ARCHIVED - Saving thyroid patients from unnecessary surgery
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September 01, 2011— Ottawa, Ontario
Nova Scotia researchers are hot on the trail of a diagnostic blood test for thyroid cancer, the most rapidly increasing form of cancer in Canada.
Thyroid cancer is the seventh most often diagnosed cancer in Canada and its incidence rate in women has increased almost five-fold over the past 20 years, due in part to better imaging techniques for diagnosis. The disease is most common in young women, occurring four times more often among women under age 50 than men.
This year, an estimated 5500 Canadians will be diagnosed with thyroid cancer, most of whom will be women. The most common treatment is surgical removal of the thyroid gland, yet up to 70 percent of removed tumours turn out to be benign, meaning that many patients lose their thyroid uncessarily.
The only way to determine whether a thyroid nodule is benign or malignant without removing the gland is with a fine needle aspirate. This involves inserting a needle into the nodule to extract tissue. “However, this biopsy is literally a hit or miss procedure,” says Dr. Devanand Pinto of the NRC Institute for Marine Biosciences in Halifax. “If the needle misses the nodule, the patient could have a false negative result. Even if the needle hits the nodule, it won’t necessarily extract the tissue necessary for a pathologist to make an accurate diagnosis, since cancer tissue is very heterogeneous.”
To improve the diagnosis of suspicious nodules and thereby avoid unnecessary surgeries, doctors at the Queen Elizabeth II Health Sciences Centre in Halifax asked NRC for help in establishing a tumour bank and identifying potential biomarkers for a blood test. So far, Dr. Pinto and his colleagues have analyzed tissue samples from about 100 patients.
Out of several hundred molecules, the research team has narrowed its focus to a handful of biomarker candidates. “We’re looking at lipids, proteins and microRNAs — very small RNA molecules that regulate protein production.” says Dr. Pinto. By 2013, the team hopes to begin validating potential biomarkers in a wider population of patients.
“We think that by looking at three different types of molecules — all of them involved in a similar process — we have a better chance of developing an accurate blood test for thyroid cancer than if we focused on just one set of molecules,” he says. “We’re very optimistic that our approach will succeed.”
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