New Uchicago Medicine Research Sheds Light On Outcomes As Cases Increase Dramatically
Thyroid cancer survivors report poor quality of life after diagnosis and treatment compared with other patients who are diagnosed with more lethal cancers, according to new research from the University of Chicago Medicine.
The findings, published Dec. 11 in the journal Thyroid, shed light on a rarely studied outcome for a growing group of patients who are expected to soon account for 10 percent of all of American cancer survivors.
Thyroid cancer patients have a nearly 98 percent five-year survival rate, according to the National Cancer Institute. More than 95 percent survive a decade, leading some to call it a “good cancer.” But those successful outcomes mean few thyroid cancer survivorship studies have been conducted.
UChicago Medicine researchers Briseis Aschebrook-Kilfoy, PhD, assistant research professor in epidemiology, and Raymon Grogan, MD, assistant professor of surgery, are trying to address that data gap. Together, they lead the North American Thyroid Cancer Survivorship Study .
For their most recent research, Aschebrook-Kilfoy and Grogan recruited 1,174 thyroid cancer survivors 89.9 percent female with an average age of 48 from across the U.S. and Canada. Participants were recruited through the thyroid cancer clinics at UChicago Chicago Medicine, the clinics of six other universities, as well as through thyroid cancer survivor support groups and social media.
The researchers will continue to track participants to further understand this data.
How Graves Disease Can Shorten Your Life
Graves disease is an autoimmune disorder that causes your thyroid to produce too much hormone. It is relatively commonaffecting about 1 in every 200 Americans, mostly women, who are 5 to 10 times more likely than men to develop it. Yet, it still is often misdiagnosed, because symptoms of overactive thyroid can mimic those of other conditions.
Untreated hyperthyroidism can cause a variety of medical problems, including:
- Irregular heartbeat, which can trigger blood clots, strokes and heart failure
- Thinning, brittle bones and osteoporosis
- Graves ophthalmopathy, an eye disease which can cause bulging eyes, double vision, light sensitivity and, in rare instances, vision loss
- Pregnancy problems that can affect both mother and baby
- Impaired cognition and dementia
Cardiovascular diseasewhich contributes to heart attacks, heart failure and strokesis the most common cause of death in patients with hyperthyroidism. The longer you have excess thyroid hormones circulating in your body, the greater the likelihood of an earlier death. On the other hand, controlling hyperthyroidism early in its course can result in less chance of developing cardiovascular disease and suffering its fatal complications.
In general, if your hyperthyroidism is caught early and you control it well with medication or other options, experts say your Graves disease life expectancy and prognosis is favorable. But detection as well as effective treatment is crucial.
Are There Different Kinds Of Thyroid Cancer
There are 4 main types of thyroid cancer. They are listed below. Your doctor can tell you more about the kind you have.
- Papillary thyroid cancer is the most common kind of thyroid cancer. It may also be called differentiated thyroid cancer. This kind tends to grow very slowly and is most often in only one lobe of the thyroid gland. Even though they grow slowly, papillary cancers often spread to the lymph nodes in the neck.
- Follicular cancer is the next most common type. Its more common in countries where people dont get enough iodine in their diet. These cancers do not tend to spread to lymph nodes, but they can spread to other parts of the body, like the lungs or bones.
- Medullary cancer is a rare type of thyroid cancer. It starts in a group of thyroid cells called C-cells. C-cells make calcitonin, a hormone that helps control the amount of calcium in the blood.
- Anaplastic cancer is a rare type of thyroid cancer. It often spreads quickly into the neck and to other parts of the body, and is very hard to treat.
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Thyroid Cancer: What Women Should Know
The symptoms start slowly. Fatigue is the most common. There might bechanges in hair, nails or skin, and other vague complaints that could becaused by aging, diet, stress or dozens of other factors.
Women in the prime of their lives, busy with work and families, may noteven notice. When a doctor finally diagnoses an underactivethyroiddue to cancer, it often comes as a shock.
Jonathon Russell, M.D., assistant professor ofOtolaryngology Head and Neck Surgeryat The Johns Hopkins Hospital, says, Typicalthyroid cancerpatients are women between the ages of 30 and 60younger than many peoplewould think. Theyre likely to put off getting seen by a doctor and mayblame their symptoms on other causes.
Which Is Better Hypothyroidism Or Hyperthyroidism
Hypothyroidism causes symptoms like slowed metabolism, tiredness, and weight gain. Having an underactive thyroid can decrease or slow down your bodily functions. With hyperthyroidism, you may find yourself with more energy, as opposed to less. You may experience weight loss as opposed to weight gain.
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Despite Current Practice Age Should Not Drive Thyroid Cancer Staging
New data suggest changes to guidelines used to determine patient prognosis
A study from the;Duke Cancer Institute; finds a lack of statistical evidence to support the current practice of treating thyroid cancer patients under age 45 differently from those 45 and older.
The study, published Oct. 31 by the Journal of Clinical Oncology, found that in nearly 32,000 cases of papillary thyroid cancer, there was no specific age at which patients prognoses changed so significantly as to require age-based standards.
The data suggest doctors should evaluate patients of all ages using the same standards, including tumor size and lymph node involvement, to determine the stage and prognosis of the disease, said senior author;Julie Ann Sosa, M.D., an endocrine surgeon and surgical oncologist at Duke.
The findings challenge current thyroid cancer staging guidelines from the American Joint Committee on Cancer , as well as revised AJCC guidelines that were published this month and take effect in January.
The bottom line is that a staging system based on age may not be the optimal way to assess a patients prognosis and guide their treatment, said Sosa, who herself served on the AJCC panel to draft new guidelines, which convened before the new data were available.
Rather, survival rates decreased gradually as patients got older, the researchers found, using a statistical model that accounted for factors including overall patient health and treatment received.
What About Other Treatments That I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
Stage 5: Progression To Other Autoimmune Disorders
Having Hashimotos puts a person at greater risk for developing another autoimmune condition like celiac disease, psoriasis, Sjogrens, rheumatoid arthritis, lupus, multiple sclerosis, and many others
This is a progression of the autoimmune response as the immune system continues to be imbalanced, it may find additional glands and body tissues to attack, such as the small intestine in celiac disease, saliva and tear glands in Sjogrens, and the joints in rheumatoid arthritis.
At this stage, the person will have been likely treated with thyroid medications, so if they are receiving ideal treatment, their TSH, Free T3, and Free T4 numbers should be in a good range.
But, unfortunately, thyroid medications and removing the thyroid gland do nothing to stop the disease progression.
If a person is not well controlled with medications, has an enlarged thyroid gland, out of control antibodies, Graves disease, thyroid nodules, or thyroid cancer, or is not able to have balanced thyroid hormones as they swing from hyper/hypothyroidism, some doctors may recommend surgical removal of the thyroid gland.
Removing the thyroid gland will eliminate thyroid antibodies, but unfortunately, will not stop the autoimmune progression.
Additionally, people who have had their thyroid glands removed may suffer adverse reactions from these procedures and will need to take thyroid medications for the rest of their lives.
The 5 Stages Of Hashimotos Thyroiditis
Medically reviewed and written by Izabella Wentz, PharmD, FASCP on August 6, 2020
Did you know that most cases of thyroid disease are autoimmune in nature? Hashimotos thyroiditis is an autoimmune condition that happens to affect the thyroid gland. This means that our immune system recognizes the thyroid gland as a foreign invader and begins to attack it, eventually leading to the destruction of our thyroid tissue. When this destruction goes on long enough, the person will lose their ability to produce thyroid hormone.
Hashimotos is a progressive autoimmune condition that results in the destruction of the thyroid gland and leads to hypothyroidism and in some cases, to other types of autoimmune conditions as well.
The condition may take many years to develop and is thought to be triggered by damage to the thyroid gland. This results in immune cells congregating in the thyroid gland, and eventually losing their ability to differentiate the thyroid gland from a foreign invader .
Hashimotos is not usually discovered until it has progressed to the advanced stages, where there is significant damage to the thyroid gland.
In this article, Id like to start at the beginning and walk through the stages of Hashimotos. Ill cover:
- How Hashimotos is diagnosed
- The 5 stages of Hashimotos
- Reversing the condition
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What Happened To The Thyroid
There are several reasons one may not have a thyroid. Individual situations influence the impact of not having a thyroid. Each person and their situation is unique and should be treated with that in mind.
In rare cases, the body may not produce a functional thyroid. This means that a person may be born with a malformed or non-functional thyroid gland or simply not have one at all. Situations such as these fall into the category of congenital hypothyroidism. In the United States tests are conducted on newborns to confirm the presence of a functioning thyroid gland. If doctors recognize that the child has congenital hypothyroidism, the newborn is immediately enrolled in hormone replacement treatment. In addition to helping maintain bodily function in adults, optimizing thyroid hormones in children helps combat inhibited growth, lethargy, and delayed mental and physical development.
Another reason one may not have a thyroid is that it was surgically removed via thyroidectomy. This procedure consists of removing most or all the thyroid. Such an action can result in one experiencing a severe shift in symptoms relating to hypothyroidism. There are several reasons one may have their thyroid removed.
What Will Happen After Treatment
Most people do very well after treatment, but you may need follow-up care for the rest of your life. This is because most thyroid cancers grow slowly and can come back even 10 to 20 years after treatment. Your cancer care team will tell you what tests you need and how often they should be done.
Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back. At first, your visits may be every 3 to 6 months. Then, the longer youre cancer-free, the less often the visits are needed.;
Sometimes treatments may not cure your cancer. You many need to keep getting treatment and care. From time to time tests will be done to see how your treatment is working.;
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life.
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Ask Your Doctor For A Survivorship Care Plan
Talk with your doctor about developing a survivorship care plan for you. This plan might include:
- A suggested schedule for follow-up exams and tests
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- A schedule for other tests you might need, such as early detection tests for other types of cancer, or test to look for long-term health effects from your cancer or its treatment
- Diet and physical activity suggestions that might improve your health, including possibly lowering your chances of the cancer coming back
- Reminders to keep your appointments with your primary care provider , who will monitor your general health care
Latest Diet & Weight Management News
Whether it’s takeout or dining in, lives filled with lots of restaurant fare could turn out to be shorter, new research shows.
The study found that dining out frequently — two or more meals prepared away from home each day — is tied to an increased risk of death from any cause.
One nutritionist who wasn’t involved in the study said the findings come as little surprise.
“Many meals prepared outside of the home are higher in salt, fat, refined sugars and overall energy,” noted Nicole Roach, a cardiac dietitian at Lenox Hill Hospital in New York City. “Intake of these items can pose a risk for increased risk of obesity, diabetes and other chronic diseases.”
The new study was published March 25 in the Journal of the Academy of Nutrition and Dietetics and was led by Dr. Wei Bao, assistant professor of epidemiology at the University of Iowa. He called it “one of the first studies to quantify the association between eating out and mortality.”
America’s love of dining out continues to rise. According to the U.S. Department of Agriculture, by 2011, Americans were already consuming 34% of their daily calories on food that wasn’t made at home. That’s twice the amount reported by the USDA in 1977.
So how is all that restaurant fare affecting Americans’ health?
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How Serious Is My Cancer
If you have thyroid cancer, the doctor will want to find out how far it has spread. This is called staging. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the spread of the cancer through the thyroid gland. It also tells if the cancer has spread to other organs of your body that are close by or far away.
Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside of the thyroid gland. Be sure to ask the doctor about the cancer stage and what it means for you.
What Is A 5
A relative survival rate compares people with the same type and stage of thyroid cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of thyroid cancer is 90%, it means that people who have that cancer are, on average, about 90% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.
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Hypothyroidism Without A Thyroid
Those with hypothyroidism are frequently directed to avoid substances that slow thyroid function. However, if one is without a thyroid there is little need to be concerned about this because it will have no impact on their non-existent thyroid. Therefore, those lacking a thyroid can be more liberal with their diet. However, as with anyone undergoing hormone replacement treatment, it is important not to overconsume soy. When there is an overabundance of soy in ones system, it can negatively impact absorption of thyroid hormone. This can negatively impact the effectiveness of ones thyroid medications.
Without a thyroid, the body cannot produce the critical thyroid hormones T4 and T3. Furthermore, conversion of T4 into T3 primarily takes place in the thyroid . Without a thyroid gland, one will almost assuredly be T3 deficient. For this reason, it is important for hypothyroid patients without a thyroid to be prescribed treatments that include T3 in addition to T4.
Graves Ophthalmopathy: Common Questions & Answers
How can I check my thyroid at home?
If you want to check your thyroid at home, youll need to have a mirror and glass of water at your disposal. Once you have both, take the mirror and hold it in front of you. Focus on the lower, front zone of the next.;
Your thyroid gland will be there, above the collar bone and below the voice box. Tipping your head back while maintaining your focus, drink some water.;
Next, look at your neck as you swallow and see if any bulges or protrusions appear in the swallowing area.;
Youll want to repeat this process various times, making sure to remember that the gland is closer to the collarbone. If you notice any bulges or protrusions, you should see your healthcare provider for a follow-up confirmation.;
Does thyroid eye disease go back to normal?
Thyroid eye disease can resolve within 1-2 years. However, people with this condition may not always restore their normal orbital anatomy . In these cases, skilled orbital surgery is necessary.;
Can thyroid eye disease resolve on its own?
Yes, it can. It lasts approximately 1-2 years. However, you should speak with your physician to explore management and treatment options.;
Thyroid eye disease is a serious condition that can affect daily life vision dramatically. You may need medications to reduce symptoms and close-up monitoring.;
What is the best treatment for Graves disease?
Your doctor may recommend three treatment options, including medications, radioiodine therapy, and thyroid surgery.
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