Recent Developments in Evaluating and Managing Thyroid Cancer

Editorial
Cancer Control
Journal of the Moffitt Cancer Center
Recent Developments in Evaluating and
Managing Thyroid Cancer
This issue of Cancer Control focuses on thyroid cancer.
clues will become available to better guide treatment and
The last time this journal devoted an issue to thyroid
genetic counseling in families who have a potential to
cancer was over 5 years ago. During that interval, sig-
develop thyroid cancer. The second article focuses on the
nificant advances have been made in the detection and
optimal management of thyroid carcinomas in the future,
management of thyroid cancer, and guidelines for the
which will need to be based on an understanding of the
treatment of patients with thyroid nodules have been
process of dedifferentiation and its relationship to pro-
revised and updated.
gression and prognosis. Dr. Kepal Patel and Dr. Bhuvanesh
Thyroid cancer presents unique problems not seen in
Singh present a review of the genetic tools currently avail-
other cancers. Thyroid cancer comprises a relatively small
able in classifying and predicting the progression of thy-
portion of newly detected cancers. In 2006 in the United
roid carcinomas — from well-differentiated to the poorly
States, more than 30,000 new cases of thyroid cancers are
differentiated and anaplastic tumors that exhibit aggres-
expected out of 1,400,000 new cases of cancers at all
sive local behavior. Third, Dr. Kepal Patel and Dr. Ashok
sites.1 Although cancer of the thyroid is relatively rare, thy-
Shaha discuss the small minority of poorly differentiated
roid nodules, which are the primary indicator of develop-
and anaplastic thyroid carcinomas that require innovative
ing thyroid cancer, are quite common. Palpable thyroid
management strategies in order to achieve disease control.
nodules occur in approximately 5% of women and 1% of
While these articles cover only a small fraction of the inter-
men. Using ultrasound, thyroid nodules are identified in
esting topics and new developments in thyroid cancer, they
19% to 67% of individuals. The issue then becomes deter-
provide valuable information for oncologists, surgeons,
mining the most efficient and cost-effective means to
and primary practitioners.
discover which thyroid nodules may represent cancers at
Several advances over the past 5 years have prolonged
a stage suitable for effective treatment. Because of the
survival of patients with thyroid cancer. Perhaps in 5 years
importance of appropriate initial evaluation and manage-
from now, we will again focus on thyroid cancer and will
ment of thyroid nodules and thyroid cancers, we have
be able to report many more promising developments in
included in this issue an article by Dr. Christopher Lansford
treating this disease.
and Dr. Theodoros Teknos on the evaluation of incidental
In addition to the articles focusing on thyroid cancer,
thyroid nodules. With more imaging studies being per-
we have included a paper that takes a look at targeted ther-
formed in the head and neck area for diagnosis and follow-
apies for non-small cell lung cancer. Patients often present
up of disease processes, primary care physicians, surgeons,
with inoperable advanced-stage disease and are difficult to
and oncologists are faced with decision making related to
treat; the median survival with combination chemothera-
these incidentally identified nodules.
py is only 8 to 10 months. Drs. Petra Martin, Catherine
Well-differentiated thyroid cancers represent over 90%
Kelly, and Desmond Carney review the use of two epider-
of thyroid carcinomas. Dr. Cristian Slough and Dr. Gregory
mal growth factor receptor inhibitors, gefitinib and
Randolph present the decision-making process involved in
erlotinib, for non-small cell lung cancer and conclude that
the evaluation and management of these tumors. These
although to date they have not provided a significant sur-
articles can be read in association with the management
vival advantage when combined with chemotherapy in the
guidelines recently published by the American Thyroid
first-line setting, such targeted therapies remain promising.
Association for patients with thyroid nodules and differen-
tiated thyroid cancer.2 This paper is included in our list of
Thomas V. McCaffrey, MD, PhD
recommended readings presented in this issue.
Head & Neck Oncology Program
We also present a series of articles on topics not cov-
H. Lee Moffitt Cancer Center & Research Institute
ered in our previous issue on thyroid cancer. These arti-
Tampa, Florida
cles cover recent developments in the management of
poorly differentiated and anaplastic thyroid cancers. First,
References
Dr. Carl Malchoff and Dr. Diana Malchoff present new infor-
1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer
mation on epidemiologic and genetic studies indicating
J Clin. 2006;56:106-130.
that nonmedullary thyroid carcinomas may follow a famil-
2. Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines
for patients with thyroid nodules and differentiated thyroid cancer. Thyroid.
ial inheritance. As sophisticated genetic testing evolves,
2006;16:4-33.
88 Cancer Control
April 2006, Vol. 13, No. 2

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