New Medical Technology Reduces Thyroid Surgeries

Dr. Lisa Schwartz is a medical professor at Dartmouth. She recently shared with colleagues and interns her concern that many senior citizens are becoming the victims of overactive screening for tumors of the prostate, breast, and especially the thyroid. Dr. Schwartz says that these unnecessary screenings can lead to radical treatments, including surgery, that will have no perceptible effect on longevity and may cause ancillary pain and discomfort. A growing chorus of doctors and other medical professionals are beginning to register their own doubts as to the efficacy of surgical intervention in all cases of thyroid nodules, which often lead to the complete removal of the gland.

Just several months ago a worldwide panel of two dozen thyroid pathologists announced a bold rethinking of the thyroid surgery paradigm. As reported in the media, the panelists decided that one of the most common thyroid cancers is no longer to be considered a cancer at all, since it is non-invasive of other tissues — they hope that removing the word ‘carcinoma’ from its medical name will discourage radioiodine and surgical overtreatment.

The groundswell among diagnosticians and surgeons is clear; with an estimated 100 thousand unnecessary thyroid surgeries occurring each year in the United States, new diagnostic technologies are imperative to reduce the occurrence of superfluous thyroid surgeries in America. Once this occurs, it is expected to save millions of dollars in hospital and in-patient care costs, as well as free up surgeons for more vital and imperative surgeries.

This being the case, a recent announcement by ThyroSeq concerning their international study presented at the American Thyroid Association is most welcome. At the ATA meeting in Victoria, BC, Canada, the outcome of their latest multi-center, double-blind study is providing validation of a clinical nature concerning the performance of ThyroSeq V3 with thyroid nodules that exhibit an indeterminate cytology. Their presentation showed that ThyroSeq’s V3 is a valid tool in the definitive diagnosis of thyroid nodules during pretreatment exploration. This, in turn, will decrease the number of invasive surgeries and thus be a positive influence on patient care cost effectiveness.

The study exhibits conclusively that ThyroSeq V3 can provide a trusted procedure across a broad spectrum of both benign and cancerous thyroid nodules — among variable population demographics with wide disease variables. This means it is the perfect tool for standard clinical use.

An expanded genomic classifier for ThyroSeq V3 is showing a higher sensitivity as well as specificity for cancer detection in the thyroid gland, which includes most follicular oncocytic carcinomas and lesion of the parathyroid. Clinical validation has been approved for several multi-center study groups.

In technical terms, the V3 procedure can help to decrease diagnostic and exploratory surgery by as much as sixty percent in patients who exhibit cytologically undetermined Bethesda 3 and 4 nodules — which is a significant portion of the overall patient population.

For the past ten years the partnership of UPMC and CBLPath, working together as ThyroSeq, has been continuously researching and refining to be able to increase sensitivity and specificity; to give the cleanest optimum personalized diagnosis for cancerous thyroid nodules; and continues to increase the size of their gene panel to provide definitive options to diagnosticians, surgeons, and patients undergoing thyroid nodule treatment. All without the threat of complete glandular removal, which often leads to early menopause in women and other unwelcome effects, such as hyperthyroidism, laryngeal nerve damage, which in turn can lead to semi-permanent hoarseness; and complete removal may adversely affect the parathyroid glands, which have a direct influence on the amount of calcium your body is able to produce and absorb.

Given the above background and reasons, it seems reasonable to expect that ThyroSeq V3 will soon become the optimum standard of care in the vast majority of cases of benign, precancerous, and cancerous thyroid nodule treatment.   

Photo by euthman