On May 19, 2016, Thyroid Care Collaborative (TCC) user, Ralph P. Tufano, MD, MBA, along with co-authors Maisie Shido, MD and Ashok R. Shaha, MD published an article titled “New Recommendations for Extent of Thyroidectomy and Active Surveillance for the Treatment of Differentiated Thyroid Cancer” online through JAMA: Otolaryngology- Head & Neck Surgery. This article addresses concerns of overtreatment for small (<1cm) thyroid cancer nodules via total thyroidectomy and radioactive iodine (RAI) therapy, as opposed to a hemi-thyroidectomy procedure or active surveillance of a cancer with a strategy of delayed surgery, in the event that progression is identified on follow up ultrasound. Although the reported locoregional recurrence for these small cancers is between 2 and 6%, Tufano, et al. remind us that all large and aggressive papillary thyroid cancers must have been small cancerous nodules at one point.
Ultimately, there are several patient specific variables that the physician should carefully consider and include in the decision making process. This article opens up the conversation between physicians and patients to consider a wider spectrum of options when making a decision about the care and treatment of thyroid cancer patients. This article also highlights the importance of long term follow up of patients with thyroid cancers. The TCC provides an invaluable platform to record and track both routine patient health information as well as clinical decisions made along the thyroid patient care journey.