Opinion: De-intensifying treatment for early thyroid cancer

Choosing less-intense cancer care can make doctors and patients nervous, but it's sometimes the right thing to do.
For many people with early thyroid cancer, a less-intense operation called lobectomy is as good as complete removal of the thyroid gland. Source: AP Photo/Carlos Giusti

How much thyroid gland is enough? Can you get by with half of one?

That question is relevant to the more than 50,000 Americans diagnosed with thyroid cancer each year. As we point out in a study published Wednesday in the New England Journal of Medicine, it is also a question that doctors who treat thyroid cancer need to give more attention to, while the rest of us consider the broader questions about the appropriate intensity of treatment for early cancer.

First, some background on thyroid cancer. Although it is a rare cause of death, autopsies often show the existence of what is called papillary thyroid cancer. In other words, this is typically a cancer you die with — not from.

Before the mid-1990s, the incidence of thyroid cancer had been relatively stable as ultrasound, MRI, and CT scans now detect small papillary thyroid cancers that cannot be felt. Yet despite this dramatic increase in new cases, the death rate from thyroid cancer has been rock stable.

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