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Experts Divided on Whether to Treat Thyroid Cancer
Date:5/17/2010

Study suggests quick action makes little difference, but others call this risky

MONDAY, May 17 (HealthDay News) -- Immediate treatment of thyroid cancer that has not spread beyond the gland doesn't make much difference in long-term survival, according to a study that quickly aroused controversy.

"One thing that really surprised me was how good survival was," said Dr. Louise Davies, lead author of a report on the study, published in the May issue of Archives of Otolaryngology. "We found that for cancers of any size that are confined to the gland, the 20-year survival rate for those that got immediate treatment was 99 percent, and for those not treated immediately, in the first year or even longer after diagnosis, 20-year survival was 97 percent."

That finding "led me as a surgeon to think about the risks versus the benefits of surgery for such thyroid cancers," Davies said. "It certainly made me feel a lot less anxious about working with these patients to watch small thyroid modules and not biopsy every one. I'm a lot less worried than I used to be that there will be a cancer in that module that is going to kill a person."

That conclusion drew a quick rebuttal from Dr. Erich M. Sturgis, an associate professor of head and neck surgery at the M.D. Anderson Cancer Center and co-author of an accompanying editorial.

"Our concern is that a general person reading that paper will draw the conclusion that there is no size limit to a tumor of that gland that can be observed rather than treated," Sturgis said.

Davies, an assistant professor of surgery in the Dartmouth Medical School section of otolaryngology and a staff surgeon at the Veterans Affairs Medical Center in White River Junction, Vt., was also the author of a 2006 report that started an ongoing controversy about the incidence of thyroid cancer in the United States. That paper reported a sharp increase in the number of thyroid cancers being
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