The American Association of Endocrine Surgeons, Patient Education Site

Thyroid cancer: Metastatic and advanced

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1. Overview

Thyroid cancer may spread (metastasize) to the lymph nodes, lungs, bone and occasionally brain. Sometimes, thyroid cancer is very large and starts growing into structures in the neck, such as the windpipe (trachea), the food pipe (esophagus), blood vessels, muscles, or nerves. This is considered "locally advanced" thyroid cancer.

Fortunately, metastasesMetastases - spread of cancer will often take up iodine at first. Therefore RAIRAI - radioactive iodine may still be a useful treatment for patients with metastases. RAI is particularly useful for small lung metastases that may not be visible by CAT scan, but are seen on a radioactive iodine scan. Metastatic thyroid cancer, that is large enough and visible on ultrasound or CAT scan, should be surgically removed. This is a common treatment for lymph node metastases in the neck. However, for tumors that either lose the ability to take up radioactive iodine or are not surgically resectable, new clinical trials are currently enrolling patients that have metastases (determined by high thyroglobulin levels). A list of these trials can be seen on the websites listed below.

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2. Clinical trials

Many of the current clinical trials for treating metastatic papillary carcinoma, follicular carcinoma, Hurthle cell carcinoma, or medullary carcinoma involve the use of commercially available, small molecule kinase inhibitors, such as sorafenib (Nexavar®, Bayer) or sunitinib (Sutent®, Pfizer, Inc.). Initial results are promising, however more studies are required to determine which patients benefit the most from these drugs. Patients considering enrollment in a clinical trial should read the list of conditions below from the National Cancer Institute. They can also call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) and ask for a customized search of the PDQ database, which provides information on current studies.

From the National Cancer Institute, National Institutes of Health
Bethesda, Maryland
NIH Publication No. 00-4830

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3. Useful websites — This is the website for the U.S. Government's Clinical Trials Database. This database provides information about clinical research trials for thyroid cancer and other diseases. This list describes clinical trials that are recruiting new participants. — This is the American Thyroid Association website. It is a renowned professional association of thyroid specialists in the U.S.A. — This is the American Thyroid Association's (ATA) compendium of clinical trials for thyroid diseases, including thyroid cancer. The ATA Trial finder is a one-stop site to search multiple information sources, including public and private information sources and trials screened by experts from the American Thyroid Association. — This website is maintained by a non-profit organization of survivors of thyroid cancer.

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