Newly updated treatment guidelines for medullary thyroid carcinoma

A Task Force convened by the American Thyroid Association (ATA) released updated guidelines for the diagnosis and treatment of medullary thyroid carcinoma (MTC). The current document is the first revision of the original guidelines published in 2009. The Task Force has presented their recommendations in the article “Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma”), in Thyroid, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers and the official journal of the American Thyroid Association (ATA). The guidelines are available free on the Thyroid website.

Lead author and Task Force Chair Samuel A. Wells, Jr., MD, Cancer Genetics Branch, National Cancer Institute, National Institutes of Health (Bethesda, MD), together with a team of expert colleagues, reviewed the basic science and clinical literature and developed evidence-based recommendations to guide physicians in the diagnosis and treatment of patients with sporadic and hereditary MTC. The 67 recommendations represent current and optimal medical practice.

The authors observe that despite significant progress in the management of patients with MTC, much remains to be done. Although patients with advanced disease, who receive recently developed novel therapeutic compounds, experience reduction in tumor size and have significantly prolonged progression-free-survival, compared to patients receiving placebo, drug resistance almost always develops and the tumor progresses. There is a critical need for more effective drugs, or combinations of drugs, that will improve the overall survival of these patients.

“The updated MTC guidelines provide a superb overview on the biology, diagnosis, and therapy of MTC. They form a state-of-the-art basis for a differentiated clinical care of patients with MTC and also highlight areas that are in need of further investigation and improvements,” says Peter A. Kopp, MD, Editor-in-Chief of Thyroid and Associate Professor of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago.

The Facts on Thyroid Cancer

The thyroid is a small gland in the front of the neck that releases hormones that regulate the body’s metabolism (how it uses energy to perform its many processes). Tiny nodules can form on the thyroid gland, but they’re often harmless and remain in the gland storing excess thyroid hormone. Not all thyroid nodules are harmless, however. Some of these small tumors turn out to be thyroid cancer.

Types of Thyroid Cancer
There are different types of cells in the thyroid gland, and a different kind of cancer can form from each of these cell types. Here are the forms of thyroid cancer that can develop:

  Papillary carcinoma. This is the most common form of thyroid cancer; 80 percent of all thyroid cancers are diagnosed as papillary carcinoma. It’s slow-growing, can occur in both sections or “lobes” of the thyroid (though it’s usually confined to just one lobe), and it may spread to the lymph nodes located in the neck.

  Follicular carcinoma. This is the second most common type of thyroid cancer following papillary carcinoma - about 1 in 10 cases of thyroid cancer are considered follicular carcinoma. This type of thyroid cancer may spread to the lungs or bones, and it’s a more serious cancer than papillary carcinoma.

  Medullary thyroid carcinoma (MTC). This thyroid cancer develops in the C cells, which produce the hormone calcitonin. MTC makes up about 5 percent of all cases of thyroid cancer. This cancer is more difficult to detect and treat, and the prognosis is generally worse.

  Hurthle cell carcinoma. This thyroid cancer is another form of follicular carcinoma. This type of thyroid cancer is more difficult to detect and treat than the others but is less common; accounting for only 4 percent of all cases of thyroid cancer.

Even rarer forms of thyroid cancer exist, including anaplastic carcinoma, thyroid lymphoma, and thyroid sarcoma.

Overall, the outlook for patients diagnosed with thyroid cancer is very good. Even in the more serious forms of thyroid cancer with a poorer prognosis, treatment can be very effective. With the exception of the very rare anaplastic carcinoma, thyroid cancer is rarely fatal, with a survival rate of 97 percent across all types of thyroid cancer.

“The revised guidelines for management of medullary thyroid carcinoma are an excellent detailed review of the literature, and they provide an invaluable resource for the practicing endocrinologist, surgeon, oncologist, and others to assist in care of their patients,” says Robert C. Smallridge, MD, President of the ATA, Professor of Medicine and former Chair, Endocrinology Division, Mayo Clinic, Jacksonville, Florida.


About the Journal

Newly updated treatment guidelines for medullary thyroid carcinoma Thyroid, the official journal of the American Thyroid Association , is an authoritative peer-reviewed journal published monthly online with Open Access options and in print. The Journal, celebrating 25 years in 2015, publishes original articles and timely reviews that reflect the rapidly advancing changes in our understanding of thyroid physiology and pathology, from the molecular biology of the cell to clinical management of thyroid disorders. Complete tables of contents and a sample issue may be viewed on the Thyroid website. The complete Thyroid Journal Program includes the highly valued abstract and commentary publication Clinical Thyroidology®, led by Editor-in-Chief Jerome M. Hershman, MD and published monthly, and the groundbreaking videojournal companion VideoEndocrinology™, led by Editor-in-Chief Gerard M. Doherty, MD and published quarterly. Complete tables of content and sample issues may be viewed on the Thyroid Journal Program website.

About the Society

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 92nd anniversary, the ATA delivers its mission—of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health—through several key endeavors: the publication of highly regarded professional journals, Thyroid, Clinical Thyroidology, and VideoEndocrinology; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators, support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease and thyroid cancer. The ATA promotes thyroid awareness and information through its online Clinical Thyroidology for the Public (distributed free of charge to over 11,000 patients and public subscribers) and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet.

About the Publisher

Mary Ann Liebert, Inc., publishers is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Diabetes Technology & Therapeutics, Journal of Women’s Health, and Metabolic Syndrome and Related Disorders. Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry’s most widely read publication worldwide. A complete list of the firm’s more than 80 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website.


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