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Thyroid cancer

Thyroid cancer is cancer of the thyroid gland. There are four forms: papillary, follicular, medullary and anaplastic. The most common forms (papillary and follicular) are fairly benign, and the medullary form also has a good prognosis; the anaplastic form is fast-growing and poorly responsive to therapy. more...

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Medicines

Masses of the thyroid are diagnosed by fine needle aspiration (FNA) or frequently by thyroidectomy (surgical removal and subsequent pathological examination). As the thyroid concentrates iodine, radioactive iodine is a commonly used modality in thyroid carcinomas.

Symptoms

Most often the first symptom of thyroid cancer is a nodule in the thyroid region of the neck, but only 4% of these nodules are malignant. Sometimes the first sign is an enlarged lymph node. Other symptoms that can be present are pain, changes in voice and symptoms of hypo- or hyperthyroidism.

Diagnosis

After a nodule is found during a physical examination, thyroid function is investigated by measuring, among other markers, Thyroid Stimulating hormone (TSH), the thyroid hormones thyroxine (T4) and triiodothyronine (T3), and Thyroid Binding Globulin (TBG). Tests for serum thyroid autoantibodies are also sometimes done. The blood assays are usually accompanied by ultrasound imaging of the nodule to determine the position, size and texture. Most clinicians will also request technetium and/or radioactive iodine imaging of the thyroid. The most cost-effective, sensitive and accurate test to determine whether the nodule is malignant is the fine needle biopsy, which is almost always done. Often, the suspected nodule is removed surgically for pathological examination, or a biopsy is done using a coarse needle, so that the arrangement of the cells can be examined (where the fine needle biopsy can only give individual cells).

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Thyroid cancer rose after Chernobyl - Brief Article
From Science News, 8/7/99 by

The 1986 nuclear accident at Chernobyl in Ukraine unleashed radioactive pollution, including iodine, over a vast area now encompassing parts of Russia, Belarus, and Ukraine. The amounts far exceeded releases from any previous nuclear power station accident. Millions of people were exposed.

Since the accident, anecdotal evidence of increased cancer rates near Chernobyl has mushroomed like a radioactive cloud. Researchers now have hard proof that thyroid-cancer cases in children, while still rare, have multiplied in northern Ukraine during the post-accident years.

On average, doctors in northern Ukraine diagnosed 12 cases of childhood thyroid cancer annually in the 5-year period before Chernobyl. Between 1986 and 1990, they found 22 new cases per year. Between 1991 and 1995, the rate soared to 63 cases, and during the next 2 years, it climbed to 73 cases per year, the researchers report in the July 1 CANCER.

Children who were 5 years old or younger in 1986 were most likely to develop the cancer. Also, four children who were still in the womb at the time of the accident subsequently contracted thyroid cancer.

All but a few of the children have survived. Thyroid cancer is treated by removal of the thyroid gland. Patients must then take thyroid-hormone replacements for the rest of their lives.

While previous reports indicated thyroid-cancer incidence was up in the region, they lacked the statistical rigor of this comparison, says study coauthor Virginia A. LiVolsi, a pathologist at the University of Pennsylvania Medical Center in Philadelphia.

The thyroid gland needs iodine to manufacture thyroid hormone, which is essential to body metabolism and growth. The children in the Ukraine might have been slightly deficient in iodine before the accident, LiVolsi says, causing their thyroids to readily accept iodine--radioactive or not. Radioactive iodine kills cells or retards their development. The radiation also causes DNA damage, genetic mutations, and sometimes cancer.

Data for the new study came from a registry compiled by the Academy of Medical Sciences of Ukraine in Kiev. Scientists suspect that exposed adults might also have a higher thyroid-cancer incidence since the accident, but the researchers are only now collecting data on adults. Because children have smaller thyroid glands, their radioactive dose of iodine is proportionately larger and so has a greater impact, LiVolsi says.

COPYRIGHT 1999 Science Service, Inc.
COPYRIGHT 2000 Gale Group

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