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Why Thyroid Cancer Is On The Rise

Thyroid Cancer Rates Triple And Scientists Look For Cause

Why thyroid cancer diagnosis are on the rise

31 March 2017

Thyroid cancer rates are rising faster than any other cancer in the United States, a new study found: Between 1975 and 2013, the number of thyroid cancer cases diagnosed yearly more than tripled.

The numbers have prompted many epidemiologists to caution in recent years that the increase in cases is really just a matter of doctors catching more cases. This includes cases that are slow-growing and that would be unlikely to cause symptoms that affect a person’s life. Doctors refer to the diagnosis of cases like this as the “overdiagnosis” of a condition.

But in the new analysis, scientists argued that the alarming rise isn’t just due to improvements in detecting thyroid cancer.

“While overdiagnosis may be an important component to this observed epidemic, it clearly does not explain the whole story,” said Dr. Julie Sosa, one of the authors of the new study and the chief of endocrine surgery at Duke University in North Carolina.

Sosa, along with epidemiologists at the National Cancer Institute, acknowledged in their new study that better tools from diagnostic ultrasound to fine-needle biopsies have improved doctors’ ability to detect thyroid cancers. But the study, published today in the Journal of the American Medical Association , said that thyroid cancer is a real, growing threat, as shown by the increasing cases of a type of thyroid cancer called advanced stage papillary thyroid cancer, along with a steady rise in deaths from the disease.

What Can Go Wrong

Thyroid conditions fall into three categories: hypothyroidism, hyperthyroidism and autoimmune disorders. The most common form is hypothyroidism, an underactive thyroid, which can lead to weight gain, fatigue and an excessively slow heart rate. Hyperthyroidism is the opposite, an overactive thyroid. However, the gland cant maintain that pace and burns out over time, leading us back to hypothyroidism. As you can guess, mood swings can be a big part of this condition. Autoimmune disorders, such as Hashimotos thyroiditis, can have a similar effect to hyperthyroidism overactivity followed by under activity.

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.

Nuclear Receptor Ligands In Rai Refractory Thyroid Cancer

Retinoids act by binding to the retinoic acid and the retinoid X nuclear receptors, through which they regulate gene transcription by direct interaction with the regulatory regions of a diverse set of genes. Retinoids have key effects on cell differentiation and in development, and are used as cancer therapies. The most notable use of retinoids in cancer is for acute promyelocytic leukemia, more than 95 percent of which are caused by a translocation that juxtaposes the PML gene on chromosome 15 and the RAR gene on chromosome 17. Retinoids induce expression of the type I iodothyronine 5-deiodinase isoenzymes and NIS mRNA in follicular thyroid cancer cell lines. Based on these observations, numerous clinical studies of retinoids in patients with advanced thyroid cancer were initiated, mostly with isotretinoin . About 2040 percent of patients showed some response to isotretinoin therapy, including reduced tumor size and increased RAI uptake. However, more recent reports have shown that few patients had a clinically meaningful response, suggesting that retinoid monotherapy is not effective in RAI-resistant metastatic thyroid cancer.

What Are The Symptoms Of Thyroid Cancer

Incidence of thyroid cancer on the rise

You or your healthcare provider might feel a lump or growth in your neck called a thyroid nodule. Dont panic if you have a thyroid nodule. Most nodules are benign . Only about three out of 20 thyroid nodules turn out to be cancerous .

Other signs of thyroid cancer include:

How Can I Prevent Thyroid Cancer

Many people develop thyroid cancer for no known reason, so prevention isnt really possible. But if you know youre at risk for thyroid cancer, you may be able to take these steps:

  • Preventive surgery: Genetic tests can determine if you carry an altered gene that increases your risk for medullary thyroid cancer or multiple endocrine neoplasia. If you have the faulty gene, you may opt to have preventive surgery to remove your thyroid gland before cancer develops.
  • Potassium iodide: If you were exposed to radiation during a nuclear disaster, such as the 2011 incident at Fukushima, Japan, taking potassium iodide within 24 hours of exposure can lower your risk of eventually getting thyroid cancer. Potassium iodide blocks the thyroid gland from absorbing too much radioiodine. As a result, the gland stays healthy.

Thyroid Cancer: Common In Women

Thyroid disorders are more common in women, probably due to the roles of hormones, which are different in femalesthan in males.

Thyroid nodules, Russell says, affect up to 80 percent of women, but only 5percent to 15 percent of those lumps and bumps are malignant. Bettertesting means thyroid tumors are on the rise, he notes, saying that itsprojected to become the third most common cancer.

Malignant and cancer are scary words, but Russell says that mostthyroid cancer is highly treatable, even when the cancer cells spread tonearby lymph nodes, which occurs frequently.

With thyroid cancer we talk about prognosis in terms of 20-year survivalinstead of five years, as we do with most other cancers. Its usually aslow-moving disease. Theres a 98 to 99 percent survival rate at 20 years,he says.

We treat it almost like a chronic condition where the patient getstreatment and visits her doctor regularly for follow-up.

Why Your Thyroid Hormone Levels May Be Fluctuating

editorial processMedical Review Board

If you have thyroid disease, you may experience some fluctuations in your thyroid hormone levels from time to time. These fluctuations can occur as your thyroid disease progresses, but other factors, such hormonal changes, and medication variations, can alter your thyroid hormone levels as well, producing a variety of symptoms.

Radioiodine Therapy To Treat Thyroid Cancer

Thyroid cancer on the rise
  • Oct 2012

Whether due to improved detection or unknown environmental factors, the incidence of thyroid cancer is on the rise. People are twice as susceptible to this cancer today as they were in 1990. The American Cancer Society estimates that more than 56,000 Americans will be diagnosed with thyroid cancer by the end of the year. Three out of four cases will be in women. A common and successful treatment for thyroid cancer is radioactive iodine , but this therapy is not without its risks and can cause leukemia and impaired fertility. Furthermore, some thyroid cancers are resistant to radioiodine. In this Tri-Point article, a clinical practitioner discusses what factors to consider when selecting patients for radioiodine therapy; a clinical researcher weighs the therapys general benefits and risks; and two basic researchers unveil possible future therapies to fight resistant thyroid cancers.

What Causes Thyroid Cancer

In most cases, the cause of thyroid cancer is unknown. However, certain things can increase your chances of developing the condition.

Risk factors for thyroid cancer include:

  • having a benign thyroid condition
  • having a family history of thyroid cancer
  • having a bowel condition known as familial adenomatous polyposis
  • acromegaly  a rare condition where the body produces too much growth hormone
  • having a previous benign breast condition
  • weight and height

Read more about the causes of thyroid cancer

When And How You Take Your Pill

If you’re taking your thyroid replacement or antithyroid medication at different times each day, you might not be consistent about taking it on an empty stomach as recommended. Food may delay or reduce the drug’s absorption by changing the rate at which it dissolves or by changing the stomach’s acid balance, ultimately affecting your thyroid hormone levels, your symptoms, and your test results.

If you want to ensure the best possible absorption of your medication, take your thyroid medication consistently. Ideally, you should take your thyroid medicine in the morning, on an empty stomach, about one hour before eating breakfast and drinking coffee, or at bedtime .

Also, make sure to wait for at least three to four hours between taking thyroid medication and taking any fiber, calcium, or iron-rich foods or supplements, as they can prevent you from absorbing your full dose of medication.

Ultimately, when it comes to how you take your thyroid hormone drug, consistency is what you should strive for. If you plan to change the way you take your thyroid medication, make sure you clear it with your doctor first. 

Papillary Thyroid Cancer Incidence Trends Stratified By Medicare

Before the early 1990s, the incidence rate of papillary thyroid cancer among persons of Medicare-eligible age was marginally higher than among persons under 65 years old . However, in recent decades, incidence rates have diverged, with Joinpoint regression identifying an inflection point at 1993. In the Medicare-age cohort, papillary thyroid cancer incidence has increased more rapidly than in the population as a whole . In 2009, the incidence in Medicare-age patients was 18.5 per 100,000, 67% higher than the nationwide incidence rate.

In the nonMedicare-age cohort, incidence more closely tracked the overall trend, increasing at an annual percent change of 6.4% between 1993 and 2009, a slower increase than in the population as a whole . In 2009, the incidence in nonMedicare-age patients was 11.6 per 100,000 .

Diagnosis Increasing But Many Questions Left Unanswered

Thyroid Cancer on the Rise

When Rebecca Smith felt a lump on her neck the Friday of Memorial Day weekend in 2013, she spent the next three days being paranoid that it was lymphoma.

When I found out I had papillary thyroid cancer, it was a relief to me, says Smith, who because of her career in healthcare, asked that her name be changed to not draw unnecessary attention to her situation. She admits that the cancer diagnosis was still scary, but she had watched two friends go through papillary thyroid cancer and knew that the prognosis was very good.

Ranking as the fifth leading cancer in women diagnosed in 2014, thyroid cancer has an overall five-year survival rate of 98 percent. About eight out of 10 thyroid cancers are papillary cancers, which are rarely fatal.

In the United States, diagnosis rates for thyroid cancer from 2006 to 2010 increased 5.4 percent in men and 6.5 percent in women, cementing its place as the most rapidly increasing cancer in the country. The American Cancer Society estimated 62,980 people would be diagnosed with thyroid cancer in 2014, and an estimated 1,890 deaths were expected. Of those new cases, three out of four would be women.

Much is still unknown about thyroid cancer including why the diagnosis levels are increasing and why it targets women more than men.

Raymon Grogan, MD, director of the Endocrine Surgery Research Program at the University of Chicago Medical Center calls it a mystery to the medical community. 

Thats not really as clear.

Reclassifying A Thyroid Tumor

Most recently, an international panel of experts reclassified a subtype of papillary thyroid tumorremoving the word carcinoma from its namein an effort to reduce the treatment of these slow-growing, or indolent, tumors.

New cases of the subtype, known as noninvasive encapsulated follicular variant of papillary thyroid carcinoma, or EFVPTC, have increased in recent decades and now make up 10%20% of all thyroid cancers diagnosed in Europe and North America, the panel wrote in JAMA Oncology on April 14. Noting that these tumors have a very low risk of adverse outcome, the panel proposed that they should now be called noninvasive follicular thyroid neoplasm with papillary-like nuclear features, or NIFTP.

The reclassification of these tumors is a timely and appropriate change, commented Kepal N. Patel, M.D., of New York University Langone Medical Center in an accompanying editorial. The new classification could affect the care and treatment of more than 45,000 patients around the world each year, he wrote.

The new classification, Dr. Morris said, is one chapter in the bigger story of trying to reduce the overtreatment of indolent thyroid tumors.

Related Resources

Thyroid Cancer: The Symptoms Causes And Treatments

Thyroid cancer is one of the most common forms of cancer. The thyroid is a small gland in the neck that sits below the larynx and near the trachea. When overactive cells start growing, it causes a malignant tumor that can destroy nearby tissue and metastasis to other parts of the body. In 2020, its estimated that nearly 53,000 Americans will be diagnosed with thyroid cancer. And surprisingly, its easy to overlook symptoms because they can be commonly associated with other conditions.

Recognizing the symptoms of thyroid cancer is the first step towards treatment and recovery. This can also prevent the cancer from spreading and infecting other parts of the body.

Here is what you need to know about thyroid cancer.

Risks And Causes Of Thyroid Cancer

A persons risk of developing thyroid cancer depends on many factors, including age, some non cancerous thyroid conditions and a family history of thyroid cancer. 

We dont know what causes most thyroid cancers. But there are some factors that might increase your risk of developing it.

Having any of these risk factors doesnt mean that you will definitely develop thyroid cancer.

Tests For Thyroid Cancer

Thyroid cancer is fastest-rising cancer in women

Some nodules are more worrisome than others and that will depend on the size and characteristics of the tumor. It is difficult to tell by look and feel if a nodule is cancer. Doctors decide on a course of action based on the results of imaging and blood tests. For instance, if hormones are out-of-whack, it probably isn’t cancer.

Tests performed to diagnose thyroid cancer:

  • Blood tests measuring thyroid stimulating hormone to assess thyroid functioning
  • Diagnostic thyroid ultrasound to measure and determine features of the nodule
  • Radionuclide thyroid scan to assess activity inside the nodules
  • Fine-needle aspiration biopsy to view a sample of the nodule’s tissue under the microscope

The most common type of thyroid cancer is the papillary type , which is also the most responsive to treatment and cure.

Calcitonin: The Thyroid Hormone For Calcium Regulation

Responsible for the metabolism of calcium and phosphorous, calcitonin is produced mostly in the C-cells or the parafollicular cells of the thyroid gland.

Calcitonin is widely known to lower the levels of calcium in the blood. It does so by stopping osteoclast activity in the bone.

This then inhibits the release of calcium and phosphorous in the body.

It also works on the kidney by preventing the reabsorption of these two minerals in the kidney tubules, and instead excretes them into the urine.

Because of calcitonins action on the body, secretion of this hormone is usually brought about by increased levels of calcium in the body.

Likewise, calcitonin secretion is halted if there is a drop-in calcium levels in the body.

Find Out Why This Disease Is On The Rise And How To Spot It Before It’s Too Late

There is a worrisome trend emerging that puts the lives of women at great risk, and you might be staring at it each time you look in the mirror. The number of cases of thyroid cancer has more than doubled since the 1970s and that has a lot of people wondering why. Thyroid cancer is one of those stealth cancers that can grow under the radar, sometimes for decades. For this reason, catching it early is critical.

It’s a wonder that this tiny gland with so much responsibility would fail to announce it is harboring a potentially deadly cancer. The thyroid gland is the body’s engine driver; it manufactures the thyroid hormone that is used to fuel metabolism and oversees the activities of other critical hormones produced elsewhere. When the amount of thyroid hormone is unbalanced too much hormone causes hyperthyroidism, too little, hypothyroidism it can wreak havoc in the body.

The thyroid gland is located just under the skin, splayed like a butterfly across the windpipe, right below the Adam’s apple. About six percent of women and 1% of men with adequate dietary iodine have small bumps of tissue in and about the gland called thyroid nodules. For the most part, thyroid nodules never cause any trouble; they are just benign irregularities. In fact, most people will develop a thyroid nodule by the time they are 60 years old.

And that is why this increase in diagnosis is troubling.

More: 5 Surprising Foods That Can Help Your Thyroid

Not All Thyroidectomy Patients Require Radioiodine

Prospective trials are warranted in these latter patients, to identify those who should receive post-operative radioactive iodine remnant ablation. In the absence of prospective trials, retrospective studies have shown that serum Tg may already be undetectable after total thyroidectomy and before any radioiodine administration, and only 3 percent of such patients had persistent disease on WBS, and all had lymph node metastases. After total thyroidectomy, patients with no lymph node metastases at a prophylactic lymph node dissection or with no evidence of lymph node metastases on neck ultrasonography may not require any radioiodine.14 In these low-risk patients, some questions remain unresolved and, because initial treatment includes several steps that are still not validated, successive prospective randomized trials are needed to answer these questions: What is the optimal protocol for post-operative radioiodine administration? Which low-risk patients should receive radioactive iodine remnant ablation? When should prophylactic neck dissection be performed?

Why The Rise In Thyroid Problems

One big reason aggressive thyroid cancer is on the rise

We dont think much about the thyroid and we really should.

Especially considering that this non-descript little gland located in your neck produces hormones that regulate energy metabolism, control protein synthesis and adjust your bodys sensitivity to other hormones.

With all these critical functions, it makes sense your thyroid should get more attention and care. But, unfortunately, problems seem to be on the rise

According to the American Thyroid Association, nearly 60 million Americans, mostly women, have some type of thyroid problem.  As a result, they may experience anxiety, achiness, weakness, unexplained weight fluctuations and other issues. As you can see, these symptoms are mostly non-specific. They could be caused by any number of conditions, or simply be a part of normal life. However, its important to be alert to thyroid problems, which can increase the risk for heart disease, infertility, depression and other serious conditions.

Non Cancerous Thyroid Disease

Some non cancerous conditions of the thyroid increase your risk of thyroid cancer. These include:

  • an enlarged thyroid
  • a condition where the immune system attacks the thyroid gland
  • nodules

Its important to remember that although having a lump or nodule increases the risk, thyroid cancer is rare. Thyroid lumps are common. But only about 5 out of 100 thyroid lumps are cancer.

Case Definition And Tumor Characteristics

Analyses were restricted to 48,403 patients with malignant thyroid tumors that were microscopically confirmed and not diagnosed at autopsy or identified solely through death certificates; 887 cases were excluded based on these criteria. Since the late 1970s, histologic type has been coded according to the first International Classification of Diseases for Oncology , the second edition ICDO-2 for cases diagnosed from 19922001 , and the third edition ICDO-3 for cases diagnosed since 2001 ; all cases have been recoded with the use of the ICDO-3. To allow adequate time for all registries to convert to ICDO coding, the 1st y included for analyses was 1980. Histologic categories of papillary, follicular, medullary, anaplastic, other, and unspecified were defined according to the recommendations of the International Association of Cancer Research as used in Cancer Incidence in Five Continents, Volume IX . Data on stage at diagnosis were determined for each case according to SEER Historic Stage A codes. Stage at diagnosis was evaluated first because this variable was available for the entire study period. Tumor size has been recorded in the SEER data for thyroid cancer cases diagnosed since 1983; however, before 1988 size was not stated for 23% of all thyroid tumors. Therefore, size was analyzed beginning in 1988 by combining two SEER variables, EOD 10 size and CS tumor size , to form a single size variable.

Treatments For Thyroid Cancer

After getting a diagnosis for thyroid cancer, your doctor will decide how it should be treated. The decision will depend on the severity of the condition and how much the cancer has spread.

The typical first form of treatment is surgery. There are at least seven types of surgeries that could be performed, each with its own goal. Low risk patients might get a lobectomy, which removes one side or lobe of the thyroid. Patients with more severe conditions might get their thyroid completely removed through a total thyroidectomy, or a neck dissection that removes lymph nodes and nearby tissues if cancer has spread to the lymph nodes.

Radiation is another common form of treatment that might be performed to kill any remaining cancer in the body. If the previous treatments are not enough, targeted drug therapy can attempt to directly treat the cancer.

Despite how common thyroid cancer is, there is a high survival rate for patients. The five-year relative survival rate is divided into three main categories based on how much the cancer has spread.

  • Localized : near 100 percent
  • Regional : 99 percent
  • Distant : 78 percent

Doctors Question Thyroid Cancer Cases On The Rise

LG Health in the News: Thyroid Cancer is on the rise (WGAL) Shari Rudavsky, The Indianapolis Star

INDIANAPOLIS Thyroid cancer, which affects about 11 people per 100,000 each year, seems to be on the rise. Its a trend that baffles medical researchers.

National Cancer Institute statistics suggest that in recent years the number of cases of this often curable cancer has increased by about 6.5%. Over a decade, that has added up to make thyroid cancer the fastest-increasing cancer, says Tod Huntley, an otolaryngologist and head and neck surgeon with the Center for Ear, Nose, Throat and Allergy in Indianapolis.

Ten years ago, if I saw four new thyroid cancer patients a year, it would have been a lot, says G. Irene Minor, a radiation oncologist with Indiana University Health Central Indiana Cancer Center. Now sometimes I see that many in a month, and I have seen three in a week.

Thyroid cancer is more common in women younger than 45, Minor said. Doctors dont know why thats the case, but thyroid problems in general such as hyper- or hypo-thyroidism are more common in women.

The thyroid helps regulate heart rate, blood pressure, body temperature and weight. Thyroid cancer is three times more common in women than men.

When she learned she had cancer, she vowed to fight it. Numbers were on her side. The five-year survival rate for thyroid cancer is 97%.

Consideration In Choosing Patients To Receive Radioactive Iodine Remnant Ablation

The goals of primary therapies, including radioiodine treatment, for any cancers are: to improve cancer-related survival, to minimize the risk of disease recurrence and metastatic spread, to permit accurate long-term surveillance for disease recurrence, to permit accurate staging of disease, and to minimize treatment-related morbidity.1 In order to choose the appropriate patients who may benefit from radioiodine remnant ablation, we must first stratify these patients by risk. The American Joint Commission Against Cancer/Tumor, Nodes, Metastases staging system is used to determine overall survival and disease-specific survival. To estimate risk of disease persistence or recurrence, the American Thyroid Association Guidelines classified patients into three risk categories: low, intermediate, and high. These categories appear to be quite good at predicting persistent or recurrent structural disease.2 Patients in the low-, intermediate-, and high-risk categories have a 2 percent, 19 percent, and 67 percent risk of recurrence. The tumor marker serum thyroglobulin, measured at its nadir under levothyroxine suppression therapy, may help further define which low- to intermediate-risk patients may benefit from radioiodine therapy and those who may not.


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