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.