Do we have to treat Thyroid Cancer?

Do we need to treat all thyroid cancers?

The short answer is "No".

The long answer is obviously more complex than that. The articles are correct in that most small thyroid cancers will not go on to become any bigger.

The difficulty comes in trying to predict which cancers will remain small and "harmless" and which will progress to larger cancers with a chance of spreading and causing significant health issues and even death.

Having this discussion with your surgeon is vital. Your surgeon should remain up to date with the latest treatment guidelines and be prepared to offer you ongoing observation for small thyroid masses. 

Read about Dr Matthew Magarey's experience with thyroid cancer. If you have been diagnosed with thyroid cancer, or have concerns you may have thyroid cancer and wish to discuss your care with Dr Magarey, you can make an appointment here.

 

The article from the Australian is below. The link to the Sydney Morning Herald article is the source link at the end of this blog.

 

Artificial epidemic of harmless neck cancers to cost $400m

  • The Australian
  • 6:00AM September 7, 2016

  • JOHN ROSS

  • Higher Education reporter

Over-diagnosis of mostly harmless neck cancers has created an “artificial epidemic”, subjecting thousands of Australians to unnecessary suffering and costing health budgets hundreds of millions of dollars a year.
An Australian study has found the prevalence of “differentiated” thyroid cancers, which account for about 90 per cent of thyroid tumours, has not changed over the past 45 years although diagnoses have tripled.
The findings, published in the Journal of Clinical Oncology, reinforce suspicions that an apparent global spike in thyroid cancer results from overenthusiastic testing, not mounting incidence of the disease.
Lead author Suhail Doi, of Australian National University, said “overly meticulous examinations” unnecessarily led to major surgery, the need for lifelong thyroid-replacement therapy and risked damage to neck nerves and glands. Dr Doi said treatment costs were projected to reach almost $400 million a year in Australia, and $4 billion in the US, within three years. About one in two people develop lumps in the thyroid, a butterfly-shaped gland that produces hormones that help control metab­olism. The nodules are often tiny and found during ultrasound tests.
Of about 10 per cent found to be not benign, around 90 per cent are either “papillary” cancers or tumours of follicular cells that secrete hormones. Dr Doi said neither type usually progressed to clinical forms of cancer, and sufferers usually died from other causes.
“There is no point intervening if the cancer is not causing any problems,” he said.
The team analysed six decades of international autopsy data, looking for differentiated thyroid cancer in patients who had not been investigated or treated for thyroid problems, and found that prevalence had not changed since 1970.
Australian diagnoses have doubled in men and tripled in women since 1982, reaching about 2500 diagnoses a year.
The US, Britain and Canada experienced similar spikes, while diagnoses in South Korea had ­increased 15-fold.