Saturday, July 14, 2012

Everything you wanted to know about thyroid cancer but were afraid to ask

How much do you know about thyroid cancer? Let's start with in a lot of ways it is very different than any other type of cancer in terms of incidence, treatment, life after cancer, etc.

Thyroid Cancer Canada just released a very interesting report which summarizes the disease. Here are a few bullet points on the differences with thyroid cancer and other cancers:
  • thyroid cancer usually leads to the loss of the thyroid gland -- a major organ of the body -- necessitating life-long hormone replacement and monitoring similar in effect to some chronic diseases
  • for the most part there are no early warning signs; no means of prevention of thyroid cancer
  • neck exams can find thyroid cancer at an early stage, but currently neck exams are an optional inclusion in most standard physical examinations
  • thyroid cancer is now the #1 cancer (in incidence and prevalence) in young women
  • wait times for diagnosis and surgery are amongst the longest in the western world
  • thyroid cancer has the greatest range of possibilities in prognosis, depending on the type diagnosed
  • for some, surgery and treatments have lasting negative after-effects
  • 80% of thyroid cancer patients are women
  • overall it is very treatable, however males struck with the disease have a lower cure rate
  • thyroid cancer is increasing in incidence at a higher rate than any other cancer
  • a unique form of treatment -- radioactive iodine therapy -- is an option for the majority of patients
  • thyroid cancer has a high rate of recurrence, up to 30 years later
  • thyroid cancer patients impacted by low number of resources, and inequitable distribution of tools across the country, including PET scans
  • there is a high rate of bankruptcy amongst thyroid cancer survivors
  • only 0.1% of cancer research dollars are invested in thyroid cancer
While the focus of the numbers in the report are for Canada I think we can assume it pretty much parallels the rest of the world, including the US.

Thyroid cancer is unique in many ways summarized as follows:
All Cancers Thyroid Cancer
Treatment ~60% of cancer patients are treated with radiation therapy such as External Beam radiation (EBR)5 Less than 3% of thyroid cancer patients have EBR treatment
More than 50% of cancer patients receive chemotherapy Less than 2% of thyroid cancer patients receive chemotherapy
0% of non-thyroid cancer patients receive RAI treatment ~60% of thyroid cancer patients receive RAI treatment
Specialized Diagnostic Tools Thirteen types of cancer have a oncologic indication for PET Scans, internationally Thyroid cancer is one of only 4 cancers on the PET Registry in ON, yet ON has amongst the lowest number of scans per population
Age 53% are more than 55 years old Median age is 40 years old
Gender Cancer by gender ratio: women/men - 48/52 Thyroid cancer gender ratio: women/men - 80/20. Relevant Survival Ratio: 98% survival for women, drops to 94% for men
Life Sustaining It is possible for a person to live with the loss of some organs (due to cancer) and function normally otherwise (ie. not require medication to mitigate the loss) such as with the loss of: one kidney, part of the reproductive organs, part of the liver, part of the intestines, breasts, etc. The thyroid gland is a major organ of the body. Patients cannot maintain life without a thyroid gland or in its absence, replacement hormone (T4) taken in pill form; with need of frequent monitoring. Therefore, even with a good surgical outcome and excellent prognosis, a thyroid cancer diagnosis is akin to a chronic illness

Its very different than many other cancers, it is also rapidly increasing in incidence and has the least amount of research. Maybe I should become a lab rat and help them.

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