When it comes to treating thyroid cancer, less can be more.
The adage certainly proved true for Lisa Anderson. After the mother of one was diagnosed with papillary thyroid cancer, doctors at Huntsman Cancer Institute assessed her risk to decide which treatment would be most effective for her.
Jason Hunt, MD, a surgical oncologist at Huntsman Cancer Institute, says this approach to treating thyroid cancer is the product of a decade’s worth of evolution. Before, doctors treated all thyroid cancers aggressively. They removed the entire thyroid gland and used radioactive iodine to destroy any remaining thyroid cells.
“Sometimes such treatments are warranted,” says Dr. Hunt, “but evidence collected over the years suggests that they’re often excessive.”
Patients who have their thyroids removed need to take thyroid hormone replacement medicines for the rest of their lives. They’re also at increased risk for calcium deficiency, anxiety, depression, and muscle cramps and spasms. Radioactive iodine can lead to reduced function of the salivary glands, and it increases the risk of developing leukemia later in life.
Lisa says she was scared after her diagnosis, but she became less afraid as she learned that her thyroid cancer was very slow-growing and not too aggressive. “Based on what Dr. Hunt and my endocrinologist said, I felt confident relying on surgery followed by yearly screenings,” she said.
The risk level from Lisa’s cancer clearly indicated she did not need radioactive iodine treatment, but it’s not always easy to tell. For many patients, the level of threat is less clear, and the best treatment plan is less obvious.
Dr. Hunt and other specialists hope to create a model for assessing the risks that an individual’s thyroid cancer poses to the patient. It would consider factors such as the cancer’s precise location in the thyroid, the type of thyroid cancer, and genetic markers. With a risk stratification model such as this, doctors could more accurately identify the risks for each patient and recommend appropriate treatment plans.
“Currently, less than 10 percent of thyroid cancer patients get aggressive treatment,” says Dr. Hunt. “An effective model of risk stratification could reduce that number further.”
For now, Lisa is pleased that her diagnosis and the treatment she’s received haven’t completely turned her life upside down. “I have a few more doctor appointments than I did before, but I was able to heal quickly from the surgery, and I didn't have to miss too much work,” she says. “I'm really grateful that I was able to get back to my regular life and doing fun things with my family.”
When Lisa was diagnosed, her family had a trip to Disneyland planned in just a few months. Thanks to her doctors, Lisa took her trip secure in the knowledge that she’d taken the steps necessary to maintain her health while avoiding the risks of more aggressive treatment than she needed.
Huntsman Cancer Institute (HCI) is a National Cancer Institute (NCI)-Designated Comprehensive Cancer Center, which means it meets the highest standards for cancer research and receives support for its scientific endeavors. HCI is located on the campus of the University of Utah in Salt Lake City and is a part of the University of Utah Health Care system. HCI treats patients with all forms of cancer and operates several high-risk clinics that focus on melanoma and breast, colon, and pancreas cancers, among others. HCI also provides academic and clinical training for future physicians and researchers. For more information about HCI, please visit www.huntsmancancer.org.