Dr. P Guhan, the Director and Consultant Oncologist, SRIOR stated, “Thyroid Cancer is a unique cancer because there is an actual potential cure if detected early and managed adequately. However, when detected late, the thyroid cancer can spread to other parts of the body and can lead to poor quality of life and even death.”
Dr. P Guhan, the Director and Consultant Oncologist, SRIOR stated, “Thyroid Cancer is a unique cancer because there is an actual potential cure if detected early and managed adequately. However, when detected late, the thyroid cancer can spread to other parts of the body and can lead to poor quality of life and even death.”
Thyroid cancer is a rare disease which affects the thyroid, a small gland at the base of the neck that produces thyroid hormones. Every year 14,000 patients are diagnosed with Thyroid Cancer in India which is one of the few cancers that has increased in incidence rates over recent years. It occurs in all age groups from children through to seniors. Dr. P Guhan, said that many patients, especially in the early stages of thyroid cancer, do not experience symptoms. However, as the cancer develops, symptoms can include a lump or nodule in the front of the neck, hoarseness or difficulty in speaking, swollen lymph nodes, difficulty swallowing or breathing, and pain in the throat or neck.
There are several types of thyroid cancer: papillary, follicular, medullary, anaplastic, papillary and follicular thyroid carcinomas which are referred to as well-differentiated thyroid cancer and account for over 90 percent of all thyroid cancers. Their treatment and management are similar. If detected early, most papillary and follicular thyroid cancers can be treated successfully. Medullary thyroid carcinoma (MTC) accounts for 3-4 percent of all thyroid cancers. Anaplastic thyroid carcinoma is the least common and accounts for only 1–2 percent of all thyroid cancer. This type is difficult to control and treat because it is a very aggressive type of thyroid cancer.
Treatments for thyroid cancer includes surgery, radioactive iodine treatment, external beam radiation therapy and targeted therapy. In most cases, patients undergo surgery to remove most of the thyroid gland and are treated with thyroid hormone replacement therapy. In some cases, the thyroid cancer progresses and becomes metastatic (it spreads to neighbouring regions or organs) and does not respond to RAI therapy. Thereon, targeted therapy (Tyrosine Kinase Inhibitors), newer drugs that help prolong survival are used. The DCGI has approved Lenvatinib, a novel Tyrosine Kinase Inhibitor for use in patients who no longer respond to treatment with radioactive iodine. It has shown to have superior survival benefits than the current systemic treatment options due to its unique mechanism of action. It acts on multiple receptors and has more pronounced action on tumor cells.
Factors associated with thyroid cancer include a family history of thyroid cancer, gender (women have a higher incidence of thyroid cancer), age (the majority of cases occur in people over 40, although thyroid cancer affects all age groups from children through to seniors), and prior exposure of the thyroid gland to radiation.
Dr. Guhan said that while the prognosis for most thyroid cancer patients is very good, the rate of recurrence can be up to 30 percent and recurrences can occur even decades after the initial diagnosis. Therefore, it is important that patients get regular follow-up examinations to detect whether the cancer has re-emerged. Monitoring should continue throughout the patient’s lifetime. It is also important to spread public awareness, as well as early and appropriate diagnosis which can help in treating Thyroid Cancer.
Early Diagnosis of Liver Cancer the Need of the Hour
Liver cancer is the second leading cause of cancer-related death and is estimated to be responsible for 7,50,000 deaths per year globally, with 7,80,000 cases newly diagnosed each year. HCC accounts for 85% to 90% of liver cancer cases. Treatment options for unresectable HCC are limited and the prognosis is poor, making this an area of high unmet medical need.
Dr. P Guhan says, “In Liver Cancer, when a tumour is found at an early stage, the treatment is aimed at trying to eliminate the cancer by using curative measures. The care plan may also include treatment for symptoms and side effects, an important part of cancer care. When liver cancer is found at a later stage and the patient’s liver is not functioning well, the treatment is aimed at palliative care and the patient and doctor will discuss the various options available to the patient and the goal of treatment. The goals of treatment may focus on slowing the growth of the cancer and relieving symptoms to improve the quality of the patient’s life.”
Dr.Guhan states that the treatment options may be to either cure the cancer or improve chances of survival based on the stage of liver cancer. If a patient is at a very early stage of liver cancer but has good liver function, the tumour does not take up too much of the liver, the tumour has not spread outside the liver or the liver is not too damaged, then a surgery that involves removal of the tumour and some surrounding healthy tissues during an operation, transplantation if there is a single tumour that is 5 cm or smaller, or just 3 or fewer tumours, all of which are smaller than 3 cm, radio frequency ablation which uses heat to destroy cancer cells can be done.
If the patient’s cancer has progressed and resection of the liver is not possible, then treatment options that will shrink or slow the tumour growth are considered, like Chemoembolization and Radioembolization. This therapy uses chemotherapy to destroy cancer cells and is injected into the hepatic artery, and the flow of blood through the artery is blocked for a short time so that chemotherapy stays in the tumour longer. Blocking the blood supply to the tumour also destroys cancer cells.
In situations where Chemoembolization cannot be performed on a patient, targeted therapy is used. Targeted therapy is drug treatment that targets the cancer’s specific genes, proteins or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells. In March 2019, the DCGI granted marketing authorization for the oral Tyrosine Kinase Inhibitor (TKI), Lenvatinib mesylate as a single agent for the first-line treatment of adult patients with advanced or unresectable hepatocellular carcinoma (HCC) who have received no prior systemic therapy. This is the first new first-line treatment option for advanced or unresectable HCC to be approved in approximately 10 years.
Lenvatinib is a unique TKI which acts on multiple receptors and has more pronounced action on tumour cells. So, more patients are expected to be benefited by the drug. It has shown to have good tolerance possibly due to a manageable safety profile.
Dr. Guhan emphasised the importance of public awareness of Liver Cancer since by the time the patient develops symptoms, it is too late and therefore early and appropriate diagnosis can help in treating Liver Cancer and bring down mortality rate.
Thyroid cancer is a rare disease which affects the thyroid, a small gland at the base of the neck that produces thyroid hormones. Every year 14,000 patients are diagnosed with Thyroid Cancer in India which is one of the few cancers that has increased in incidence rates over recent years. It occurs in all age groups from children through to seniors. Dr. P Guhan, said that many patients, especially in the early stages of thyroid cancer, do not experience symptoms. However, as the cancer develops, symptoms can include a lump or nodule in the front of the neck, hoarseness or difficulty in speaking, swollen lymph nodes, difficulty swallowing or breathing, and pain in the throat or neck.
There are several types of thyroid cancer: papillary, follicular, medullary, anaplastic, papillary and follicular thyroid carcinomas which are referred to as well-differentiated thyroid cancer and account for over 90 percent of all thyroid cancers. Their treatment and management are similar. If detected early, most papillary and follicular thyroid cancers can be treated successfully. Medullary thyroid carcinoma (MTC) accounts for 3-4 percent of all thyroid cancers. Anaplastic thyroid carcinoma is the least common and accounts for only 1–2 percent of all thyroid cancer. This type is difficult to control and treat because it is a very aggressive type of thyroid cancer.
Treatments for thyroid cancer includes surgery, radioactive iodine treatment, external beam radiation therapy and targeted therapy. In most cases, patients undergo surgery to remove most of the thyroid gland and are treated with thyroid hormone replacement therapy. In some cases, the thyroid cancer progresses and becomes metastatic (it spreads to neighbouring regions or organs) and does not respond to RAI therapy. Thereon, targeted therapy (Tyrosine Kinase Inhibitors), newer drugs that help prolong survival are used. The DCGI has approved Lenvatinib, a novel Tyrosine Kinase Inhibitor for use in patients who no longer respond to treatment with radioactive iodine. It has shown to have superior survival benefits than the current systemic treatment options due to its unique mechanism of action. It acts on multiple receptors and has more pronounced action on tumor cells.
Factors associated with thyroid cancer include a family history of thyroid cancer, gender (women have a higher incidence of thyroid cancer), age (the majority of cases occur in people over 40, although thyroid cancer affects all age groups from children through to seniors), and prior exposure of the thyroid gland to radiation.
Dr. Guhan said that while the prognosis for most thyroid cancer patients is very good, the rate of recurrence can be up to 30 percent and recurrences can occur even decades after the initial diagnosis. Therefore, it is important that patients get regular follow-up examinations to detect whether the cancer has re-emerged. Monitoring should continue throughout the patient’s lifetime. It is also important to spread public awareness, as well as early and appropriate diagnosis which can help in treating Thyroid Cancer.
Early Diagnosis of Liver Cancer the Need of the Hour
Liver cancer is the second leading cause of cancer-related death and is estimated to be responsible for 7,50,000 deaths per year globally, with 7,80,000 cases newly diagnosed each year. HCC accounts for 85% to 90% of liver cancer cases. Treatment options for unresectable HCC are limited and the prognosis is poor, making this an area of high unmet medical need.
Dr. P Guhan says, “In Liver Cancer, when a tumour is found at an early stage, the treatment is aimed at trying to eliminate the cancer by using curative measures. The care plan may also include treatment for symptoms and side effects, an important part of cancer care. When liver cancer is found at a later stage and the patient’s liver is not functioning well, the treatment is aimed at palliative care and the patient and doctor will discuss the various options available to the patient and the goal of treatment. The goals of treatment may focus on slowing the growth of the cancer and relieving symptoms to improve the quality of the patient’s life.”
Dr.Guhan states that the treatment options may be to either cure the cancer or improve chances of survival based on the stage of liver cancer. If a patient is at a very early stage of liver cancer but has good liver function, the tumour does not take up too much of the liver, the tumour has not spread outside the liver or the liver is not too damaged, then a surgery that involves removal of the tumour and some surrounding healthy tissues during an operation, transplantation if there is a single tumour that is 5 cm or smaller, or just 3 or fewer tumours, all of which are smaller than 3 cm, radio frequency ablation which uses heat to destroy cancer cells can be done.
If the patient’s cancer has progressed and resection of the liver is not possible, then treatment options that will shrink or slow the tumour growth are considered, like Chemoembolization and Radioembolization. This therapy uses chemotherapy to destroy cancer cells and is injected into the hepatic artery, and the flow of blood through the artery is blocked for a short time so that chemotherapy stays in the tumour longer. Blocking the blood supply to the tumour also destroys cancer cells.
In situations where Chemoembolization cannot be performed on a patient, targeted therapy is used. Targeted therapy is drug treatment that targets the cancer’s specific genes, proteins or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells. In March 2019, the DCGI granted marketing authorization for the oral Tyrosine Kinase Inhibitor (TKI), Lenvatinib mesylate as a single agent for the first-line treatment of adult patients with advanced or unresectable hepatocellular carcinoma (HCC) who have received no prior systemic therapy. This is the first new first-line treatment option for advanced or unresectable HCC to be approved in approximately 10 years.
Lenvatinib is a unique TKI which acts on multiple receptors and has more pronounced action on tumour cells. So, more patients are expected to be benefited by the drug. It has shown to have good tolerance possibly due to a manageable safety profile.
Dr. Guhan emphasised the importance of public awareness of Liver Cancer since by the time the patient develops symptoms, it is too late and therefore early and appropriate diagnosis can help in treating Liver Cancer and bring down mortality rate.