Rare Form of Thyroid Cancer

rare form of thyroid cancer via rarecancers.org.au

Charlie Mayo was primarily known as a thyroid surgeon at the time he was practicing there was a real problem with surgical mortality from treatment surgical treatment whiter and he

and combined with some innovations of Henry Plummer decreased this mortality from a very

 high 20 percent here at Mayo we've had a long-standing collaboration related to thyroid

diseases of all types including thyroid cancer and in the last five years we've really had a a

group mature multidisciplinary group across pathologist endocrinologist radiation oncologists

statisticians many individual surgeons of ilorin colleges to come together to try and improve

 outcomes for different thyroid cancers and this has resulted in much innovation in terms of

clinical trials were feasible and in anaplastic thyroid cancer which is usually pretty rare we see

on the average about five new cases recently per year that's resulted in new approaches to try

 and improve upon outcomes that have been historically historically of poor mainly we have

 not had a lot of treatment options these therapies have have remained largely unaltered for

decades we're trying to change that here and have a endocrine malignancies group within the

 Cancer Center that's really striving toward that goal historically the problem with anaplastic

thyroid cancer has been both recurrences in the neck which can threaten airway breathing and

 swallowing eating and also metastatic disease threatens patients in lungs liver bone others we

knew that even though many times we do not see spread disease at diagnosis these patients will ultimately succumb to this disease telling us that there must be early metastatic

microscopic disease found in reviewing a series of patients dating back 50 years is that survival

historically has been relief rapport and overall both we and many other institutions have

found that survival tends to be no more than twenty percent at one year with only a five

 month median survival we really found this to be you know disagreeable and we wanted to do

whatever could be done in terms of modifying treatment approaches to improve this so the

approach we chose to this was to add early on chemotherapy many times even before

radiation therapy and also with radiation therapy sometimes after so this approach was to

 alter both the radiation therapy approach and also the chemo therapeutic approach and we

report the results of the first ten consecutive straight it with this altered program basically

 those results are telling us that this altered approach is producing far better survival and

outcomes than we had ever seen before in contrast to a ten to twenty percent one-year

survival we have seventy percent one-year survival seven of the ten patients are alive at one

 year with sixty percent six of 10 alive two years and five of those patients at two years plus

without any evidence of disease I think that the the real surprise for for all of us was the

 survival because we expected well I guess I would say we had really limited expectations and

we were stunned to see the high survival we of course would like to see better survival but to

 see an improvement from a median survival of five months to have not attained a median

survival over two years into a examination of patients is really stunning to us the issues

related or the potential problems related to this pilot approach or several one is we found that

overall the treatment though tolerable and no deaths resulted from the treatment we found

the two of the ten patients required hospitalization during treatment in subsequent patients I

think that that's probably an underestimate I think probably half of our patients require

hospitalization overall in a larger series so the treatment is toxic and it requires the patient's

be able to withstand the treatment and be in good shape to start with which is not always the

case the second issue is this is not a prospective trial but report of practice change so we really

ideally need to validate this in a larger prospective trial which is firmly designed what we

 found is when we set up the practice guidelines necessarily there was considerable

individualization of treatment so although the the intended radiation and chemotherapy approaches we're very uniform that turned out to not necessarily be the case because of

 modification for various patient-related prior health problems side effects from treatment we

have not yet been able to effectively salvage or lead to long-term disease control and patients

with metastatic disease so this study really relates to those patients with apparently regionally

confined disease at the outset in that group of patients constitutes probably about 60 percent

 of the total and if you're in that group what I would say based upon our experience and results

 is that an aggressive approach combining intensity-modulated radiation therapy at Taylor

approach to radiation with aggressive chemotherapy is we're do is producing better outcomes

better long-term results than we've ever previously seen and I would be encouraging patients

wishing an aggressive approach to their disease to utilize to avail themselves to this approach.
Next Type of Thyroid Cancer Associated with Radiation

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