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Treatment of Recurrent Thyroid Cancer

Insights From: Robert I. Haddad, MD, Dana-Farber; Matthew H. Taylor, MD, Oregon Health;R. Michael Tuttle, MD, MSKCC
Published: Saturday, Apr 25, 2015
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The initial treatment for thyroid cancer is most commonly a thyroidectomy, but in many patients, thyroid cancer will recur. To properly manage these patients, it is necessary to determine the extent of recurrence: local, regional, or distant. To help determine the next steps in the treatment, Robert I. Haddad, MD, recommends involving a team of experts that includes an endocrinologist, surgeon, medical oncologist, and radiation oncologist.

Based on a thorough assessment by the team, recommendations may include surgery, chemotherapy, radiation therapy, radiofrequency ablation, cryotherapy, or even a watch and wait approach. Some patients may still benefit from surgery at this point, and may not require chemotherapy or other treatment immediately.

For patients who develop lesions in critical areas that are unresectable, treatment should be considered sooner, Haddad notes. In many cases, watchful waiting may be a viable option depending on the number, size, location, and rapidity of growth of the lesions. Each patient’s treatment must be individualized, and having a team engaged will ensure the most optimal sequencing of treatments.
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The initial treatment for thyroid cancer is most commonly a thyroidectomy, but in many patients, thyroid cancer will recur. To properly manage these patients, it is necessary to determine the extent of recurrence: local, regional, or distant. To help determine the next steps in the treatment, Robert I. Haddad, MD, recommends involving a team of experts that includes an endocrinologist, surgeon, medical oncologist, and radiation oncologist.

Based on a thorough assessment by the team, recommendations may include surgery, chemotherapy, radiation therapy, radiofrequency ablation, cryotherapy, or even a watch and wait approach. Some patients may still benefit from surgery at this point, and may not require chemotherapy or other treatment immediately.

For patients who develop lesions in critical areas that are unresectable, treatment should be considered sooner, Haddad notes. In many cases, watchful waiting may be a viable option depending on the number, size, location, and rapidity of growth of the lesions. Each patient’s treatment must be individualized, and having a team engaged will ensure the most optimal sequencing of treatments.
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