Endocrine Abstracts

Thyroid cancer (DTC) is diagnosed more frequently these days due to increased awareness, wider availability of detection tools and, possibly, to true increasing incidence. The epidemiology of DTC is thus changing and more ‘innocent’ tumours are now being detected. The management of thyroid cancer and nodules is evolving and much progress has recently been made in the diagnosis and follow-up. Management guidelines have recently been published by scientific bodies and are continuously revised incorporating the accumulating new data.

The most important changes have been made in the management of these patients, where in the past a uniform approach was used almost regardless of risk factors for recurrence. The use of lower radioiodine doses (RAI) for remnant ablation and different strategies to increase RAI uptake have been examined in randomized clinical trials and have provided useful information that may now be used in practice. Measurement of stimulated thyroglobulin (either with endogenous or exogenous TSH) and high resolution ultrasound are valuable tools used to evaluate the success of intervention and assess the possibility of ‘cure’.

Furthermore, individualisation of care is supported from data about the excellent prognosis in the majority of cases. The current, ‘modern day’, approach involves the reassessment of risk of recurrence at regular intervals during follow up incorporating the response to treatment. The aim of such strategy is to identify the few cases that are at higher risk and modify the intensity of re-evaluation in the others. Thus the ‘optimal’ management of thyroid cancer patients is currently the focus of research to assure that patients will not be over-treated or over-followed up, such that they may have fewer complications and side effects and less psychological burden.