# It's not cancer: Doctors reclassify a thyroid tumor



## joplin1975 (Jul 21, 2011)

http://mobile.nytimes.com/2016/04/15/health/thyroid-tumor-cancer-reclassification.html?_r=0&referer=http://apple.com/spotlight-suggestion

The reclassified tumor is a small lump in the thyroid that is completely surrounded by a capsule of fibrous tissue. Its nucleus looks like a cancer but the cells have not broken out of their capsule, and surgery to remove the entire thyroid followed by treatment with radioactive iodine is unnecessary and harmful, the panel said. They have now renamed the tumor. Instead of calling it "encapsulated follicular variant of papillary thyroid carcinoma," they now call it "noninvasive follicular thyroid neoplasm with papillary-like nuclear features," or NIFTP. The word "carcinoma" is gone.


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## creepingdeath (Apr 6, 2014)

So thousands of people who were diagnosed with cancer and had their thyroid removed didn't have cancer and didn't have to have the thyroid removed?

And also didn't have to have radioactive treatment. Which I assume can actually cause cancer?

*Do I smell many a lawsuit *????


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## joplin1975 (Jul 21, 2011)

I have some mixed feelings about this. Because, essentially, what they are saying is the cell structure is the same...its just that some people's tumors grow and some don't. So, do you want to play the watch and wait game or not?

And nothing is said about the co-occurrence of auto-immune disease and the potential impact on quality of life.


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## creepingdeath (Apr 6, 2014)

I agree.

But I think even if no signs of cancer "no tumors" but never ending symptoms the patient should have more options.

I'm so sick of this thyroid that I would like to have it removed with no questions ask from Doctors or insurance companies.

Isn't that what Obama care is all about~ preventive medicine?

I do have a greater chance of getting thyroid cancer with Hashimoto's autoimmune disease too.

"And don't even get me started on the right to the hormone of choice issue"


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## WhatHappened (Nov 12, 2015)

Hmm.. to quote some advice on the boards, tell me you feel like your are choking. It's a shame to have to resort to it.

Without the understanding of whether autoimmune disease was present it's hard to know if it was wasted effort or accidental Improvement.


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## joplin1975 (Jul 21, 2011)

Follow up Q&A provided to the Thyroid Cancer Survivors Association from the lead author, Yuri Nikiforov:

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The researchers note that this reclassification does not apply to all tumors of this variant. Some of the tumors are cancer, because they have capsular invasion, vascular invasion, or both.

Here are a few of the questions raised in the last few days in ThyCa local support groups, online groups, and e-mails, plus information based on the two articles linked above. If you have any questions about your diagnosis and/or care after reading this article, we encourage you to consult with your physician.

1. Does this reclassification apply to every thyroid tumor that is encapsulated follicular variant of papillary thyroid cancer (EFVPTC)?

No. This reclassification is specifically only for EFVPTC with no invasion. The researchers concluded this reclassification does not include invasive EFVTPC

2. Does surgery need to be done?

Yes, at least the part of the thyroid that contains the tumor needs to be removed so that the pathologist can examine the tissue to determine whether the tumor is completely surrounded by a capsule of fibrous tissue and whether there is capsular or vascular invasion. The results of the tissue analysis will determine whether there is invasion, and, therefore, whether the reclassification applies.

3. Will a patient with a noninvasive tumor of this variant need further treatment after the surgery?

The articles note that patients whose tumors will be classified as not cancer will not need further surgery such as a completion thyroidectomy, and will not require radioactive iodine (RAI). All the patients in the study who fit the criteria for reclassification were free of disease during the entire follow-up period of from 10 to 26 years after their initial surgery. None received RAI.

4. What will be the follow-up over the long term?

The articles focus on the reclassification rather than on overall long-term care. Individuals should consult with their own physician regarding their care.

As noted in earlier articles in this Bulletin, during regular medical and dental appointments, ThyCa encourages neck checks to find thyroid nodules. According to the Academy of General Dentistry, brief head and neck evaluations are a standard of care for dental appointments.

5. Do these findings apply to all papillary thyroid cancer?

No. The reclassification does not apply to most papillary thyroid cancer. It applies only to encapsulated follicular variant of papillary thyroid cancer (EFVPTC), and only to noninvasive EFVPTC, not all EFVPTC. From the articles, the reclassification applies to about 10,000 of the 64,300 people expected to be diagnosed with thyroid cancer in the United States in 2016.

6. Is this new classification official?

The authors of the medical journal article proposed this reclassification and the new name. An editorial in the same issue of the journal also recommends renaming these tumors. The New York Times article says that "eight leading professional societies from around the world signed on to the declassification and to the new name."

The eight societies are the American Academy of Otolaryngology Head and Neck Surgery, American Head and Neck Society, Brazilian Society of Endocrinology and Metabolism, Brazilian Society of Head and Neck Surgery, British Association of Endocrine and Thyroid Surgeons, International Neural Monitoring Study Group, Japanese Thyroid Association, Latin American Thyroid Association, and World Congress on Thyroid Cancer.


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## Octavia (Aug 1, 2011)

Very interesting.


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## webster2 (May 19, 2011)

Indeed, definitely worth watching for further developments.


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