Madrid, 21 September 2023-. According to the Spanish Society of Medical Oncology (SEOM), it is estimated that there will be around 6,084 new cases of thyroid cancer in 20231. This is not one of the more common or frequently diagnosed tumour groups. Nevertheless, the advances made in this field over recent years are not only improving survival rates and the quality of life for the patients, but also serving as a reference model for the development of other oncology drugs.
As Dr. Enrique Grande, Head of the MD Anderson Cancer Center Madrid Medical Oncology Department clarifies; there are four distinct lines of treatment for this condition. In addition to radioactive iodine therapy, known as radioiodine, and advances in precision medicine, patients and health professionals have three approved tyrosine kinase inhibitors available. “Even in the most aggressive tumours we have obtained significant advances thanks to molecular biology, achieving results that were unimaginable five years ago”, said the specialist.
Nodules in the neck area, the most common symptom of thyroid cancer
Thyroid cancer is the most common tumour of the endocrine system and represents approximately 3% of all cancer cases. The diagnosis of this pathology generally follows the identification of nodules in the area of the neck or the joint between the collarbone and the sternum, and a subsequent biopsy.
Although not always evident, patients may develop “vague” symptoms, such as the appearance of a lump on the neck that is neither swollen nor painful. However, there is a smaller percentage, between 2 and 4% that do exhibit more aggressive signs, including redness of the lump, fistulisation or problems with swallowing or breathing2.
“There are three types of thyroid cancer, with differentiated thyroid cancer being the most frequent, with a high curability rate thanks to surgery. The second type is medullar thyroid cancer, which is often hereditary or a specific mutation in what is known as the RET gene. Thirdly, we have anaplastic thyroid cancer, which can end a patient’s life in a matter of weeks. This last condition requires further advances in research to produce a new generation of drugs and swifter treatment”, explained the Head of Medical Oncology Department at MD Anderson Madrid.
The wide variety of current lines of treatment guarantees a higher survival rate and quality of life for the patients
The approach is different for each type of thyroid cancer. In this regard, Dr. Enrique Grande confirms that if the patient can identify a confined and localised nodule then surgery can be the first option, given that it is normally curable. However, the specialist also insists that this is not the only route available to patients with thyroid tumours, as other options exist such as radioactive iodine therapy, which is used to eradicate thyroid cells and reduce the thyroid gland. According to the specialist, the initial course of radioiodine has an 80% success rate.
“When surgery fails and the patient becomes part of that 20% in which radioiodine unfortunately does not work, we look at other possibilities. We have tyrosine kinase inhibitors, which are drugs that impede the formation of blood vessels and effectively ‘stifle’ the tumour resulting in a notable slowing of its growth. In addition to these tyrosine kinase inhibitors we can add drugs directed at specific mutations and alterations, such as the BRAF, TRK and RET inhibitors”, explains Grande.
“Thanks to an understanding of molecular biology, the development of drugs and the application of this knowledge to the day to day situation of the patients, we are managing to significantly improve life expectancy and survival rates, which have increased from an average of two years to more than five”, concluded Dr. Enrique Grande.
References
- The Spanish Society of Medical Oncology (SEOM). Cancer figures in Spain 2023. Available on: https://seom.org/images/Las_cifras_del_Cancer_en_Espana_2023.pdf
- The Spanish Society of Medical Oncology (SEOM). Thyroid cancer