherapy, possibly in combination with radiation.  Chemotherapy drugs are used to kill cancer cells. They can sometimes reduce the symptoms of MTC. Although there is no standard chemotherapy or combination of chemotherapy drugs, the following chemotherapies (alone or in combination) are sometimes used to treat MTC:

• Adriamycin^® (doxorubicin) - Doxorubicin hydrochloride belongs to the group of chemotherapy drugs known as anthracycline antibiotics. Doxorubicin stops the growth of cancer cells, which kills them.  This drug is given by a shot in a vein over about 15 minutes. The dose and how often you get the medicine depend on your size, your blood counts, how well your liver works, and the type of cancer being treated. Your blood counts will be checked before each treatment; if they are too low, your treatment will be delayed.
• Adrucil ^® or Efudex ^® (5-fluorouracil or 5-FU) - 5-FU belongs to the group of chemotherapy drugs known as antimetabolites. 5-FU prevents cells from making DNA and RNA, which stops cells from growing. 5-FU is given as a shot in the vein over 5 to 10 minutes or 20 to 60 minutes, or continuously over 22 to 24 hours for 1 to 4 days or longer. The treatment can be repeated every week, every other week, or every 3 weeks. The dose depends on your size and blood counts.
• Blenoxane ^® (bleomycin) - Bleomycin belongs to the group of chemotherapy drugs known as antibiotics. Bleomycin interferes with cell division, which destroys the cells. Bleomycin is given by a shot into a vein, either over 10 minutes or as a continuous infusion for 24 hours, or as a shot into the muscle or under the skin. The dose is based on your size.
• Cytoxan ^® (cyclophosphamide) - Cyclophosphamide belongs to a group of chemotherapy drugs known as alkylating agents. It stops cancer cells from growing, which kills them. Cyclophosphamide can be given by mouth as a pill or liquid, or by a shot into a vein. The dose depends upon your size, your type of cancer, and your blood counts.
• DTIC-Dome ^® (dacarbazine) - Dacarbazine is a chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Dacarbazine is given by a shot in a vein over 20 minutes or longer. The dose and how often you get the medicine depend on your size, your blood counts, and the type of cancer being treated.
• Oncovin ^® (vincristine) - Vincristine belongs to the group of chemotherapy drugs known as plant (vinca) alkaloids. It stops cells from dividing, which kills them. Vincristine is given by an injection in a vein over 2 to 5 minutes. The dose and how often you get the medicine depend on your weight, how well your liver is working, and the type of cancer being treated.
• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein over at least 1 hour. Your dose depends upon the type of cancer you have, your size, and how well your kidneys work.

This content has been reviewed and approved by Myo Thant, MD. 

Stage I and II Medullary Thyroid Cancer Treatment

If you have Stage I or II medullary thyroid carcinoma (MTC), you will  be treated with total thyroidectomy. If your cancer has spread to the lymph nodes (tiny bean-shaped organs throughout the body that help fight infections), your doctor might recommend that you have a modified radical or radical neck dissection in addition to the thyroidectomy.

• Total thyroidectomy - The surgeon removes the entire thyroid, and sometimes nearby lymph nodes, through an incision in the neck. In some rare cases, the surgeon also takes out other tissues in the neck that have been affected by the cancer.
• Neck dissection - The surgeon removes lymph nodes in the front and side of the neck that may contain cancer. Neck dissection is sometimes the best way to prevent MTC from spreading or coming back after treatment (recurring).
• Modified radical - The surgeon removes all of the lymph nodes on one side of the neck from the lower edge of the jaw to the upper edge of the collarbone. However, the surgeon does not take out sections of muscle, nerve, and the large veins in the neck.
• Radical -  The surgeon removes all of the lymph nodes on one side of the neck from the lower edge of the jaw to the upper edge of the collarbone. The surgeon also takes out sections of muscle, nerve, and the large veins in the neck.

Regardless of the type of surgery you had, you will be treated with thyroid hormone after surgery. However, if your doctor plans to treat you with radioactive iodine, you might not start taking thyroid hormone until after you finish your radioactive iodine treatments.

• Thyroid hormone replacement - These pills can give your body the natural thyroid hormone it can no longer make on its own. The generic name of the hormone is levothyroxine sodium. It is sold as Synthroid^®, Levoxyl^®, Levothroid^®, Unithroid^®, and other brand names.

Chemotherapy for Thyroid Cancer

Chemotherapy drugs are used to kill cancer cells. These drugs destroy cancer that is still left after surgery, slow the tumor's growth, or reduce symptoms.

Chemotherapy is not usually used to treat thyroid cancer. But certain chemotherapy drugs are useful in combination with external radiation beam therapy for anaplastic thyroid cancers. Chemotherapy is also used sometimes for thyroid cancers that have continued to grow after treatment with radioactive iodine or external beam radiation therapy. Some of the chemotherapy drugs that are used to treat thyroid cancer are listed below.

• Adriamycin^® (doxorubicin) - Doxorubicin hydrochloride belongs to the group of chemotherapy drugs known as anthracycline antibiotics. Doxorubicin stops the growth of cancer cells, which kills them. This drug is given by a shot in a vein over about 15 minutes. The dose and how often you get the medicine depend on your size, your blood counts, how well your liver works, and the type of cancer being treated. Your blood counts will be checked before each treatment; if they are too low, your treatment will be delayed.

• Adrucil ^® or Efudex ^® (5-fluorouracil or 5-FU) - 5-FU belongs to the group of chemotherapy drugs known as antimetabolites. 5-FU prevents cells from making DNA and RNA, which stops cells from growing. 5-FU is given as a shot in the vein over 5 to 10 minutes or 20 to 60 minutes, or continuously over 22 to 24 hours for 1 to 4 days or longer. The treatment can be repeated every week, every other week, or every 3 weeks. The dose depends on your size and blood count.

• Blenoxane ^® (bleomycin) - Bleomycin belongs to the group of chemotherapy drugs known as antibiotics. Bleomycin interferes with cell division, which destroys the cells. Bleomycin is given by a shot into a vein, either over 10 minutes or as a continuous infusion for 24 hours, or as a shot into the muscle or under the skin. The dose is based on your size.

• Cytoxan ^® (cyclophosphamide) - Cyclophosphamide belongs to a group of chemotherapy drugs known as alkylating agents. It stops cancer cells from growing, which kills them. Cyclophosphamide can be given by mouth as a pill or liquid, or by a shot into a vein. The dose depends on your size, your type of cancer, and blood count.

• DTIC-Dome ^® (dacarbazine) - Dacarbazine is a chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Dacarbazine is given by a shot in a vein over 20 minutes or longer. The dose and how often you get the medicine depend on your size, your blood counts, and the type of cancer being treated.

• Oncovin ^® (vincristine) - Vincristine belongs to the group of chemotherapy drugs known as plant (vinca) alkaloids. It stops cells from dividing, which kills them. Vincristine is given by an injection in a vein over 2 to 5 minutes. The dose and how often you get the medicine depend on your weight, how well your liver is working, and the type of cancer being treated.

• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein over at least 1 hour. Your dose depends upon the type of cancer you have, your size, and how well your kidneys work.

• VePesid ^® or Etopophos ^® (etoposide) - Etoposide belongs to the class of chemotherapy drugs known as plant alkaloids. It stops cells from dividing, which kills them. Etoposide can be given by an injection in a vein over 30 to 60 minutes, or at higher doses over 1 to 4 hours. Etoposide can also be given by mouth as a capsule. The dose depends on your size, the type of cancer being treated, and your blood counts.

This content has been reviewed and approved by Myo Thant, MD. 

Medullary Thyroid Cancer Follow Up

Dr. Kurt Frederick, talking with patient Leigh Rhodes

Blood calcitonin monitoring is the most sensitive test to identify persistent recurrent tumor in patients with MTC.  Patients can have loco-regional or distant metastasis as their primary site of recurrence. Ultrasound of the neck by an experienced ultrasonographer is the most sensitive method for identifying residual disease.

• If the plasma calcitonin is not elevated, patients should continue to undergo basal and provocative testing annually for 5 years. 

• Calcitonin levels in the normal range after total thyroidectomy suggest persistent disease. Calcitonin levels greater than 1000 pg/ mL indicate distant metastasis. 

• Chemotherapy plays a limited role in advanced surgically unamenable MTC in clinical trials.

•  Radioiodine may play a role for destroying and residual normal thyroid tissue, and for patients with mixed tumors of follicular and parafollicular cell origin. Its role, however, is still controversial. 

SOURCE: Weill Cornell Medical College

Diagnostic Testing for Thyroid Cancer Basics

The Following Diagnostic Tests and Procedures  that examine the thyroid, neck, and blood are used to detect (find) and diagnose thyroid cancer.

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or swelling in the neck, voice box, and lymph nodes, and anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

• Laryngoscopy: A procedure in which the doctor checks the larynx (voice box) with a mirror or with a laryngoscope. A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing. A thyroid tumor may press on vocal cords. The laryngoscopy is done to see if the vocal cords are moving normally.

• Blood hormone studies: A procedure in which a blood sample is checked to measure the amounts of certain hormones released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. The blood may be checked for abnormal levels of thyroid-stimulating hormone (TSH). TSH is made by the pituitary gland in the brain. It stimulates the release of thyroid hormone and controls how fast follicular thyroid cells grow. The blood may also be checked for high levels of the hormone calcitonin.

• Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as calcium, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

• Radioactive iodine scan (RAI scan): A procedure to find areas in the body where thyroid cancer cells may be dividing quickly. Radioactive iodine (RAI) is used because only thyroid cells take up iodine. A very small amount of RAI is swallowed, travels through the blood, and collects in thyroid tissue and thyroid cancer cells anywhere in the body. Abnormal thyroid cells take up less iodine than normal thyroid tissue. Areas that do not absorb the iodine normally (cold spots) show up lighter in the picture made by the scan. Cold spots can be either benign (not cancer) or malignant, so a biopsy is done to find out if they are cancer.

• Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later. This procedure can show the size of a thyroid tumor and whether it is solid or a fluid-filled cyst. Ultrasound may be used to guide a fine-needle aspiration biopsy.

• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

• Fine-needle aspiration biopsy of the thyroid: The removal of thyroid tissue using a thin needle. The needle is inserted through the skin into the thyroid. Several tissue samples are removed from different parts of the thyroid. A pathologist views the tissue samples under a microscope to look for cancer cells. Because the type of thyroid cancer can be hard to diagnose, patients should ask to have biopsy samples checked by a pathologist who has experience diagnosing thyroid cancer.

• Surgical biopsy: The removal of the thyroid nodule or one lobe of the thyroid during surgery so the cells and tissues can be viewed under a microscope by a pathologist to check for signs of cancer. Because the type of thyroid cancer can be hard to diagnose, patients should ask to have biopsy samples checked by a pathologist who has experience diagnosing thyroid cancer.

MEDICAL REVIEW: 02/12/2012

What Causes Thyroid Cancer ?

 Although scientists have found that thyroid cancer is linked with a number of other conditions (described in  "What are the risk factors for thyroid cancer?"), the exact cause of most thyroid cancers is not yet known. Researchers have made great progress in understanding how certain changes in a person's DNA can cause thyroid cells to become cancerous. 

• DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells function. We usually look like our parents because they are the source of our DNA. However, DNA affects more than how we look. It also can influence our risk for developing certain diseases, including some kinds of cancer.

• Some genes contain instructions for controlling when our cells grow and divide. Certain genes that speed up cell division or cause cells to live longer than they should are called oncogenes. Others that slow down cell division or cause cells to die at the appropriate time are called tumor suppressor genes. Cancers can be caused by DNA changes that turn on oncogenes or turn off tumor suppressor genes.

• People inherit 2 copies of each gene – one from each parent. People can inherit damaged DNA from one or both parents, which accounts for inherited cancers. Most cancers, though, are not inherited. In these cases, a person's DNA is damaged by exposure to something in the environment, like smoking or radiation. Other DNA changes may just be random events that sometimes happen inside a cell, without having an external cause.

Papillary Thyroid Cancer:  Several DNA mutations have been found in some forms of papillary thyroid cancer. Many of these cancers have changes in specific parts of the RET gene. The altered form of this gene, known as the PTC oncogene, is found in about 10% to 30% of papillary thyroid cancers overall, and in a larger percentage of these cancers found in children and/or linked with radiation exposure. These RET mutations usually are acquired during a person's lifetime rather than being inherited. They are present only in cancer cells and are not passed on to the patient's children.

• Many (30% to 70%) papillary thyroid cancers contain a mutation of the BRAF gene. The BRAF mutation is less common in thyroid cancers in children and in those thought to arise from exposure to radiation. Cancers with BRAF changes tend to have more aggressive growth and a greater likelihood of spreading to other parts of the body. 

• Both BRAF and RET/PTC changes are thought to cause cells to grow and divide. It is extremely rare for papillary cancers to have changes in both the BRAF and RET/PTC genes. Some doctors now advise testing papillary cancer samples for these gene mutations, as some studies have suggested they may affect a person's prognosis (outlook). 

• Changes to other genes have also been tied to papillary thyroid cancer, including those in the NTRK1 gene and the METgene.

Follicular Thyroid Cancer:  Acquired changes in the RAS oncogene have a role in causing some follicular thyroid cancers.

Anaplastic Thyroid Cancer:  These cancers tend to have some of the mutations described above and often have changes in the p53 tumor suppressor gene and the CTNNB1 oncogene as well.

Medullary Thyroid Cancer:  People who have medullary thyroid carcinoma (MTC) have mutations in different parts of the RET gene compared with papillary carcinoma patients. Nearly all patients with the inherited form of MTC and about 1 of every 10 with the sporadic (non-inherited) form of MTC have a mutation in the RET gene.

• Most patients with sporadic MTC have acquired mutations present only in their cancer cells. Those with familial MTC and MEN 2 inherit the RET mutation from a parent. These mutations are present in every cell of the patient's body and can be detected by testing the DNA of blood cells.

• In people with inherited mutations of RET, one RET gene is usually normal and one is mutated. Because every person has 2RET genes but passes only one of them to a child (the child's other RET gene comes from the other parent), the odds that a person with familial MTC will pass a mutated gene on to a child are 1 in 2 (or 50%).

Last Medical Review: 06/29/2011

Last Revised: 01/20/2012

Supporting a Loved One with Advanced Medullary Thyroid Cancer

The Voices of Advanced Medullary Thyroid Cancer: Perspectives on supporting a loved one with advanced MTC

Faces of Thyroid Cancer: Lucy Advanced Medullary Thyroid Cancer

Stevie JoEllie's Cancer Care Fund is seeking guest bloggers and videographers that would like to participate in our Faces of Thyroid Cancer Series. Share your story and help us raise thyroid cancer awareness, dyspel myths and save lives. You dont have to have a professional video or be a professional author just a willingness to share your story honestly and help raise thyroid cancer awareness in our global cybercommunity.

For more information on this project email info@sjccfthynet.org

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Faces of Thyroid Cancer: Jean Advanced Medullary Thyroid Cancer

Faces of Thyroid Cancer Series: Voices of Advanced Medullary Thyroid Cancer -Jean's Story

Stevie JoEllie's Cancer Care Fund is seeking guest bloggers and videographers that would  like to participate in our Faces of Thyroid Cancer Series.  Share your story and help us raise thyroid cancer awareness, dyspel myths and save lives. You dont have to have a professional video or be a professional author just a willingness to share your story honestly and help raise thyroid cancer awareness in our global cybercommunity.

For more information on this project email info@sjccfthynet.org

Support Our Programs and Services 

Donate $10 USD today: THANK YOU!

PET Scans May Allow Early Prediction of Response to Targeted Therapy of Thyroid Cancer

Reston, Va. -- Positron emission tomography (PET) can image metabolic changes following treatment with the protein kinase inhibitor vandetanib, helping to define the therapy response or the effectiveness of the therapeutic agent, according to research published in the February issue of The Journal of Nuclear Medicine. Currently being tested in clinical trials, vandetanib inhibits the function of the RET (rearranged-during-transfection protein) proto-oncogene and other protein kinases involved in the development and progression of cancer.

"For the most part, clinical trials have been measuring the effectiveness of vandetanib by changes in tumor size. Based on the activating effects of mutated RET and other protein kinases on numerous intracellular metabolic pathways, we hypothesized that PET imaging could play a role in the early evaluation of response to vandetanib," said Martin A. Walter, MD, lead author of the study "Metabolic Imaging Allows Early Prediction of Response to Vandetanib."

The study examined the usefulness of metabolic imaging to determine response to vandetanib in three ways. First, medullary thyroid cancer cells were used to create an in vitro model. After cultivation, the cells were treated with vandetanib, and changes in the metabolic profile of the cells were successfully monitored by transcriptional profiling and by radiotracer uptake studies.

Using the same untreated cells, the researchers then created an in vivo model by injecting mice with the cancerous cells and treating them with vandetanib. Small animal PET/computed tomography (CT) imaging was performed and was found to reproduce the in vitro findings of metabolic activity after three days.

Finally, a 43-year old patient with biopsy-proven metastasized medullary thyroid cancer was treated with vandetanib. PET scans taken at 12 and 24 weeks after treatment were able to detect metabolic response to vandetanib, consistent with the in vitro and in vivo samples.

"With the increasing number of available treatment options, careful patient selection is necessary to ensure targeted therapy is administered to those most likely to gain clinical benefit," said Walter. "The identification of markers of treatment efficacy is a key factor for the success of these novel treatment approaches."

"Furthermore," he continued, "relating in-vivo PET imaging metabolic data with transcriptional profiling data using cluster analysis is an innovative concept that allows much potential in the field of molecular imaging."

SOURCE: Society of Nuclear Medicine

Vandetanib may be effective treatment for medullary thyroid cancer patients

A recent phase three trial conducted by the National Cancer Institute (NCI) suggests that vandetanib, a once-daily selective oral inhibitor of vascular endothelial growth - which describes the lining of cells, extended progression-free survival (PFS) in patients with medullary thyroid cancer, Endocrine Today reports.

The research, which was presented at the International Thyroid Congress, focuses on a study which included 331 adults with medullary thyroid cancer. Researchers assigned all patients to vandetanib or placebo between December 2006 and November 2007.

Two-year follow-up results showed that 37 percent of the patients had progression and 15 percent had died. Median PFS was 19.3 months in the placebo group, and it had not yet been found in the vandetanib group.

"The primary endpoint was met - vandetanib demonstrated a statistically significant advantage in progression-free survival versus placebo," wrote Samuel A. Wells, of the medical oncology branch of the NCI.  The researchers said overall survival data were "immature" at the time of data cutoff at 24 months.

A final survival analysis will take place after 59 percent of patients have died.  The American Cancer Society estimates that 44,670 new cases of thyroid cancer will be diagnosed nationwide this year.

THYROID CANCER BASICS

What is cancer of the thyroid? 

Cancer of the thyroid is a disease in which cancer (malignant) cells are found in the tissues of the thyroid gland. The thyroid gland is at the base of the throat. It has two lobes, one on the right side and one on the left. The thyroid gland makes important hormones that help the body function normally. It is one of the few cancers that has increased in newly diagnosed incidence rates over the past decade worldwide.

Fast Facts

• There are expected to be 11% more new cases in 2008 than in 2007 in the United States. 
• The American Cancer Society estimates that there will be about 37,340 new cases of thyroid cancer in the U.S. in 2008. 
• Of newly diagnosed thyroid cancer cases, about 28,410 will occur in women and about 8,930 will occur in men. 
• About 1,590 people (910 women and 680 men) will die of thyroid cancer in 2008.
• Thyroid Cancer is three times more more common in women than in men regardless of age or race. 
• Most patients newly diagnosed with thyroid cancer the past decade are between 25 and 50 years old. 
• Many patients, especially in the early stages of thyroid cancer, do not experience symptoms. 
• As thyroid cancer develops, symptoms can include a lump or nodule in the front of the neck, hoarseness or difficulty peaking, swollen lymph nodes, difficulty swallowing or breathing, and pain in the throat or neck.
• People who have been exposed to large amounts of radiation, or who have had radiation treatment for medical problems in the head and neck such as childhood cancer have a higher chance of getting thyroid cancer later in life. In many cases "secondary" thyroid cancer may not occur until 20 years or longer after the initial radiation treatment. 

You should see a  doctor immediately if there is a lump or swelling in the front of the neck or in any other parts of the neck. Your doctor should  "feel" and examine your neck and thyroid for nodules, tumors or "lumps"during your annual physical examination.

If a nodule or abnormality is found The doctor may order blood tests and special scans to see whether a lump in the thyroid is making too many or too little hormones. If your doctor forgets to check your neck, you can gently remind him that you would like him or her to please check your neck for abnormalities "just in case".

Thyroid Cancer is the most common endocrine cancer worldwide

Depending on your physical test results, neck check and individual risk factors your doctor may want to take a small amount of tissue from the thyroid. This is called a biopsy. To do this, a small needle is inserted into the thyroid at the base of the throat and some tissue is drawn out. The tissue is then looked at under a microscope to see whether it contains cancer.

There are four main types of cancer of the thyroid (based on how the cancer cells look under a microscope): papillary, follicular, medullary, and anaplastic.

The individual chance of  recovery or survival (prognosis) depends on the type of thyroid cancer, whether it is just in the thyroid or has spread to other parts of the body (stage), and the patient's age and overall health. Some types of thyroid cancer grow much faster than others but overall most thyroid cancers have a good cure and survival rate if diagnosed early and treated properly.

Thyroid Cancer Genetics: Could it be inherited?

The genes in our cells carry the hereditary information from our parents. An abnormal gene has been found in patients with some forms of thyroid cancer such as medullary thyroid cancer. If medullary thyroid cancer is found, the patient may have been born with a certain abnormal gene which may have led to thyroid  cancer. Family members may have also inherited this abnormal gene.

Tests have been developed to determine who has the genetic defect long before any cancer appears therefore, it is important that the patient and his or her family members (children, grandchildren, parents, brothers, sisters, nieces and nephews) see a doctor about tests that will show if the abnormal gene is present.

These tests are confidential and can help the doctor help patients. Family members, including young children, who don't have cancer, but do have this abnormal gene, may reduce the chance of developing medullary thyroid cancer by having surgery to safely remove the thyroid gland (thyroidectomy).

Remember to talk to your doctor about your personal risk factors such as a family history of thyroid cancers.