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Surveillance of Treated Thyroid Cancer Patients and Thyroid Hormone Replacement and Suppression

  • Jennifer M. PerkinsEmail author
Chapter

Abstract

Differentiated thyroid cancer (DTC) incidence is increasing worldwide in recent decades and is the most common endocrine cancer. Fortunately, most of the increase is in low-risk tumors; however, we are seeing an increase across all sized tumors. Papillary thyroid cancer (PTC) is the most common form accounting for about 85 % of DTC, and prognosis overall is very favorable for patients with DTC. Initial therapy often consists of surgery and then radioactive iodine (RAI) ablation of thyroid remnant in those that are deemed intermediate risk or high risk by the American Thyroid Association (ATA) classification. An additional component of therapy also includes achieving low normal or suppression of thyroid-stimulating hormone (TSH) levels.

Post RAI, many modalities exist for surveillance including thyroglobulin monitoring, neck ultrasonography, I123 or I131 whole-body scanning (WBS), and other cross-sectional imaging and positron emission tomography (PET) scanning depending on initial risk and concern for recurrence.

There is little consensus in guidelines for long-term surveillance of treated thyroid cancer and TSH suppression goals over the patient’s life time especially after the first 5 years following diagnosis. The following chapter will discuss the data on surveillance of thyroid cancer patients and goals and risks of TSH suppression based on patient’s overall risk for recurrence and death.

Keywords

TSH suppression Thyroid cancer surveillance Long-term surveillance thyroid cancer TSH suppression morbidity TSH suppression goals Thyroglobulin 

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Division of EndocrinologyDuke University Health SystemDurhamUSA

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