The Perlmutter Cancer Center Thyroid Cancer Interdisciplinary Program is an active clinical and translational laboratory research program focused on the biology of thyroid cancer. This program features clinicians and scientists dedicated to achieving a shared goal: understanding the mechanisms involved in the initiation and growth of thyroid cancers, and using this knowledge to improve the care of patients with these cancers.
This year, there will be more than 40,000 new cases of thyroid cancer in the United States. This is roughly the same incidence as cancers of the oral cavity and oropharynx combined, more than cancers of the ovary, about the same as cancers of the pancreas, and almost half as common as all lymphomas. At a time when the incidence of most cancers is decreasing, stable, or increasing only minimally, thyroid cancer incidence is rising at a rate far greater than any other cancer in this country: a rate that is now approaching 7 percent per year.
With this rapidly escalating incidence of thyroid cancer, the ability to predict its behavior is critical for developing appropriate treatment strategies. Clinical factors alone cannot accurately predict the biological behavior of thyroid cancer; thus, the rationale for determining the extent of surgery (central node dissection) and treatment (radioactive iodine) is not well defined.
Based on current guidelines, patients with potentially indolent (slow-growing) tumors often undergo extensive surgery and radioactive iodine, while patients with unanticipated aggressive disease are undertreated. Clearly, in this era of increasing thyroid cancer incidence and financial restraints on our health care system, there is an urgent need to understand the biologic mechanisms controlling thyroid cancer behavior. Such knowledge will help us properly select those patients who need aggressive treatment and minimize the risk of side effects for patients with indolent tumors, who may not even require surgery. This approach would maximize cure rates while minimizing complications.
The Perlmutter Cancer Center Thyroid Cancer Interdisciplinary Programemphasizes translational research and fosters a productive collaborative environment. We understand that the optimal management of patients with thyroid cancer depends on the assessment of the malignant potential of an individual tumor at presentation. Understanding the genetic mechanisms controlling thyroid tumor progression can help us identify valuable prognostic markers and potential therapeutic targets.
We collect thyroid cancer tissue specimens from our patients undergoing thyroid surgery. We have an IRB-approved registry and biorepository, where we store our samples for research purposes. Our research focuses on changes in intracellular molecular pathways that lead to the progression of thyroid cancer. When we learn to understand these pathways better, we can develop specific drugs to block these changes.
By comparing genomic differences between different thyroid cancers, our laboratory has identified genes that may play a role in determining tumor behavior. Furthermore, we have identified molecular factors that potentially promote the development of thyroid cancer metastases. We are developing new strategies to target the genes associated with the behavior of aggressive thyroid cancer. By understanding the biology of individual tumors, we may be able to create personalized, more effective treatment plans for our patients.