Thursday September 9, 2010
September is Thyroid Cancer Awareness Month, and sites around the web are talking about thyroid cancer. One hot button issue is the idea that thyroid cancer is "the good cancer." They're writing about it over at DearThyroid, in their piece,
"Myth-Busting: The Good Cancer -- We're Talking About Thyroid Cancer." And while you're at it, also check out pieces at Empowher:
Thyroid cancer is not the good cancer, and
The Good Cancer? at CureToday.
So what is all this "good cancer" business all about anyway?
Typically, the "good cancer" label is one that some doctors use, because many types of thyroid cancer are highly survivable. According to the American Cancer Society, the following are 5-year relative survival rates for the three common types of thyroid cancer, and Stage I, II and III:
- Papillary thyroid cancer: Stage I - 100%, II - 100%, III - 93%
- Follicular thyroid cancer: Stage I - 100%, II - 100%, III - 71%
- Medullary thyroid cancer: Stage I - 100%, II - 98%, III - 81%
Compare this to breast cancer, for example, which has 5-year survival rates for stage I - 96%, II - 84% and III - 52%, and lung cancer, which has 5-year survival rates for Stage I of 45 - 49%, II 30-31% and III 5 - 14%.
Yes, statistically, thyroid cancer is, in comparison "the good cancer." And while the survival rates for most forms of thyroid cancer are very encouraging, and offer hope for recuperation and a cancer-free life for most people who are diagnosed, it's still common for patients to feel frightened, angry, confused, and even shocked to have any type of "cancer."
Thyroid cancer patients need to deal with a number of life-changing issues. Most thyroid cancer patients will require surgery, radioactive iodine treatment, periodic scanning for recurrence, and a lifetime of thyroid hormone replacement medication to treat the hypothyroidism that results from having the thyroid surgically removed. To then be told that this cancer is "good" when you're in the midst of coping with thyroid cancer treatment and its aftermath feels denigrating and callous to some patients.
I have an idea. Maybe the medical community can change their terminology: instead of saying thyroid cancer is the "good cancer," how about "thyroid cancer usually has a good prognosis?"
What do you think? If you are a thyroid cancer survivor, have it now, or know someone with thyroid cacner, what are your thoughts about it being called "The Good Cancer?" Take our "Thyroid Cancer: The Good Cancer?" Poll now.
Read more...
Thursday September 9, 2010
The Thyroid Cancer Survivor's Association (ThyCa) is hosting its 13th annual international conference, on October 15-17, 2010, in Dallas, Texas, at the Sheraton Grand Hotel at DFW Airport.
According to ThyCa, the event is "for everyone whose life has been touched by thyroid cancer-- people being tested, those newly diagnosed, long-term survivors, people with advanced disease, caregivers, and friends."
The conference will feature more than 80 sessions focusing on the latest research, advances in treatment and follow-up, issues for survivors and caregivers, and coping skills for well-being. More than 50 speakers -- including physicians and other specialists -- will be present.
You can register in advance for a discount, and walk-in attendees are also welcome. For details and a registration form:
About Mary Shomon | Thyroid Forum | Twitter | Facebook
Thursday September 9, 2010
The
Telegraph UK newspaper has a Q&A health column called "LifeCoach," and this week's question was of particular interest to me. In it, M. Anderson writes to ask: "I am female, 62, 5ft 5in and seven and a half stone [105 pounds]. I eat well but am losing weight. I suffer frequent infections, rapid heartbeat, loose bowels and fatigue. ...I am suffering from painful swollen eyes but antihistamine eye drops and tablets, and Chloramphenicol ointment, have not helped. My father had Graves' disease but thyroid tests I had were normal...."
Sound familiar? One of the coaches is a physician, and Dr. Dan Rutherford does suggest that her symptoms suggest an overactive thyroid. But, he goes on to say that "it is unlikely, though, that this will have failed to be picked up already..." He then goes on to ask "Have you spent any time in the tropics?" Meanwhile, Sara Stanner, the nutrition coach, is suggesting that the reader eat "sardines on toast..."
This seemed like a great opportunity to spread the word that "your tests are normal" is not usually enough information to truly rule out thyroid disease. Read the full response from Dr. Rutherford and Sara Stanner, along with my comment, at the Telegraph UK site now.
Do You Want to Learn More About Graves' Disease?
If you want to learn more about Graves' disease and hyperthyroidism, here are some additional resources:
About Mary Shomon | Thyroid Forum | Twitter | Facebook
Photo: clipart.com
Thursday September 2, 2010
So many thyroid patients contact me here at About, and at my
Facebook Thyroid Support page, and ask the same question: "I'm on Synthroid (or another levothyroxine drug like Levoxyl) and I don't feel well. What else can I do?"
What I tell fellow thyroid patients is that in this situation, the first thing you'll want to think about is whether or not you might benefit from the addition of supplemental T3.
(A brief recap: Synthroid, Levoxyl and other levothyroxine drugs -- also called "l-thyroxine, and L-T4) are synthetic forms of the T4 thyroid hormone. T4 is the storage hormone, and it must be converted into T3, the active hormone, to be used by the cells. The drug Cytomel is a synthetic form of T3. There is a generic version of Cytomel, and some practitioners work with time-released/sustained-release T3 by prescription from compounding pharmacies. Natural desiccated thyroid drugs like Nature-throid, Armour Thyroid and Erfa contain natural forms of T4, T3 and other thyroid hormones.)
Now, back to the issue of whether or not you might benefit from the addition of T3. The operative question is: will your doctor be willing to even discuss this with you, much less prescribe it? There's no definitive answer.
If you say to the doctor, "Could I benefit from some additional T3?" the response is likely to fit one of four possible scenarios...
- A. The doctor rolls his/her eyes, snorts with derision, shakes his/her head, or otherwise makes it clear that he/she has no interest whatsoever in further discussion about T3.
- B. The doctor respectfully says, "that's not something I'm comfortable with. Sorry."
- C. The doctor thinks about it, and says, "well, let's take a look at your Free T3 level to see what it looks like and then make a decision.
- D. The doctor says, "that's certainly a possibility. Let's try a very low dose of T3 and see how you feel on it. But let's make sure there are no contraindications for you...
Clearly, if you're up against Doctor A, my advice is
get a new thyroid doctor. Asking to discuss a possible treatment is a legitimate request, and it should never be met with derision, disrespect or dismissal. Those sorts of responses are, in fact, clear evidence that it's time for a new doctor.
If you're working with with Doctor B, well, you might want to ask what his/her rationale is for not being comfortable with adding T3 to a levothyroxine-only thyroid treatment. Here, you might want to mention, or even bring a recap or copy of, the new Danish study that came out in late 2009 in the European Journal of Endocrinology. That study looked at the controversial issue of treatment with synthetic T3 as a supplement to T4-only (levothyroxine) therapy for hypothyroidism. The research reported that 49% of the patients studied preferred the treatment that combined levothyroxine plus a T3 drug, and only 15% preferred levothyroxine-only treatment. (See below for more information on that study, and how you can get a copy to show your doctor.) If Doctor B still categorically refuses to discuss T3 with you and can't satisfy you with a rational explanation, it's time for a new thyroid doctor.
Now, if you are dealing with Doctor C, consider yourself lucky, because Doctor C is thoughtful and open-minded. Ask the doctor what his or her target is for Free T3. And go ahead and get that Free T3 test, keeping in mind that many thyroid experts believe that patients feel best when Free T3 levels are in the top half of the normal range, and even at the 75th percentile and above of the range.
(How does that work? Let's do the math. If the lab's reference range for Free T3 is 2.0-4.4 pg/mL, then the midpoint is halfway between them -- or 3.2 -- and the 75th percentile is 3.8.)
And if you are Doctor D's patient, again, consider youself lucky to have an open-minded and knowledgeable physician. As for those contraindications, doctors tend to be cautious about using T3 in anyone who has a history of heart disease or heart problems, and in the elderly, so T3-savvy doctors will keep this in mind.
More Info on the T4/T3 Study
