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When is a Thyroid Tumor Considered Cancerous?

Expert Chats

An international panel of doctors issued a statement in 2016 that some thyroid tumors are, in fact, not cancerous. Dr. Gregory Randolph, a member of that panel, explains what this means.

You may remember news outlets buzzing a few years back that previously diagnosed thyroid cancers were not actually cancerous.

An international panel of experts had published a statement with an important message. EFVPTC tumors (“encapsulated follicular variant of papillary thyroid carcinoma”) should be reclassified as noncancerous growths.

The panel proposed changing the name of these tumors to “noninvasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP).

“After an extensive review, this tumor was found to be highly indolent, with little chance of hurting patients,” said Gregory W. Randolph, MD, a thyroid surgeon at Massachusetts Eye and Ear who was part of the panel.

With these tumors representing up to 20 percent of all thyroid cancers, the new designation — from cancerous to noncancerous — undoubtedly saved many future patients from unnecessary treatment.

Understanding the New Name

A change in name may not seem overly important. But, in this case, it’s the difference between a cancer diagnosis and a non-cancer diagnosis (which still needs to be treated).

These patients previously endured the psychological and medical impact of having a cancer diagnosis, including unnecessary removal of their thyroid gland and lifelong medications — when their tumor may not actually be malignant.

So, let’s break down the name.

  • Noninvasive means that the tumor cells are confined to the layer of tissue from which they first developed and are not spreading elsewhere.
  • Neoplasm is a synonym for a “growth,” which, in this case, is felt to be pre-malignant rather than malignant.
  • Papillary refers to the similarity some cells have to what is seen in a typical papillary thyroid cancer, which is the most common form type.

“Now that we have a better understanding of the sequential model for these tumor’s development, we can approach it differently,” said Dr. Randolph. “We don’t have to be as aggressive as we would with malignant tumors, which can save a lot for patients.”

New evidence suggests that certain thyroid tumors need less aggressive treatment and monitoring.

Changes to the Recommended Treatment Path for Thyroid Tumors

The name change does not mean that previous diagnoses are necessarily wrong. It also does not imply that abnormal growths of the thyroid should be ignored.

It does mean that new evidence suggests that these tumors need less aggressive treatment and monitoring.

“These patients need surgery to confirm NIFTP as their diagnosis, but the surgeon may only need to remove the growth — not the entire thyroid gland,” said Dr. Randolph.

Patients with a confirmed diagnosis of NIFTP probably won’t need radioactive iodine treatment. They’ll also need fewer follow-up appointments.

Perhaps most importantly, learning that one does not have cancer provides immense relief and eliminates the psychological burden that people and their families carry after being diagnosed with cancer.

How to Use This Information

If you or a loved one has an abnormal growth on your thyroid, be sure to discuss the possibility of NIFTP with your doctor. There are still many other forms of thyroid cancer that can cause growths. However, staying informed can help you and your doctor find the best treatment plan for you.

If you have been previously diagnosed with EFVPTC, review your case with your physician. Keep in mind that many cases may not have enough material available for a re-analysis.

About Our Expert

Gregory W. Randolph, MD, is Division Chief of General Otolaryngology and Thyroid and Parathyroid Endocrine Surgery at Mass. Eye and Ear. He sees patients at the main campus (243 Charles Street) of Mass. Eye and Ear.

 

 

 

 

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