Watch-and-Wait Strategies are Reshaping Thyroid Cancer Care

Lori J. Wirth, MD, associate professor of medicine at Harvard Medical School and medical director of the Center for Head and Neck Cancers at Massachusetts General Hospital, provides an overview on the latest advancements in diagnosis of thyroid cancer.

The landscape of thyroid cancer diagnosis has undergone a paradigm shift as clinicians are now refining their approaches to diagnosis by evaluating nodules for aggressive potential. Through the use of a watch-and-wait type strategy, there has been a significant reduction in unnecessary diagnoses and interventions, sparing patients with thyroid cancer from the potential harms of overtreatment.

Secondly, Wirth highlights that there has been a greater integration of molecular testing into the diagnostic armamentarium. This advanced technique provides more accurate diagnoses, especially for patients with difficult-to-identify cancers.

Transcription:

0:09 | One of the most important advances in the diagnosis of thyroid cancer is really refining who we are diagnosing with thyroid cancer and who we are not diagnosing with thyroid cancer. In the last decade, there has been an increasing appreciation for the fact that we have been over diagnosing some thyroid cancers that are clinically insignificant, that are small, that will never cause illness to patients, and in the last decade, we are appreciating the fact that we have been over diagnosing and over treating those patients. We are a lot smarter now in terms of not diagnosing thyroid cancers that don't need to be diagnosed.

1:00 | Then also, 1 of the important advancements is using molecular testing in the diagnostic workup of thyroid nodules. There are some thyroid cancers that can be difficult to diagnose on a fine needle aspiration. Coupling the fine needle aspiration with molecular diagnostic diagnostics allows for more specific diagnosis of thyroid cancers, and that can then help in the initial treatment approaches to those cancers.