Our Publications Visit PubMed for a listing of journal articles authored by our thyroid cancer team 
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Memorial Sloan-Kettering is a comprehensive center for the detection and treatment of thyroid cancer. A multidisciplinary team of head and neck surgeons, endocrinologists, medical oncologists, nuclear medicine specialists, pathologists, radiologists, pediatricians, and radiation oncologists works together to ensure an accurate diagnosis and the best care possible for each patient.
Risk Group Stratification
Most patients with thyroid cancer will need surgery as the initial definitive treatment. Our approach to surgery for thyroid cancer depends on the biological behavior of the cancer. We employ what is known as risk group stratification, in which our surgeons tailor the extent of surgery based on whether the patient has a low-risk or high-risk thyroid cancer.
The majority of thyroid cancers occur in adults (defined as individuals aged 20 to 50) and is rare in the very young and the very old. Most young adults diagnosed have a small, incidentally discovered, favorable thyroid cancer, which is confined to the thyroid gland. These are low-risk thyroid cancers. Extensive or aggressive thyroid cancer at any age is considered high-risk cancer and requires aggressive surgery and additional therapy. The extent of surgery, therefore, will depend on the risk group.
If only part of the thyroid is surgically removed, generally no further treatment is usually necessary. If the entire thyroid is removed, patients will need to take daily thyroid hormone pills to replace the hormones produced by the thyroid, which are essential to proper metabolism and other body functions.
Radioactive Iodine Therapy
In addition to surgery, some patients may require therapy that involves the ingestion of radioactive iodine. Radioactive iodine kills normal thyroid tissue and it may detect thyroid cancer cells throughout the body, destroying them without significantly affecting healthy tissue.
Before radioactive iodine therapy, thyroid cells must be primed so they are more vulnerable to the radioactive iodine. Until recently, the only way to do this was for the patient to stop treatment with thyroid hormone pills, to allow levels of a pituitary hormone called thyroid-stimulating hormone (TSH) to rise. Now, many patients have the option of receiving synthetic, or "man-made," human TSH before radioactive iodine therapy, which causes TSH levels to rise without the patient having to go off thyroid hormone therapy. This approach can spare patients the unpleasant and sometimes disabling consequences of not having enough thyroid hormone present in the body (a condition known as hypothyroidism). Investigators at Memorial Sloan-Kettering played an important role in testing and validating this new approach for radioiodine therapy. Memorial Sloan-Kettering researchers have also pioneered new uses of radioactive iodine therapy, including determining the most effective dose levels and treatment regimens.
Investigative Genetic Approaches
Our investigators are also leaders in the basic genetics of thyroid cancer and were instrumental in identifying many of the genetic changes that lead to the development of the disease. This knowledge is now spawning the development of novel therapies directed against the genetically modified proteins found in human thyroid cancers.
With the combined approach of surgery, radioactive iodine, and/or thyroid hormone therapy, most people with thyroid cancer are successfully treated. However, about a quarter of patients have recurrent thyroid cancer. Radioactive iodine therapy is typically not effective in managing recurrent disease. Researchers at Memorial Sloan-Kettering are now using PET scanning to detect cancer that has spread -- an important step to reclassify the disease in patients who may need additional therapies. For these patients, external beam radiation therapy, additional surgery, or systemic treatments with chemotherapy, or experimental medications may also be used as treatments. Many therapies are now being developed on the basis of the genetic characteristics of a patient's tumor -- an area of treatment in which Memorial Sloan-Kettering investigators have shown significant leadership.
