New evidence suggests that a type of tumor, which until now has been treated as cancerous, may have been misdiagnosed. Research published last week in the Journal of the American Medical Association (JAMA) Oncology, which combined data from a collaboration of scientists across the world, conclusively indicated that a type of thyroid tumor previously thought to be cancerous is actually noninvasive.
As a result of the study, the American Medical Association has downgraded the status of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) to “noninvasive follicular thyroid neoplasm with papillary-like nuclear features.” The impact of these findings are significant. Thousands of patients across the world will be spared invasive surgery to remove their thyroid gland, avoiding dangerous treatments involving radioactive iodine, and skipping regular checkups for the rest of their lives.
The tumor in question manifests itself as a small lump in the thyroid gland that is completely surrounded by a capsule of fibrous tissue. Its nucleus appeared to medical practitioners to be a cancerous tumor. However, in this instance, the cells do not break out of their capsule. This means that surgery to remove the thyroid (which plays an important role in hormone regulation in the body) followed by treatment with radioactive iodine is unnecessary.
For those who have already been through this process, this news may be troubling since it suggests that the life-changing steps they had to take to remove the threat of cancer were essentially futile. It’s good news, however, for an estimated 15 percent of approximately 65,000 patients diagnosed with thyroid cancer each year. These patients will now be spared from having to undergo invasive surgery and risky drug treatments.
Many cancer specialists welcomed the study’s findings, and have long been pushing for a reclassification of the tumor. The findings may also have positive implications for other forms of cancer, which are in need of reclassification and disassociation from cancer, including small lesions in the breast, lung and prostate. Thus far, other than the reclassification of a urinary tract tumor in 1998 and early-stage ovarian and cervical lesions over 20 years ago, no other move has been made by the medical community to examine the validity of certain questionable carcinoma classifications.
The thyroid cancer reclassification movement began two years ago, when Dr. Yuri Nikiforov, vice chairman of pathology at the University of Pittsburgh, was asked to examine a small thyroid tumor in a young woman. The tumor was completely encased inside the capsule and the lobe of her thyroid gland had been removed to allow doctors to reach a diagnosis. Dr. Nikiforov told the surgeon who had asked his opinion on the matter that it was a “very low-grade tumor” and that no further action or surgery was necessary. The surgeon replied that in accordance with practice guidelines, the woman’s entire thyroid gland needed to be removed and that she required treatment with radioactive iodine, as well as life-long checkups.
This was the last straw for Nikiforov, who had been observing this unnecessarily drastic diagnosis and treatment for some time. The overdiagnosis was being caused by worried doctors treating these patients as worst-case scenarios, assuming all tumors composed of cells with nuclei were cancerous. Doctors were more willing to treat a questionable tumor aggressively than risk a patient’s life, despite the fact that the surgery would affect the patient’s health and livelihood. Dr. Nikiforov had been aware of this practice, but the young woman with the low-grade tumor spurred him to action. He brought together the international panel of experts that would ultimately produce the article requiring the reclassification of thyroid tumors.
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Liivi is an Integrative Nutrition Health Coach and is training to become a doula. She inspires women to find peace and personal power by taking control of health and fertility naturally. Liivi‘s passion is ancestral nutrition and primal lifestyle design. She and her partner Will live between Toronto, Canada and Queenstown, New Zealand.