Thyroid Cancer

 The Rising Incidence of Thyroid Cancer in The New York Times. (October 14, 2010). The article, written by Carolyn Sayre points out,“…that the incidence has more than doubled since the early 1970s, and for women, it is the cancerwith the fastest-growing number of new cases.”(1)Similarly, Sabiston’s textbook of surgery agrees by saying, “Several studies have shown that the incidence of well-differentiated thyroid carcinoma has increased perhaps as much as 50% since 1990.”

And goes on to point out, that…“Whether this increase is due to enhanced sophistication in screening and diagnostic techniques or possible exposure to environmental factors such as radiation or environmental mutagenic chemicals is not clear.” (2)

Types of thyroid cancer include: Papillary (70-80%), Follicular (10%), Medullary (6%), Anaplastic (< 1%). Let’s concentrate on papillary:

  • Commonly associated with previous ionizing radiation
  • 3x more common in women
  • Typically present as asymptomatic nodule
  • Treatment:
    • <1cm: lobectomy & isthmectomy
    • 1-2cm: Controversial. total thyroidectomy vs. lobectomy & isthmectomy
    • 2cm: total thyroidectomy
    • Can metastasize to local lymph node
      • Spread to lymph nodes of the neck present in more than 50% of cases
      • Stage II-IV patients also undergo lymph node resection
  1. Sayre C. The Rising Incidence of Thyroid Cancer. The New York Times. October 14, 2010. FULL ARTICLE
  2. Hanks JB, Salomone LG. Thyroid. Townsend: Sabiston’s Textbook of Surgery. 18th Edition. Saunders. 2008. Chapter 36.
  3. Miccoli et al. Modified lateral neck lymphadenectomy: Prospective randomized study comparing harmonic scalpel with clamp-cut-tie technique. Otolaryngology-Head and Neck Surgery. 2009; 140; 61-64. (Abstract)

About Ed Chekan, MD, FACS

Minimally Invasive Surgeon An American Board of Surgery certified, Fellowship trained Minimally Invasive Surgeon that fills the gap between the clinical practice of surgery and the business of medical device innovation. Minimally Invasive Surgery Medical Devices Device Tissue Interaction Life Science Education Professional Education Opinions expressed here are my own.
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