Thyroid cancer affects endocrine glands that regulate crucial bodily processes via hormone production. Tumor growth in the neck region, which characterizes thyroid cancer, can result in discomfort, difficulty swallowing, and inflamed lymph nodes. Previously, radiation was the go-to treatment option. However, recent advancements have enabled the medical community to understand the disease better, leading to more advanced diagnoses and treatments. Overdiagnosis, which refers to detecting small, slow-growing nodules or tumors that may not be cancerous, is а significant issue when diagnosing thyroid cancer. Studies from the National Cancer Institute (NCI) reveal that in one-third of instances where а questionable nodule (tumor) is removed from the thyroid, it is not cancerous. Researchers backed by the NCI have devised novel genomic tests to identify if these dubious nodules are cancerous, reducing unwarranted surgeries and enabling the selection of the most suitable treatment alternatives. Optical diagnostic imaging (OI) is a new technology that utilizes light to observe cellular, tissue, or organ structure and function, assisting in diagnosis. Compared to traditional imaging methods like x-ray, OI provides molecular specificity, flexibility, and safety, potentially mitigating issues of overdiagnosis and enhancing diagnostic efficacy. Additionally, it supports precise and non-invasive treatments for thyroid cancer. Fluorescence imaging (FI) is another promising modality for cancer diagnosis. It involves intravenous injection of a fluorescent dye before the operation. Upon exposure to а specific light wavelength, the dye emits fluorescence that helps highlight the parathyroid glands and other cancerous tissues. This technique offers several advantages over conventional imaging methods, including reduced invasiveness, cost-effectiveness, and superior spatial and temporal resolution. FI has demonstrated clinical potential in various applications, such as image-guided surgery. Doctors typically recommend radioactive iodine therapy (RIT) to treat differentiated thyroid cancers, such as papillary cancer originating from follicular cells in thyroid glands. RIT involves the patient taking a pill or liquid containing high doses of radioactive iodine, which collects in the thyroid gland and targets cancerous cells. Before treatment, doctors may conduct tests to determine if the cancer will likely respond to RIT. Targeted therapy is another thyroid cancer treatment involving drugs that specifically attack certain targets on cancer cells. Kinase inhibitors and anti-angiogenesis drugs are examples of drugs used in targeted therapy. Kinase inhibitors help treat thyroid cancer cells with mutations in specific genes, while anti-angiogenesis drugs disrupt the formation of new blood vessels supplying tumors with nutrients and enabling them to grow. An alternative treatment for thyroid cancer is ethanol ablation, whereby a doctor injects alcohol into the targeted nodule to shrink or kill tumor cells by changing the structure of their proteins. The procedure involves inserting a thin needle, guided by ultrasound, into the nodule to inject alcohol. It is one of the safest therapeutic profiles and has successfully been used to treat toxic and benign cystic nodules. Alcohol ablation is a good alternative for patients unwilling or unable to undergo surgery. RNA therapy is another innovative approach to treating thyroid cancer. It involves using small interfering RNA (siRNA) to target and silence genes associated with cancer cells. Anaplastic thyroid cancer (ATC), a difficult-to-treat form of thyroid cancer, can now be targeted with novel nanotechnology that allows for the precise delivery of RNA therapy to ATC cells. Animal testing has demonstrated RNA therapy’s effectiveness in halting tumor growth and preventing cancer from spreading to other body parts.
Karim Sarhane, MD