Thyroid cancer is very common and it appears to be on the rise. It’s one of the two or three cancers that is almost exponentially growing in incidence. However, rather than a true increase in incidence, the real reason is that we are performing more scans in modern medicine and therefore detecting more tumours.
We caught up with endocrine and head and neck surgeon Dr Navin Niles to find out more.
Dr Niles says: “The reason is that we are finding it more is due to the large amount of radiological investigations being done. We’re picking up thyroid nodules that turn out to be thyroid cancer using CT scans and ultrasounds.”
An endocrine surgeon operates on endocrine glands. Of these, the thyroid and parathyroid are the most common but they also do adrenal and sometimes pancreatic surgery because it overlaps with endocrine. Dr Niles does some head and neck work, but his main area of interest is thyroid cancer.
Although doctors are seeing more and more cases of thyroid cancer, overall survival hasn’t changed. This suggests that doctors are finding many harmless cancers.
“There’s a currently a paradigm shift underway where surgeons are moving away from operating on these smaller tumours, to adopting a watch and wait approach where they just keep an eye on them.”
These are small types of thyroid tumours called papillary thyroid microcarcinomas.
The Japanese have led the world in this approach, and Australian surgeons are watching with great interest. This is because a big risk factor for thyroid cancer is exposure to radiation, and Japan has had such a large amount of radiation exposure.
The good news is that thyroid cancer has a greater than 98 per cent survival rate. On the flip side, it is a cancer that may come back many years after treatment. Patients can have ongoing treatment and monitoring for periods as long as 20 years.
It affects four women to every one man. Doctors don’t know why this is.
When asked about the latest research in thyroid cancer, Dr Niles said: “The real breakthrough is in the area of molecular pathways. We can profile the tumour into one of two main groups and we can tell a lot about how it will behave biologically from which pathway it takes.”
Dr Niles is trialling different forms of immune therapy on thyroid cancer cells in the lab in the hope of identifying drugs that can fight the cancers at the cellular level.
Dr Niles is married with two daughters aged eight and ten. When he’s not in theatres, he swims a lot and goes for runs. When it comes to unwinding, he says: “I’m a TV series addict. I get myself hooked and I can’t stop watching episode after episode.”