A new approach to therapy can avoid most of the debilitating effects of preparing for critical, postsurgical treatment for patients with
thyroid cancer, according to an international study led by researchers from
Johns Hopkins and the
University of Pisa.
Using a genetically engineered thyroid stimulating hormone (TSH) - called thyrotropin alfa, or rTSH - doctors were able to ablate, or destroy, the small amount of thyroid gland tissue that often remains after thyroidectomy, without the need to temporarily withhold thyroid hormone medication. This new approach also avoided the temporary but troubling symptoms flowing from the deficiency of thyroid hormone (or hypothyroidism), such as fatigue, weight gain, chilliness, slowed thinking, depression, constipation and muscle cramps.
The findings will be highlighted during the clinical trial symposium at the 86th annual meeting of The Endocrine Society in New Orleans, June 16-18.
"Recovery from thyroid cancer has been very difficult for patients because thyroid medication - to replace the thyroid hormone naturally produced by a healthy thyroid gland - has traditionally been withheld for four to six weeks after surgery so radioiodine could be used to identify and destroy glandular tissue that remained," said study co-lead investigator Paul Ladenson, M.D., professor and chief of the Division of Endocrinology at the Johns Hopkins School of Medicine.
The study - at nine centers in North American and Europe - examined 63 patients with thyroid cancer, all of whom had thyroid removal surgery and were undergoing post-operative radioiodine therapy to ensure that all tissue was destroyed. This procedure, called remnant ablation, lowers the risk of thyroid cancer recurrence for some patients and makes for more accurate testing to detect it when it does return. It uses radioactive iodine to ablate remaining tissue and has previously required withholding of replacement thyroid hormone to allow the patient's own levels of TSH to rise, stimulating thyroid tissue to take up the radioiodine that destroys it.