Due to considerable scientific advancements in the cause, prevention, and treatment of thyroid nodules and differentiated thyroid cancer, the ATA Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer released revised guidelines last month – the first update since 2009. The recommendations enable clinicians, physicians, surgeons, and patients to gain additional understanding of the diagnosis and management of these conditions. According to the authors of the report – all of whom were appointed by the ATA to independently formulate the content of the manuscript – the guidelines “represent contemporary optimal care for patients with these disorders”.
“This is good news for patients who are diagnosed with noncancerous benign thyroid nodules, or one of the four types of thyroid cancer – and for surgeons who treat them,” says Amit Kharod, M.D., a general surgeon, board-certified in general and laparoscopic surgery, and a specialist in the detection and treatment of thyroid cancer and signs of hypothyroidism, hyperthyroidism and other thyroid diseases in men and women. “These recommendations support our belief that most types of thyroid cancer can be successfully treated, and bothersome benign nodules can be removed easily through surgical procedures.”
Here are a few key updates regarding recommendations concerning diagnoses, treatment, and research initiatives. (All 100 recommendations can be found on the ATA’s website.)
Fine Needle Aspiration (FNA) Biopsy is Still Recommended Procedure to Evaluate Thyroid Nodules
Fine Needle Aspiration (FNA) biopsy, under ultrasound guidance, remains the procedure of choice in the evaluation of thyroid nodules. The American Association of Endocrine Surgeons explains that an FNA uses a very fine needle that is lead into the thyroid nodule to aspirate or suck up a small sampling of cells. The extracted cells are examined under a microscope by a cytologist.
Near-Total or Total Thyroidectomy Remains Primary Treatment of Differentiated Thyroid Cancer
When cytology results confirm a malignancy, surgery to remove the tumor remains the course of primary treatment. The new guidelines continue to endorse a near-total or total thyroidectomy, with the removal of the entire gland and lymph nodes around the gland, as the initial surgical procedure for differentiated thyroid cancer based on tumor size and other characteristics. However, a thyroid lobectomy, the removal of one of the two lobes that leaves part of the thyroid behind to retain some of its function, has been found to be a sufficient initial surgical approach for low risk cancers.
Using Genetic Code for Diagnostics on Thyroid Nodules Will Increase Accuracy
The rapid paced progress using a patient’s unique genetic code for molecular diagnostics on thyroid nodules may yield a highly accurate prediction of cancer risk, detection, prognosis, and treatment of the disease in the not-so-distant future. “These new genetic breakthroughs may offer patients promising treatments such as targeted drug therapies that combat cancer cells from the inside or enable a patient’s immune system to fight off the disease,” adds Dr. Kharod.