There are three main types of thyroid cancer;
* Benign follicular adenomas (benign)
* Differentiated follicular carcinoma (malignant)
* Differentiated papillary carcinoma (the most frequent, with over 80% of thyroid cancers reported).
Tools of differential diagnosis arise, including in 2004 a test for molecular detection, created in France by CEA, detecting molecular signatures unique to differentiate the 3 types of tumors of the thyroid with a DNA chip, allow d ' refine the diagnosis, and better direct the medication or surgery (in better differentiating benign and malignant).
1. family history of thyroid cancer
2. cervical irradiation
The passage of radioactive cloud from Chernobyl and the increase in thyroid cancers have been several European studies, in what concerns do not seem to link cause and effect. The fallout from atmospheric nuclear tests are recognized as a cause of the observed increase in this type of cancer (which began before the Chernobyl disaster), including the tests in the Pacific.
1. gradual emergence
1. a lump (mass) of the midline of the neck;
2. a cervical adenopathy;
2. recent amendment of a thyroid goiter existing and former
3. persistent ear pain reflex (without cause at the ear)
4. very rare hormonal disorders reveal cancer:
1. flushing cervico-facial motor diarrhea, high blood pressure instability is found in a medullary thyroid
5. modified the way dysphonia related to paralysis of the vocal cord (compression of recurrent laryngeal nerve)
Questioning treatment too routine internal radiotherapy
To treat this cancer, iodine 131 was in 2006 - with surgical excision, the first treatment, and it was almost always offered by the nuclear medicine services (at any stage of the tumor at diagnosis). This treatment whose effectiveness is not disputed, however, had never been scientifically evaluated term risks and benefits (deferred secondary consequences in particular).
Two recent studies have provided important information.
* A statistical study of INSERM in the Journal of Nuclear Medicine (2600 pregnancies analyzed) showed no increase in miscarriage or premature birth among young women recently treated with iodine-131 but ...
* A meta-analysis (published in 2006), compiling three studies (Italian, Swedish and French) made by Florent Vathaire and colleagues, based on a cohort of 6 840 patients, showed that this treatment increased the risk for patients so treated develop a second cancer for several types of solid tumors (colorectal cancer, osteosarcoma and soft tissue cancers) and for leukemia.
The study showed a linear relationship between the degree of irradiation with iodine 131 and the increased risk.
These findings call for a reassessment of the treatment of thyroid cancer, which should better take into account the seriousness of cancer. Only differentiated cancers over 10 mm should be treated with iodine 131, but those whose size is small at diagnosis (a few millimeters or less) should not routinely be treated by administration of iodine 131.
To clarify the risk by type of cancer, a new study comes with 3 other French cohorts (11 000 subjects in total).
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