Saturday, August 29, 2009

Thyroid cancer and a case of the warm fuzzies

Thyroid cancer is different than breast cancer. Well, doh, is a different part of your body. Thyroid cancer is considered to be a less common cancer (37,200 new cases this year, and the number is increasing) than breast cancer (192,370 new cases this year). There will also be 1630 deaths from thyroid cancer this year vs. 40,610 deaths from breast cancer.

According to the American Cancer Society, "thyroid cancer is n general, this is one of the least deadly cancers. The 5-year survival rate ... for all cases is about 97%. ...

Thyroid cancer is different from many other adult cancers in that it mainly affects younger people. Nearly 2 of 3 cases are found in people between the ages of 20 and 55. The chance of being diagnosed with thyroid cancer has risen slightly in recent years. Most of this is thought to be the result of the increased use of thyroid ultrasound, which detects small thyroid nodules that might not otherwise have been found. Most of the increase is from finding more small papillary cancers, which are rarely fatal. The death rate from thyroid cancer has been fairly stable for many years. "

However, from the NIH data on a Genzyme data sheet I was given recently are all sorts of pearls of wisdom:

"Thyroid cancer is on the rise:
- Thyroid cancer has the fastest rising incidence among cancers in the US with new cases increasing a a rate of approximately 4% annual."

They have a neat little chart that goes back to 1990 - apparently I am pre-chart - showing that in 1990, there were 8900 new cases of thyroid cancer in women and 3200 in men, for a total of 12100. That's a third of what will be diagnosed this year. In 2001, 19500 cases were diagnosed. So maybe in 1981, there were probably 8,000-10,000 cases diagnosed. Not a lot.

Then my favorite nugget of information on this data sheet is:
"Thyroid cancer recurrence is high:
- Thyroid cancer recurs in up to 1/3 of patients, and can recur even decades after initial diagnosis and treatment.
- 80% of the recurrences are in the neck alone, while 20% recur as distant metastases - the most common sites include the lung, bone, and liver
- Bulk of metastases ranks second only to age as a predictor of death."

But the absolute best 'reassuring' quotes are:
"After 10 years of remission, other cancers like breast and colon cancer are generally considered cured. This is not the case with thyroid cancer."

"50% of tumors recur within the first 5 years after initial therapy and nearly 80% do so within the first decade; however, tumor may recur as late as 45 years later. Distant metastases or serious local disease can occur over three or even four decades after apparently successful treatment. Thus, it is essential that clinicians provide lifelong surveillance for their patients."

Now that I have all the warm fuzzies going for the day. Isn't this all so 'reassuring'? Thyroid cancer (this part is my personal opinion based on the facts above) is very curable if you only look at the five and ten year survival rates which are nice and high and in the upper 90 percents. But watch out, it can come back a bazillion years later when you were least expecting it. Breast cancer on the other hand seems to be considered cured relatively quickly.

But the word cure does not go with the word cancer. Sorry. They are mutually exclusive. There is no cure for cancer. They can only treat it and hope for the best.

So where does that leave me and the others diagnosed with thyroid cancer? Apparently there are more than 350,000 of us (compard to 2.5 million breast cancer survivors)... (But I think most are hiding.) I very rarely run into thyroid cancer people. Breast cancer is highly visible with all the pink wearers and the foundations and fund raising and walks and runs. Thyroid cancer has www.thyca.org, the national Thyroid Cancer Association with an annual meeting (where I am volunteering this year because it is local). It is a much smaller organization.

Breast cancer people walk around with pink stuff, t shirts, bracelets, and go on walks and races. People run marathons for them to raise awareness. Thyroid cancer people get light blue ribbons and bracelets (if you go to events that think to include this color otherwise, we just end up lumped in with head and neck cancers).

So this fall, October 16-18, I will head to the Sheraton in Danvers for Thyca's annual conference to see what I can learn about what is new with thyroid cancer and my risk for recurrence. I might even wear light blue with a touch of pink... But will definitely look for a return of the warm fuzzies.

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