EMTC

The 'Rolls Royce' of cancers

It's been called the "Rolls Royce" of cancers - the one you want if you have to get cancer.

With a survival rate of more than 80 per cent, thyroid cancer is one of the most curable, slow-growing and in the majority of cases eminently treatable with few side effects.

But a great track record also comes with drawbacks. It means thyroid cancer often misses out on the quality and quantity of research other, more potentially life-threatening cancers and diseases attract and therefore not enough is known about what causes it or, importantly, why there's been a noticeable spike in reported cases in WA recently.

Nuclear medicine physician William Macdonald said it was probably the most rapidly increasing cancer in terms of incidence in the world. According to the most up-to-date figures from the WA Cancer registry, 139 people were diagnosed with thyroid cancer and 10 people died from the disease in 2008.

Dr Macdonald said recent increases meant the number of people diagnosed was now more likely to be around 175 cases.

Women are three times more likely to be diagnosed than men and for women aged between 15-39 thyroid cancer is the third most commonly diagnosed cancer behind breast cancer and melanoma.

Dr Macdonald said for most people the first sign of thyroid cancer was a painless lump in the neck, usually with no other symptoms. Dr Macdonald said iodine deficiency had been identified as a possible cause of thyroid cancer and the increased incidence could be linked to the fact most were iodine deficient.

Radiation was also a significant risk factor, so childhood cancer survivors and others including younger women with breast cancer who had received radiotherapy of the chest were at greater risk of going on to be diagnosed with thyroid cancer.

Female hormones produced during pregnancy also seemed to play a role in increasing risk.

Some evidence showed a weak link between a high fat diet and an increase in thyroid cancer.

Unlike other cancers, chemotherapy is not recommended for thyroid cancer. Instead the cornerstone of treatment is surgery to remove either part, or all, of the thyroid gland. Two-thirds of patients will then go on to have radioactive iodine treatment.

Patients drink the radioactive iodine and are then kept in isolation for two to three days while the radiation is excreted from their body.

Survivors would then need to take thyroid hormone replacement medication every day for the rest of their lives.

For those where cancer remained, further surgery or radioactive iodine might be considered, or, because the cancer was slow growing, a watch and wait policy might be adopted.

Dr Macdonald said for those people with the far more rare aggressive and incurable forms of thyroid cancer a new type of drug called protein kinase inhibitors showed promise. However, this type of drug came with significant side effects, similar to chemotherapy and was very expensive.

A handful of patients were currently being treated with this medication as part of a clinical trial at Sir Charles Gairdner Hospital.

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