Dr. Tuttle, clinical director of the endocrinology service at Memorial Sloan Kettering Cancer Center, and his research team reported that an active surveillance management approach to low-risk thyroid cancer could safely and effectively be employed in the US population. Dr. Tuttle notes, “An observational management approach (serial neck ultrasounds every 6 to 12 months) is a very reasonable option for thyroid nodules less than 1cm that either appear to be thyroid cancer based on ultrasound features or are biopsy-proven papillary thyroid cancer.” This approach has been pioneered and effectively implemented in Japan. However, it remains uncertain whether this type of monitoring would be accepted and successful in the US.
Dr. Tuttle and his research team studied nearly 300 patients who had fine needle aspiration biopsy results and were either definite or suspicious for papillary thyroid cancer. The patients elected to be followed with observation rather than immediate surgery. After a follow-up of nearly 2 years, only 6 patients demonstrated an increase in the size of their tumor and no patient developed lymph node metastases. Importantly, surgery was curative at the time of disease progression in the patients who initially chose an observational management approach.” The team has been pleasantly surprised with the overall findings at the time of follow-up. As of August 2016, 96% of patients continued active surveillance without evidence of structural disease progression. Additionally, no patient developed lymph node metastases.
Dr. Tuttle notes, “Obviously an observational management approach is not appropriate or preferable for all patients. But since this can be safely done in many patients, clinicians should consider observation rather than immediate surgery for very low-risk thyroid cancers.” The Thyroid Care Collaborative (TCC) provides physicians with immediate access to all of their patients’ records in order to track any changes in health status or disease progression, as is important with active surveillance. The TCC also aims to keep both patients and physicians up to date on recent thyroid related news, such as new research studies that are being conducted. The TCC works to alert patients and physicians on relevant research findings to identify new care strategies in order to ensure the best possible outcome for all patients.