An international panel of doctors has decided that a type of tumor that was classified as a cancer is not a cancer at all.
Article in New York Times Cancer Not Cancer
But this young woman’s story drove Dr. Nikiforov over the edge.
“I told the surgeon, who was a good friend, ‘This is a very low grade tumor. You do not have to do anything else.’ ” But the surgeon replied that according to practice guidelines, she had to remove the woman’s entire thyroid gland and treat her with radioactive iodine. And the woman had to have regular checkups for the rest of her life.
“I said, ‘That’s enough. Someone has to take responsibility and stop this madness,’ ” Dr. Nikiforov said.
He brought together the international panel of experts — 24 renowned pathologists, two endocrinologists, a thyroid surgeon, a psychiatrist who knew the impact a cancer diagnosis could have, and a patient. The group collected a couple of hundred cases from multiple centers throughout the world — patients who had tumors that were contained within fibrous capsules and those that had broken out. All agreed that by the current criteria every one of those tumors would be classified as a cancer. And all of the patients had been followed for at least 10 years. The patients with the encapsulated tumors had not been treated after their tumors were removed.
None of the patients whose tumors stayed within their capsules had any evidence of cancer after 10 years. But some of the patients whose tumors had broken out of their capsules had complications, including death, from thyroid cancer despite treatment.
“This study said it is not the presence of nuclear features but the presence of invasion that can make the difference between cancer and noncancer,” Dr. Nikiforov said. Patients whose tumors are confined within their capsules “have an excellent prognosis,” he said. “They do not need a thyroidectomy. They do not need radiotherapy. They do not need to be followed up every six months.”