Clinical OMICS

MAR-APR 2017

Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine

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Page 18 of 47 March/April 2017 Clinical OMICs 17 performed for unrelated reasons have caused a dramatic rise in the reported incidence of thyroid cancer over the past 15 years . "In many cases these small tumors would never be clin- ically apparent to the person . They would live out the rest of their life and never know that they had thyroid cancer except that it was incidentally found on some imaging study done for another reason," explained John Morris, M . D . , ATA president . Of course, not all thyroid cancers exhibit such a benign temperament, but how do you tell them apart? According to Sally Carty, M . D . , pro- fessor of surgery and co-director of the UPMC/University of Pittsburgh Can- cer Institute Multidisciplinary Thy- roid Center (MTC), the risk factors the ATA uses to guide treatment options are based on, with one or two excep- tions, tumor histology performed on the thyroid nodule after surgical removal . "It really puts the surgeon in a bind, because you don't know, based on current guidelines, what operation to recommend—a lobectomy or a total thyroidectomy," said Dr. Carty. As a result, more patients with aggressive thyroid cancer may have to endure the additional hassle, cost, and risk of undergoing a two-stage surgery—an initial lobectomy followed by a second surgery to remove the remaining thy- roid gland tissue . UPMC's two-year clinical trial, funded entirely by philanthropic donations from families affected by thyroid cancer, could help achieve the ATA's goal of reducing unneces- sary treatment while also avoiding the necessity for multiple surgeries . "If we could cut the healthcare dollars spent on unnecessary thyroidectomies, [we would achieve] a wonderful goal," remarked Dr . Carty . Less surgery makes sense, but will it really make a difference in the patient's daily life? To gain insight into how different treatment options affect patients after surgery, Dr. Yip included three validated quality of life surveys in the trial design: "I'm partic- ularly passionate about this part of the trial, because it will help us to know whether all of our efforts to preserve the thyroid are worth it," Dr. Yip noted in a press release . "Most people with thyroid cancer do really well—they don't die from their disease . So I think it becomes even more important that we maintain a good quality of life for them." The American Cancer Society pre- dicts that 56,870 people in the U . S . will be diagnosed with thyroid can- cer this year . For low-risk patients, better molecular markers could trans- late into fewer thyroidectomies, less hormone-regulating medication, and less long-term follow-up care, which means a lower financial burden for thousands of families affected by thy- roid cancer—proving that sometimes less really is more . Darryl Leja, NHGRI While thyroid cancer is very treatable with surgery and other therapies, it remains the fastest growing cancer in the United States.

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