Thyroid Disease Research Leading to "Personalized Medicine"


Newswise — Internationally recognized thyroid disease experts will meet to discuss “Thyroid Disorders in the Era of Personalized Medicine” May 13 – 16 in Minneapolis, Minnesota at the American Thyroid Association’s (ATA) (www.thyroid.org) Spring Meeting to be held at the Minneapolis Hyatt Regency Hotel.

Sessions and presentations will include: Why do metastatic lymph nodes matter?

Jennifer Sipos, MD, assistant professor of medicine in the College of Medicine at The Ohio State University, says that when treating thyroid cancer and watching for recurrence, the larger the metastatic lymph nodes the more important they become. Using ultrasound, clinicians can better see which lymph nodes (LN) are clinically important.

“At diagnosis, 42 percent of patients present with metastatic lymph nodes and 21 percent present with macroscopic lymph nodes,” explains Dr. Sipos. “Thorough neck dissections in patients with preoperatively detected LNs will improve LN recurrence-free survival.”

Dr. Sipos notes that studies have shown that 10 percent of patients initially rendered free of disease developed recurrence after a median of 1.5 years from diagnosis and 21 percent experienced recurrence 30 years after initial therapy.

“Recurrence rates increase as a function of primary tumor size,” she says. “Macroscopic LN metastases are a major risk factor for recurrent disease, so patients should have appropriate neck dissection at initial presentation.”

Dr. Sipos will present during the Advanced Thyroid Ultrasound Workshop & Practicum, Thursday May 13 from 9:00 am. to 1:30 pm.

Risks and safety issues in I-131 radioactive iodine administration

Using case studies, Michael T. McDermott, MD, director of the Endocrinology and Diabetes Practice at University of Colorado Hospital, Denver, will discuss issues of risk and safety surrounding I-131 on Friday May 14 during a Meet the Professor Workshop from 1:30 pm. to 2:30 pm.

Among the issues Dr. McDermott will discuss are I-131 administration safety and risks for patients with Graves’ ophthalmopathy and patients who are pregnant or nursing.

“Development or worsening of Graves’ orbitopathy is somewhat more likely after I-131 treatment when compared with treatment with anti-thyroid drugs or surgery,” says Dr. McDermott. “Risk may be lowered by preventing hypothyroidism or treating it promptly.”

According to Dr. McDermott, radioiodine exposure during pregnancy is contraindicated, but if there is inadvertent exposure, most likely during the first trimester, Propylthiouracil can be administered. Likewise, RAI is contraindicated in breast-feeding mothers because of mammary gland uptake. Six to 12 months after lactation ceases, RAI could begin. However, breast-feeding should cease if RAI is unavoidable.

Drugs and Thyroid Function

New, sophisticated, targeted anti-cancer treatments have been shown to have profound effects on thyroid function in people without pre-existing disease. Others influence the mechanism of frequently prescribed thyroid medications. Giuseppe Barbesino, MD, Thyroid Associates, Massachusetts General Hospital and the Harvard Medical School, will review these recent advancements that are helping thyroidologists treat patients more effectively. He will discuss “Drugs and Thyroid Function: An Overview” in a session titled Drugs and Disorders of the Thyroid Saturday May 15, 2:30 pm. – 4:00 pm.

BRAF Mutation--Unique Prognostic Marker in Thyroid Cancer

According to Mingzhao Xing, MD, PhD, associate professor of medicine and oncology at the Johns Hopkins University School of Medicine, one of the most exciting recent findings in thyroid cancer research is the discovery of the BRAF mutation. “This is the most common genetic alteration with a fundamental role in thyroid cancer,” says Dr. Xing. “This mutation is a unique prognostic marker that is useful in helping physicians with risk stratification and treatment decision making for patients with thyroid cancer.” Dr. Xing will speak on the BRAF mutation’s prognostic utility Friday May 14 from 9:45 am. – 11:15 am. during the session Genetic Markers and Personalized Diagnosis.

New molecular marker help guide personalized therapy

The bad news is that papillary thyroid cancer incidence rates are rising rapidly; the better news is that imaging for other diseases account for increased diagnoses of micropapillary thyroid cancer. According to Bryan R. Haugen, MD, professor of medicine and pathology, University of Colorado Health Sciences, once discovered it can be difficult to decide which patients should receive the more aggressive therapy. Some will be carefully monitored; others will undergo surgery or radioactive iodine therapy. However, newer “markers,” such as BRAF mutation, may help guide personalized therapy. Dr. Haugen will present on “Thyroid Microcarcinoma” on Friday May 14 in Recent Developments in Thyroid Cancer from 11:15 am. – 12:45 pm.

Minimally invasive, video-assisted thyroid cancer surgery

With the incidence of thyroid cancer rising significantly over the past 20 years, interest has increased for providing minimally invasive thyroid cancer surgery for patients in low and some intermediate-risk groups. David J. Terris, MD, surgical director of the Medical College of Georgia’s Department of Otolaryngology, explains a minimally invasive, video-assisted surgical procedure Friday May 14 during Personalized Surgical Therapy for Thyroid Cancer, from 2:30 pm – 4:00 pm. “We have evolved our practice to one where surgery is customized to the patient and their disease characteristics, rather than ‘one-size-fits-all’,” says Dr. Terris. “The smallest possible incision is utilized so that patients experience decreased pain, faster recovery and decreased risk for complications.”

Attendees will include endocrinologists, surgeons, family and internal medicine physicians and other health care professionals.For meeting details, please log on to: www.thyroid.org/ann_mtg/2010_spring/index.html

The American Thyroid Association (ATA) is the lead organization in promoting thyroid health and understanding thyroid biology. The ATA values scientific inquiry, clinical excellence, public service, education, collaboration, and collegiality.

A non-profit medical society founded in 1923, the ATA fulfills its mission through supporting excellence and innovation in research, clinical care, education, and public health. ATA members are physicians and scientists who work to enhance the understanding of thyroid physiology and pathophysiology, improve the diagnosis and treatment of thyroid diseases, and promote the education of physicians, patients, and the public about thyroid disorders.

Thyroid diseases are among the most common disorders of the endocrine system, affecting almost 13 million Americans. The ATA has extensive online information for patients on thyroid disease (in English and Spanish) serving the clinician as a resource for patients and the public who look for reliable information on the Internet. To further benefit patients, the ATA Alliance for Patient Education was formed in 2002 to offer an exchange of information between the ATA and patient education groups: ThyCa: Thyroid Cancer Survivors’ Association, Inc.; the Light of Life Foundation, and the National Graves’ Disease Foundation. A public forum is held each year in conjunction with the ATA annual meeting.

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