What is Thyroid cancer
The thyroid gland is a butterfly shaped endocrine organ located just below the Adam’s apple. This important gland secretes hormones that are involved in numerous major physiological processes including metabolism and regulation of heart rate and body temperature. Over the last 30 years, there has been a marked increase in the incidence of thyroid cancer cases worldwide, partly due to improvements in the techniques used for the early identification and detection of these diseases. Thyroid cancers occur more frequently in females than males, and as any other cancer, result when cells lose their ability to regulate their division and growth. Indeed, thyroid cancer is the most common endocrine malignancy, with an estimated 37,200 cases diagnosed in the United States in 2009.
There are four major subtypes of thyroid cancer: papillary, follicular, medullary and anaplastic. The most common forms (papillary and follicular) are usually less aggressive and less commonly fatal. The medullary subtype can be cured, if detected early – before it extends out of the neck, but has a poorer prognosis if it has spread to other sites. The anaplastic subtype is the most aggressive, but fortunately also the rarest type of thyroid cancer. It has a very poor prognosis with a low chance of survival.
Early detection of thyroid cancer has been facilitated in North America by our centre’s (Mount Sinai Hospital) pioneering introduction of neck/thyroid ultrasound and the use of fine needle aspiration biopsy of any suspicious lumps (nodules) or abnormal neck lymph nodes. This has permitted the improved selection of those nodules at risk for cancer, and avoided unnecessary surgery for those nodules which are benign.
Subsequent to surgical removal of the thyroid cancer, further management is undertaken to determine the degree of aggressiveness, and the need for supplementary radiation therapy or repeat surgical interventions.
Your support of the Da Vinci Gala Fundraiser has assisted our thyroid research and patient care programs at Mount Sinai Hospital’s Joseph and Mildred Sonshine Family Centre for Head and Neck Diseases in providing these services to patients with thyroid nodules who require appropriate investigation, and in the improved post-surgical management of patients proven to have thyroid cancer.
With your help we have been able to:
- Reduce the need for unnecessary surgery on benign thyroid nodules,
- Improve the selection among those thyroid nodules which do represent early cancer and will require appropriate surgical treatment,
- Avoid unnecessary radioactive iodine treatment in low-risk well differentiated papillary/follicular thyroid cancers by the use of serial follow up measurements of serum thyroglobulin biomarker and neck ultrasound monitoring, to avoid unnecessary radiation exposure, patient inconvenience, and conserve healthcare costs,
- Administer appropriate radioactive iodine treatment to high-risk well differentiated papillary/follicular thyroid cancers,
- Explore new strategies on the application of additional novel biomarkers which could distinguish between aggressive and non-aggressive forms of thyroid cancer by testing the surgical pathology and thereby predict which affected thyroid cancer patients will require earlier and more aggressive follow up investigation and treatment,
- Discover new strategies which may be similarly applied to not only thyroid cancers but also other aggressive epithelial cancers such as breast, prostate, lung, and oral cancers,
- Maintain a thyroid cancer database which catalogs responses to treatment on serial follow up for the various subtypes of thyroid cancer and maps the clinical course in response to treatment, as a valuable tool for understanding the future management of thyroid cancer,
- Acquire technologists, and research assistants to maintain these clinical care and research activities,
- Implement new potentially innovative and clinically applicable strategies which may improve the management of patients with aggressive thyroid cancer problems,
- Sponsor suitable applicants for Fellowship training in clinical or basic thyroid oncology.
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Shown below are a series of recent publications over the last seven years which acknowledge your support:
- Nuclear and cytoplasmic accumulation of Ep-ICD is frequently detected in human epithelial cancers.
- Ralhan R, He HC, So AK, Tripathi SC, Kumar M, Hasan MR, Kaur J, Kashat L, MacMillan C, Chauhan SS, Freeman JL, Walfish PG.
- PLoS One. 2010 Nov 30;5(11):e14130.
- Secretome-based identification and characterization of potential biomarkers in thyroid cancer.
- Kashat L, So AK, Masui O, Wang XS, Cao J, Meng X, Macmillan C, Ailles LE, Siu KW, Ralhan R, Walfish PG.
- Journal Proteome Research. 2010 Nov 5;9(11):5757-69. Epub 2010 Oct 15.
- EpCAM nuclear localization identifies aggressive thyroid cancer and is a marker for poor prognosis.
- Ralhan R, Cao J, Lim T, Macmillan C, Freeman JL, Walfish PG.
- BMC Cancer. 2010 Jun 25;10:331.
- Application of post-surgical stimulated thyroglobulin for radioiodine remnant ablation selection in low-risk papillary thyroid carcinoma.
- Vaisman A, Orlov S, Yip J, Hu C, Lim T, Dowar M, Freeman JL, Walfish PG.
- Head & Neck. 2010 Jun;32(6):689-98.
- Thyroid cancer outcomes in Filipino patients.
- Kus LH, Shah M, Eski S, Walfish PG, Freeman JL.
- Archives Otolaryngology Head & Neck Surgery. 2010 Feb;136(2):138-42.
- Influence of age and primary tumor size on the risk for residual/recurrent well-differentiated thyroid carcinoma.
- Orlov S, Orlov D, Shaytzag M, Dowar M, Tabatabaie V, Dwek P, Yip J, Hu C, Freeman JL, Walfish PG.
- Head & Neck. 2009 Jun;31(6):782-8.
- Prognostic value of postsurgical stimulated thyroglobulin levels after initial radioactive iodine therapy in well-differentiated thyroid carcinoma.
- Sawka AM, Orlov S, Gelberg J, Stork B, Dowar M, Shaytzag M, Tabatabaie V, Freeman JL, Walfish PG.
- Head & Neck. 2008 Jun;30(6):693-700.
- Cost savings of patients with a MACIS score lower than 6 when radioactive iodine is not given.
- Pace-Asciak PZ, Payne RJ, Eski SJ, Walfish P, Damani M, Freeman JL.
- Archives Otolaryngology Head & Neck Surgery. 2007 Sep;133(9):870-3.
- Extrathyroidal extension in well-differentiated thyroid cancer: macroscopic vs microscopic as a predictor of outcome.
- Hu A, Clark J, Payne RJ, Eski S, Walfish PG, Freeman JL.
- Archives Otolaryngology Head & Neck Surgery. 2007 Jul;133(7):644-9.
- Three-week thyroxine withdrawal: a thyroid-specific quality of life study.
- Davids T, Witterick IJ, Eski S, Walfish PG, Freeman JL.
- Laryngoscope. 2006 Feb;116(2):250-3.
- Prognostic variables and calcitonin in medullary thyroid cancer.
- Clark JR, Fridman TR, Odell MJ, Brierley J, Walfish PG, Freeman JL.
- Laryngoscope. 2005 Aug;115(8):1445-50.
- Prognostic implications of site of recurrence in patients with recurrent well-differentiated thyroid cancer.
- Waseem Z, Palme CE, Walfish P, Freeman JL.
- Journal of Otolaryngology. 2004 Dec;33(6):339-44.
- Prognostic factors in well-differentiated thyroid carcinoma.
- Cushing SL, Palme CE, Audet N, Eski S, Walfish PG, Freeman JL.
- Laryngoscope. 2004 Dec;114(12):2110-5.
- Thyroid colloid nodules diagnosed by fine-needle aspiration: efficacy of suppression.
- Popat SR, Bedard YC, Asa SL, Walfish PG, Rosen IB, Witterick IJ, Freeman JL.
- Journal of Otolaryngology. 2004 Feb;33(1):1-4.
- Management and outcome of recurrent well-differentiated thyroid carcinoma.
- Palme CE, Waseem Z, Raza SN, Eski S, Walfish P, Freeman JL.
- Archives of Otolaryngology Head & Neck Surgery. 2004 Jul;130(7):819-24.
- Three-week thyroxine withdrawal thyroglobulin stimulation screening test to detect low-risk residual/recurrent well-differentiated thyroid carcinoma.
- Golger A, Fridman TR, Eski S, Witterick IJ, Freeman JL, Walfish PG.
- Journal Endocrinology Investigation. 2003 Oct;26(10):1023-31.
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