Key Clinical Characteristics
- Accounts for 3-5% of all thyroid cancer cases.
- 20% of MTC patients may have hereditary disease, and all patients with newly diagnosed MTC should be tested for a germline mutation in the RET gene.
- 80% of MTC is sporadic and no other family members are at risk for disease.
- Patients with MEN2 may have other non-cancerous medical conditions, such as over active parathyroid glands (hyperparathyroidism) or other endocrine cancers such as pheochromocytoma, and require evaluation for these conditions.
- Medullary thyroid cancer arises from mutations in specific genes, such as RET.
Basics of Disease Management
- While MTC is occasionally diagnosed by fine needle aspiration of a thyroid nodule, many patients with sporadic MTC learn of the diagnosis after thyroidectomy.
- Surgery is the mainstay of treatment for medullary thyroid cancer.
- Thyroidectomy should be performed by an experienced thyroid surgeon.
- Endocrinologists play a key role in diagnosing and managing patients’ with thyroid cancer. Most patients will require replacement therapy with thyroid hormone (T4) which requires monitoring.
- Radioactive iodine is not used for treatment of medullary thyroid cancer.
- Thyroid cancer treatment should be individualized by a team of specialists to ensure the best possible outcome.
- Medullary thyroid cancers usually produce hormone such as calcitonin and CEA that can be monitored by blood tests.
- Patients with persistently elevated calcitonin or CEA after thyroidectomy may have residual or metastatic disease.
Advanced Disease: Special Issues
- The FDA has approved two targeted therapies for treatment of patients with progressive medullary thyroid cancer.
- Patients with metastatic disease should be followed by an experienced endocrinologist, oncologist, or surgeon.
- Some patients with medullary thyroid cancer may have distant spread of disease (metastasis) to lung, liver, or bones.
- Patients with symptoms due to metastatic thyroid cancer or growth of thyroid cancer in other organs may benefit from consultation with a medical oncologist specializing in thyroid cancer and consideration of targeted therapy or participation in clinical trials.
Participation in Clinical Trials
- Clinical trials are carefully controlled experiments that are conducted to discover more effective therapies.
- Some patients with advanced disease may be candidates for participation in clinical trials.
- Patients with advanced disease may be candidates for participation in clinical trials.
- Physicians that specialize in care of patients with advanced thyroid cancer can help identify whether you may be an appropriate candidate for participation in a clinical trial.
- Consultation with a thyroid cancer specialist to consider new forms of therapy is encouraged for patients with medullary thyroid cancer.