Thyroid Cancer: Watchful waiting is not enough
Even an early cancer diagnosis is never good news, but the silver lining is that you have more time and a better chance to beat cancer. For most, that usually means surgery or radiation and the various risks and sacrifices that come with them. However, according to a new study, about one-third of patients with papillary thyroid cancer are eligible for a new breakthrough treatment that doesn’t involve surgery or radiation. The name of this breakthrough treatment is called “watchful waiting”—as in, wait to see if the tumor develops into something that even requires medical intervention. While these patients are watchfully waiting, they can also do a few other things that will improve their quality of life and help them fight off cancer.
Watchful waiting almost seems counter to common sense. The kneejerk reaction to a cancer diagnosis would be to fight back hard and fast and with as much firepower available. But not all cancers are the same, and papillary thyroid cancer is very different in several ways.
Thyroid Cancer Grows Slowly
In the study conducted by endocrinologist Dr. Michael Tuttle at New York’s Memorial Sloan Kettering Cancer Center, 291 patients with tumors less than 3 millimeters were recommended to take a watch-and-wait approach. In two years, only 2.5% of patients’ tumors grew past 3 millimeters (the average size where doctors recommend surgery to remove). In five years, 12% of patients’ tumors grew to 3 millimeters. And most intriguing, none of the patients’ tumors even spread outside the thyroid.
By the time the study concluded…
- Only 10 of the 291 patients had surgery
- 19 patients saw their tumors shrink by at least half
- Tumors grew the least in older patients
- Patients in their 20s and 30s had a 10% to 15% chance that tumors will grow within 2 years.
- Patients over the age of 60 had a 1% to 2% chance that tumors will grow within 2 years.
The last bullet point flies in the face of typical cancer diagnoses because older people are more likely to develop cancer, and that cancer is usually harder to treat because of existing health conditions.
Not only are the findings game changing, they are more pertinent than ever. The incidence of thyroid cancer almost tripled from 1975 to 2009, and papillary thyroid cancer accounts for the vast majority of this increase.
A few conclusions I draw from this. First, patients and doctors are increasingly becoming more proactive by getting regular screens and scans. Second, this new study shows that early detection of papillary thyroid cancer doesn’t have to mean early surgery or chemotherapy. And broadly speaking, I hope that this study goes a long way to convince the medical community to avoid treating something that doesn’t have to be treated.
And third, there are more things that papillary thyroid cancer patients – and all people for that matter – can do to improve their chances of beating cancer and protecting the body from it.
Avoiding Everyday Sources of Radiation
A lot of people think that X-rays and CT scans are the biggest sources of radiation. While they do emit large amounts of radiation, they certainly aren’t the only sources. I think the bigger danger lies in the sources of radiation that we don’t know about.
On a daily basis, we are surrounded by radiation and most of us don’t realize it. Microwaves, TVs, tablets, computers, watches, and cell phones emit it. They each emit a tiny amount that seems harmless at the time, but in any given hour, you may be exposed to all of the above. Now multiply that over the course of decades.
Radiation can also make its way from rivers and lakes into the water of urban areas. In rural areas, well water can be contaminated after water flows through natural radiation sources like rocks and soil. Water sources near nuclear power plants are obvious candidates for radioactive contamination.
In addition, every time you fly in an airplane, your body absorbs cosmic radiation from outer space. And smokers? Well, let’s just say that smokers take in more radiation per year than a person with radon in their home.
Iodine and Cancer Prevention
While thyroid cancer and other cancers are on the rise, iodine levels in the United States have declined by about 50%. Before writing that off as a mere coincidence, consider these facts about iodine:
- It is essential for normal growth and development of children
- Deficiency can result in cretinism, mental deficiency, delayed physical and intellectual development and ADHD
- It elevates pH
- It is needed to produce thyroid hormones
- Iodine prevents goiter, autoimmune thyroid conditions, thyroid and other cancers, hypothyroidism
- It is antibacterial, antiviral and antiparasitic
- It is mucolytic agent (breaks up mucous)
If that’s not enough, consider that the following conditions respond positively when treated with iodine:
- Breast Disease
- Dupuytren’s Contracture
- Excess Mucous Production
- Fibrocystic Breasts
- Ovarian Cysts
- Parotid Duct Stones
- Sebaceous Cysts
- Thyroid Disorders
- Cancers (breast, ovarian, thyroid, prostate)
How did we become so iodine deficient? A lot of blame can be passed around. But a large share of our collective iodine deficiency comes from exposure to chemicals and toxins that decrease iodine uptake and inhibit iodine from binding to where it is needed. The most common anti-iodine agents are chlorine, fluoride, and bromide (used in soft drinks, baked goods, and pesticides). On top of that, erosion and poor farming techniques have depleted minerals from the soil.
Iodine Deficiency Test
All this may lead you to ask, “Am I deficient in iodine?” There is a simple way to find out. First, purchase a tincture of original orange-colored iodine (not the clear solution) at your local pharmacy. After showering in the morning, paint a 2-inch-by-2-inch square of iodine on your inner forearm. Write down your starting time.
What you’ll be looking for is how quickly your body absorbs iodine over the next 24 hours. Record the time when it begins to lighten. Record the time that it disappears completely. Finally, describe what the patch site looks like after 24 hours.
If the patch still exists after 24 hours, your iodine levels are likely normal. If it mostly or completely disappears in less than 24 hours, your iodine level is below average. If it lightens or disappears in less than 18 hours, it indicates a moderate to severe iodine deficiency.
Natural Sources of Iodine
Getting more iodine is a good idea for everyone, not just people “watchfully waiting” on a papillary thyroid cancer tumor. There are many natural sources of iodine. Sea vegetables such as kelp, arame, hiziki, kombu and wakame are good sources. If they’re available in your area, you’ll likely find them at an Asian grocer’s or Whole Foods. They’re also available online. But you have non-sea vegetable alternatives, if you’re careful.
Remember what I said earlier about depleted soil levels? That’s critical when looking for natural food sources of iodine. Organic cranberries, yogurt, navy beans, potatoes and strawberries are good sources of iodine. By buying organic, you are better assured that the soil is more mineral rich.
The most consistent source of iodine comes in supplement form. I recommend adult men and woman take 150 mcg/day of iodine.
Watchful Waiting and Watchful Living
The good news about papillary thyroid cancer is that the best treatment doesn’t require much “treatment.” But that doesn’t mean we all shouldn’t take a preventative approach. “Watchful living” is the way to go – avoiding everyday sources of radiation and ensuring you have enough iodine to help prevent cancer from even entering your body.
- Szabo, Liz. “Many People Can Delay Treatment For Thyroid Cancer, Study Finds.” NPR. Published August 31, 2017.
- Davis, Ashlee. “9 Everyday Sources of Radiation.” Health. Published date N/A.
Last Updated: August 16, 2018
Originally Published: November 13, 2017