Understanding the Treatment Options for Thyroid Cancer

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(BPT) – The good news is that with treatment, survival rates range from 71-93%, even for patients with the more severe forms of thyroid cancer. [i] The bad news is that treatment can be challenging for many patients, especially when they are unaware of their treatment options.

Thyroid cancer is commonly treated with surgery to remove the thyroid. Patients must then use thyroid hormone therapy and be carefully monitored to make sure the cancer does not return. In the past, patients had to stop taking thyroid hormone while they were treated with radioactive iodine to remove any remaining thyroid tissue after surgery. Patients also had to stop taking thyroid hormone for several weeks when they were tested to see if their cancer had returned. When patients stop thyroid hormone therapy they are at increased risk of developing hypothyroidism, which can cause symptoms ranging from fatigue and weight gain to mental health and heart problems.

“When I had to stop taking my thyroid hormone I felt extremely tired and depressed. It was difficult to sleep and work, and I found I could barely get through each day,” said thyroid cancer patient Heather Dacey.

Drug therapy is available to make it possible for patients to continue their thyroid hormone therapy when they need treatment with radioactive iodine or when they are tested to see if their thyroid cancer has recurred in the future. This can help to reduce the risk of hypothyroidism.

“The rate of recurrence for thyroid cancer can be up to 30%, and recurrences can occur even decades after the initial diagnosis, so it is very important for patients to be tested regularly. Fortunately, we are able to help patients undergo these essential tests without having to stop their treatment with thyroid hormone therapy. All patients should talk to their doctor about the risk of hypothyroidism and how to avoid it,” said Jennifer Sipos, MD.

If you or someone you know is living with thyroid cancer, be sure to talk to your doctor about all of your treatment options. Visit www.haveyouhadyourneckchecked.com to learn more.

See the attached ISI and full Prescribing Information.

[i] Thyroid Cancer Survival Rates. American Cancer Society Website. Accessed July 31, 2013. http://www.cancer.org/cancer/thyroidcancer/detailedguide/thyroid-cancer-survival-rates

Indication

Thyrogen® (thyrotropin alfa for injection) 0.9 mg/mL is a thyroid stimulating hormone indicated for:

Diagnostic: Use as an adjunctive diagnostic tool for serum thyroglobulin (Tg) testing with or without radioiodine imaging in the follow-up of patients with well-differentiated thyroid cancer who have previously undergone thyroidectomy.

Limitations of Use:

Thyrogen -stimulated Tg levels are generally lower than, and do not correlate with Tg levels after thyroid hormone withdrawal.Even when Thyrogen -Tg testing is performed in combination with radioiodine imaging, there remains a risk of missing a diagnosis of thyroid cancer or underestimating the extent of the disease.Anti-Tg Antibodies may confound the Tg assay and render Tg levels uninterpretable.Ablation: Use as an adjunctive treatment for radioiodine ablation of thyroid tissue remnants in patients who have undergone a near-total or total thyroidectomy for well-differentiated thyroid cancer and who do not have evidence of distant metastatic thyroid cancer.

Limitations of Use:

The effect of Thyrogen on long term thyroid cancer outcomes has not been determined.IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

There have been reports of death in non-thyroidectomized patients and in patients with distant metastatic thyroid cancer in which events leading to death occurred within 24 hours after administration of Thyrogen.

There are post marketing reports of stroke in young women with risk factors for stroke, and neurological findings suggestive of stroke (e.g., unilateral weakness) occurring within 72 hours of Thyrogen administration in patients without known central nervous system metastases.

Sudden, rapid and painful enlargement of residual thyroid tissue or distant metastases can occur following treatment with Thyrogen.

Pretreatment with glucocorticoids should be considered for patients in whom tumor expansion may compromise vital anatomic structures.

Patients should be well-hydrated prior to treatment with Thyrogen.

Caution should be exercised in patients who have substantial thyroid tissue still in situ or functional thyroid cancer metastases, specifically in the elderly and those with a known history of heart disease.

Hospitalization for administration of Thyrogen and post-administration observation in patients at risk should be considered.

ADVERSE REACTIONS

The most common adverse reactions reported in clinical trials were nausea and headache.

USE IN SPECIFIC POPULATIONS

Pregnancy Category C: Animal reproduction studies have not been conducted with Thyrogen. It is also not known whether Thyrogen can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Thyrogen should be given to a pregnant woman only if clearly needed.

Nursing Mothers: It is not known whether the drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Thyrogen is administered to a nursing woman.

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Geriatric Use: Results from controlled trials do not indicate a difference in the safety and efficacy of Thyrogen between adult patients less than 65 years and those over 65 years of age.

Renal Impairment: Elimination of Thyrogen is significantly slower in dialysis-dependent end stage renal disease patients, resulting in prolonged elevation of TSH levels.