Many Thyroid Tumors No Longer Considered Cancer

Were you diagnosed with encapsulated follicular variant of papillary thyroid carcinoma?  Was a portion (or all) of your thyroid removed?  Were you treated with radioactive iodine and forced to come back for follow-ups for the remainder of your life?  Whoopsie!  All of that was unnecessary! 

According to this article in the New York Times, an international panel of doctors has decided that this type of tumor that was classified as a cancer is, in fact, not a cancer at all!  As a result they have now downgraded the condition and renamed it “noninvasive follicular thyroid neoplasm with papillary-like nuclear features,” or NIFTP, leaving out the word “carcinoma” entirely.

The data and their conclusion was reported Thursday (4-14-16) in the journal JAMA Oncology.  It’s expected to affect at least 10,000 of the nearly 65,000 thyroid cancer patients a year in the United States alone. 

The reclassification drive began two years ago, thanks to a very brave (in my opinion) Dr. Yuri E. Nikiforov, vice chairman of the pathology department at the University of Pittsburgh.  He brought together an international panel of experts made up of 24 renowned pathologists, 2 endocrinologists, a thyroid surgeon, a psychiatrist and a patient.  According to the panel:

The reclassified tumor is a small lump in the thyroid that is completely surrounded by a capsule of fibrous tissue whose nucleus looks like a cancer, but the cells have not broken of their capsule, and surgery to remove the entire thyroid followed with treatment of radioactive iodine is unnecessary and harmful.

Many cancer experts have, for years, been calling for the downgrade of small lesions in not only the thyroid, but the breast, lung and prostate, among others, and to eliminate the term “cancer” from their name.  Other than a couple of changes over the years, this is the first group to have really taken the plunge.  In fact, according to Dr. Otis Brawley, CMO at the American Cancer Society, they went in the opposite direction.  They renamed them premalignant stage zero cancer or early-stage cancerous tumors, and meanwhile imaging with ultrasound, MRI, C.T. scans, etc, they are finding more and more of these tiny “cancers,” especially thyroid nodules.

According to Dr. Nikiforov:

This study said it is not the presence of nuclear features but the presence of invasion that can make the difference between cancer and noncancer.  Patients whose tumors are confined within their capsules have an excellent prognosis and do not need a thyroidectomy, radiotherapy, or to be followed up every six months.

Dr. Nikiforov and his colleagues submitted a report to the journal Thyroid about the reclassification and newly named condition.  They went so far as to say that doctors may be violating the principle of “first, do no harm” in treating patients with these tumors as though they have invasive cancer.  He said that, “informing these patients is a moral obligation of doctors.”

 

The Take-Away Of This Story:

  1. Do your own research.  Regardless of the diagnosis.  Get a second and third opinion and then take the time to learn everything you can about it, from all points of view.
  2. When (if) you return to the oncologist, be armed with a list of questions.  This list put together by Chris Wark from ChrisBeatCancer.com is the best I’ve seen of very important questions you need answers to. 
  3. Always remember that NO ONE has your best interests at heart quite like you do.  There are good people out there, but there are also people motivated by money.  Sometimes it’s hard to tell the difference.  You need to be the one in charge of your health. 

 

Reference:  New York Times

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