Thyroid cancer treatment varies by hospital, study finds
Where thyroid cancer patients go for care plays a large role in whether they receive radioactive iodine treatment, a new study from the University of Michigan Comprehensive Cancer Center finds.
While the size and severity of the tumor also played a role in treatment, researchers found unexplained hospital factors had a significant impact on radioactive iodine use.
"What hospital you go to makes a difference in use of radioactive iodine. It doesn't just matter what the tumor looks like, but where you go for care," says lead study author Megan Haymart, M.D., assistant professor of internal medicine at the U-M Medical School.
Results of the study appear in the Aug. 17 issue of the Journal of the American Medical Association.
Thyroid cancer is currently one of the 10 most common cancers in the United States and is expected to become even more common in the next decade as more small, early stage cancers are uncovered.
Radioactive iodine following surgery to remove the thyroid is known to be an effective treatment for advanced or high-risk thyroid cancer that is very likely to return. But patients with small, low-risk disease often have an excellent prognosis without radioactive iodine treatment, giving some doctors pause to wonder whether they are submitting patients to unnecessary treatment and risk of side effects.
"For some patients, radioactive iodine is a very important part of treatment, but for others, the risks may outweigh the benefit. We need more studies of this low-risk group of patients to understand what the best treatment course is," Haymart says.
In the current study, researchers looked at data from 189,219 patients diagnosed with thyroid cancer between 1990 and 2008, as reported to the National Cancer Database, a national database that captures about 85 percent of all thyroid cancers diagnosed in the United States.
Researchers found that radioactive iodine treatment is being used more frequently overall 40 percent of patients in 1990, compared to 56 percent of patients in 2008. Size and severity of the tumor did impact a patient's likelihood to have radioactive iodine, accounting for about 21 percent of the variation in care. In addition, factors such as whether the hospital saw a high volume of thyroid cancer patients played a role. But 29 percent of the variation between whether patients received radioactive iodine was attributable to hospital factors that could not be explained.
"Even among people who are high risk and the guidelines are clear that these patients should receive radioactive iodine there is still variation. This suggests doctors are unclear about the indications for radioactive iodine. We need randomized clinical trials that look at radioactive iodine in low-risk patients so that we can set better guidelines for its use," Haymart says.
Radioactive iodine treatment can have long-term side effects, including risk of a second cancer or damage to nearby tissue such as salivary glands. In addition, safety precautions need to be taken when the treatment is delivered, requiring patients to stay away from young children for a week and avoid becoming pregnant for up to a year after treatment.
Thyroid cancer statistics: 44,670 Americans will be diagnosed with thyroid cancer this year and 1,690 will die from the disease, according to the American Cancer Society
More information: Journal of the American Medical Association, Vol. 306, No. 7, Aug. 17, 2011. "Use of Radioactive Iodine for Thyroid Cancer"
Provided by University of Michigan Health System
- The case for maintaining current regulations on I-131 therapy May 05, 2011 | not rated yet | 0
- Molecular imaging enables earlier, individualized treatment of thyroid cancer Jan 02, 2009 | not rated yet | 0
- Radioactive scorpion venom for fighting cancer Jun 27, 2006 | not rated yet | 0
- Alarms over radiation from thyroid cancer patients Oct 20, 2010 | not rated yet | 0
- Radiation risks to health: A joint statement from leading scientific experts Mar 18, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
22 hours ago Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
Breast cancer characterized as "triple negative" carries a poor prognosis, with limited treatment options. In some cases, chemotherapy doesn't kill the cancer cells the way it's supposed to. New research from Western University ...
Cancer 9 hours ago | 5 / 5 (2) | 0
Mayo Clinic researchers have used next generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings ...
Cancer 9 hours ago | not rated yet | 0
Even while being dragged to its destruction inside a cell, a cancer-promoting growth factor receptor fires away, sending signals that thwart the development of tumor-suppressing microRNAs (miRNAs) before it's dissolved, researchers ...
Cancer 10 hours ago | not rated yet | 0 |
Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added ...
Cancer 14 hours ago | not rated yet | 0
Scientists have uncovered a survival mechanism that occurs in breast cells that have just turned premalignant-cells on the cusp between normalcy and cancers-which may lead to new methods of stopping tumors.
Cancer 14 hours ago | not rated yet | 0 |
(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...
9 hours ago | 4.8 / 5 (5) | 0 |
A brief visual task can predict IQ, according to a new study. This surprisingly simple exercise measures the brain's unconscious ability to filter out visual movement. The study shows that individuals whose ...
14 hours ago | 4.4 / 5 (9) | 0 |
Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.
12 hours ago | 5 / 5 (1) | 2 |
Scientists at the National Institutes of Health report they have discovered in mouse studies that a small molecule released in the spinal cord triggers a process that is later experienced in the brain as ...
12 hours ago | 5 / 5 (2) | 0 |
Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...
13 hours ago | not rated yet | 0 |
Ethnic background plays a surprisingly large role in how diabetes develops on a cellular level, according to two new studies led by researchers at the Stanford University School of Medicine.
10 hours ago | not rated yet | 0 |