Understanding Thyroid Cancer

World Cancer Day is celebrated on February 4, which was initiated by the International Union Against Cancer (UICC) and recommended by the World Health Organization. As a major cause of human death worldwide, cancer has been regarded as a tiger by both academics and the general public. Preventing cancer and improving the quality of life of cancer patients have been two eternal themes in this field of research, and there are tens of millions of misconceptions about cancer. Cancer can occur in all organs of the human body, except for the nails and hair. The thyroid gland, as the largest endocrine gland organ in the human body, is also subject to cancer, and according to a nationwide survey in recent years, thyroid cancer is one of the fastest growing types of cancer reported recently. According to a survey in Beijing, in 2010, a total of 1099 new cases of thyroid cancer were reported in Beijing, accounting for 2.9% of malignant tumors, with an incidence rate of 8.78/100,000, up 225.2% from 2.70/100,000 in 2001, with an average annual increase of 14.2%. Although the reported incidence is so alarming, the progression of thyroid cancer patients is in most cases not the same as that of liver cancer and stomach cancer, which we are generally familiar with, and the majority of patients do not affect life expectancy or cause serious damage to quality of life after timely treatment. As with many other tumors, the pathogenesis of thyroid cancer is not yet known with certainty. Therefore, there is insufficient evidence to link the increased incidence of thyroid cancer with the use of iodized salt. Early exposure to radiation, chronic excess and deficiency of iodine, genetic inheritance, adverse emotions, and hormone levels may all contribute to the development of thyroid cancer. However, there is no direct evidence that iodine overdose can cause thyroid cancer. What is more certain is that with the application of iodized salt, the pathological composition of thyroid cancer in China has changed from the original highly malignant undifferentiated carcinoma to the low malignant papillary carcinoma, and now it is almost difficult to see undifferentiated thyroid cancer in clinical practice. The treatment of cancer basically includes surgery, radiotherapy, chemotherapy, bioimmunotherapy and Chinese herbal medicine. In the treatment of thyroid cancer, most patients basically only need surgery and postoperative thyroid hormone suppressive replacement therapy, while a small number of patients need chemotherapy and isotope therapy. Bioimmunotherapy for medullary thyroid cancer (which is a less common type of thyroid cancer) is still in the clinical trial stage. Postoperative thyroid hormone suppressive replacement therapy, which accounts for a large part of thyroid cancer treatment, is subject to many operational misconceptions in clinical practice. First of all, regardless of the type of cancer, the development of a long-term postoperative drug regimen relies heavily on the surgical pathology report, and thyroid cancer is no exception. Many patients often neglect to bring their surgical pathology reports with them, which can make it difficult to develop a drug treatment plan. It is also important to note that there are two types of surgical pathology reports, one is the frozen pathology report (or rapid pathology report) and the other is the paraffin pathology report (also known as formal pathology report), and the post-operative drug treatment plan depends on the paraffin pathology report, which includes a lot of information about the tumor (such as size, differentiation, whether it is metastatic or not, etc.). Secondly, the goal of thyroid hormone suppression after surgery depends on TSH (thyrotropin), which is a laboratory index in most cases. The target TSH varies from person to person and is not as low as most patients understand. There is also the fact that many patients will choose to take herbal medicine after surgery, which is not wrong. However, it should be noted that in many cases, herbal medicine will affect the absorption and metabolism of thyroid hormone drugs, thus affecting their ability to control TSH. Therefore, it is recommended that if thyroid cancer patients take both herbal medicine and thyroid hormone drugs at the same time, the time between the two drugs should be at least one hour apart, or thyroid hormone drugs should be taken before bedtime. In addition to the treatment of the tumor itself, cancer recovery relies heavily on avoiding over-treatment and improving the quality of life. In thyroid cancer due to postoperative thyroid hormone suppressive replacement, it is difficult to avoid the resulting accelerated bone loss and increased prevalence of osteoporosis. Therefore, for this group of patients, prevention and treatment of osteoporosis is also part of the overall treatment of the tumor. There is evidence that the use of certain anti-osteoporosis drugs can significantly reduce the recurrence and metastasis of tumors and significantly improve the quality of life of tumor patients as well as prolong their lives. It is also important for post-operative thyroid cancer patients to have regular follow-up examinations and to develop the habit of regular review. In conclusion, although thyroid cancer is a kind of low-grade malignant tumor that has little impact on life time and quality of life, paying attention to the details of the treatment process will better improve the quality of life of patients.