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Abramson Cancer CenterNCI CANCERLIT® Search: Thyroid Cancer - July 2002
National Cancer Institute®
Last Modified: July 1, 2002
- Thyroid malignancy in endemic nodular goitres: prevalence, pattern and treatment.
- Thyroid malignancy in endemic nodular goitres: prevalence, pattern and treatment (EJSO 2001; 27:157-161).
- Reduced HBME-1 immunoreactivity of papillary thyroid carcinoma and papillary thyroid carcinoma-related neoplastic lesions with Hurthle cell
- C-cell hyperplasia and medullary thyroid microcarcinoma.
- Minimally invasive follicular thyroid carcinoma.
- Expression of cellular retinol- and retinoic acid-binding proteins in normal and pathologic human parathyroid glands.
- Medullary thyroid carcinoma. Rare cytologic findings.
- Rare cytologic findings in medullary thyroid carcinoma.
- [Diagnosis and therapy of differentiated thyroid gland carcinomas]
- The genetics of hereditary nonmedullary thyroid carcinoma.
- Papillary thyroid cancer with pulmonary metastases in children: long-term prognosis.
- 99mTc-MIBI scintigraphy of parathyroid adenomas and its relation to tumour size and oxyphil cell abundance.
- Methodological considerations influence the clinical value of parathyroid localisation diagnostics.
- Accuracy of thyroid fine-needle aspiration using receiver operator characteristic curves.
- Histologic changes in thyroid nodules after percutaneous ethanol injection in patients subsequently operated on due to new focal thyroid
- [Value of a structured report for the interpretation of parathyroid scintigraphy in primary essential hyperthyroidism]
- Clinical significance of molecular expression profiles of Hurthle cell tumors of the thyroid gland analyzed via tissue microarrays.
- Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review.
- Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules.
- Impact of timing on completion thyroidectomy for thyroid cancer.
- Procedure guideline for therapy of thyroid disease with (131)iodine.
- The use of recombinant thyrotropin in the follow-up of patients with differentiated thyroid cancer.
- US citizens exposed to radiation fallout during Cold War tests.
- Immunohistochemical expression of galectin-3 in benign and malignant thyroid lesions.
- The role of operations for distantly metastatic well-differentiated thyroid carcinoma.
- [The initial treatment of patients with differentiated thyroid carcinoma; consensus and controversies]
- [Surgery and referral for subsequent 131I therapy for patients with differentiated thyroid carcinoma in the south-east of the Netherlands,
- Role of US with supplemental CT for localization of parathyroid adenomas.
- [FDG PET scan of metastases in recurrent medullary carcinoma of the thyroid gland]
- Molecular cytogenetic investigations define a subgroup of thyroid adenomas with 2p21 breakpoints clustered to a region of less than 450
- Multigenerational familial medullary thyroid cancer (FMTC): evidence for FMTC phenocopies and association with papillary thyroid cancer.
- Diary of a nurse with cancer. Double whammy.
- US-guided fine-needle aspiration biopsy of thyroid nodules.
- Pitfalls of intraoperative quick parathyroid hormone monitoring and gamma probe localization in surgery for primary hyperparathyroidism.
- Minimally invasive open thyroidectomy.
- Molecular rearrangements and morphology in thyroid cancer.
- Expression of parathyroid hormone-related protein (PTHrP) in parathyroid tissue under normal and pathological conditions.
- Hurthle cell carcinoma.
- Parathyroid carcinoma.
- Well-differentiated thyroid carcinoma in Hong Kong Chinese patients under 21 years of age: a 35-year experience.
- Poorly differentiated carcinomas of the thyroid gland: a review of the clinicopathologic features of a series of 28 cases of a heterogeneous,
- Thyroid microcarcinoma: fine-needle aspiration diagnosis and histologic follow-up.
- The association between chronic lymphocytic thyroiditis and thyroid tumors.
- Expression of p57/Kip2 protein in normal and neoplastic thyroid tissues.
- Cervical metastasis in papillary carcinoma of the thyroid: a histopathological study.
- Molecular mechanisms of RET activation in human cancer.
- [Thyroid nodule pathology: proposal of a diagnostic approach based on the experience of a thyroid disease unit]
- [Differentiated carcinoma of the thyroid]
- Diary of a nurse with cancer. Rising from the ashes.
- Diagnosis and management of patients with thyroid nodules.
- [Anaplastic carcinoma of the thyroid: diagnosis and treatment]
- Expression of cAMP-responsive element binding protein and inducible cAMP early repressor in hyperfunctioning thyroid adenomas.
- Papillary thyroid cancer.
- Recurrent or persistent thyroid cancer of follicular cell origin.
- Familial nonmedullary thyroid cancer.
- Anaplastic thyroid carcinoma.
- Medullary thyroid cancer.
- The cost effectiveness of dual phase 201Tl thyroid scan in detecting thyroid cancer for evaluating thyroid nodules with equivocal fine-needle
- Excessive survivin expression in thyroid lymphomas.
- [Reflecting the mode of metastasizing of the thyroid gland tumor in TNM classification]
- Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery.
- Expression of cdc25A and cdc25B proteins in thyroid neoplasms.
- Association of RET codon 691 polymorphism in radiation-induced human thyroid tumours with C-cell hyperplasia in peritumoural tissue.
- Clinical comparison of whole-body radioiodine scan and serum thyroglobulin after stimulation with recombinant human thyrotropin.
- Vocal cord muscle activity as a drawback to FDG-PET in the followup of differentiated thyroid cancer.
- Mucoepidermoid carcinoma of the thyroid: a tumour histotype characterised by P-cadherin neoexpression and marked abnormalities of
- Overexpression of tumor susceptibility gene TSG101 in human papillary thyroid carcinomas.
- The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma.
- [Changes in cell immunity indexes under the influence of thymalin, thyroxine and fibronectin in patients with hyperplastic diseases of
- Management of thyroid cancer.
- [Papillary carcinoma of the thyroid: clinical experience and prognosis factors]
- [Role of Doppler color ultrasonography in the diagnosis of thyroid carcinoma]
- [Follicular neoplasm of the thyroid: usefulness of extemporaneous histologic study of frozen sections]
- [Clinical role of the cytologic study of thyroid nodules]
- Hyperthyroidism with concurrent thyroid cancer.
- [Principles and general ultrasound practice. Diseases of the neck soft tissues]
- Impact of nodal metastases on prognosis in patients with well-differentiated thyroid cancer.
- [The thyroidectomized follow-up]
- [Pelvic and spinal giant metastases from thyroid carcinomas: report of 8 cases]
- [Differentiated thyroid carcinoma. Prognosis and therapy]
- [Ultrasonic method of study and puncture biopsy in diagnosing thyroid nodules]
- Intraoperative localization of parathyroid glands with gamma counter probe in primary hyperparathyroidism: a prospective study.
- The endocytic catalysts, Rab5a and Rab7, are tandem regulators of thyroid hormone production.
- Benign thyroid disease and dietary factors in thyroid cancer: a case-control study in Kuwait.
- Recent experience with preoperative fine-needle aspiration biopsy of thyroid nodules in a community hospital.
- Highly sensitive serum thyroglobulin and circulating thyroglobulin mRNA evaluations in the management of patients with differentiated thyroid
- Multiple neoplasms in an irradiated cohort: pattern of occurrence and relationship to thyroid cancer outcome.
- Is the serum thyroglobulin response to recombinant human thyrotropin sufficient, by itself, to monitor for residual thyroid carcinoma?
- Expression and activity of g protein-coupled receptor kinases in differentiated thyroid carcinoma.
- Aberrant localization of beta-catenin correlates with overexpression of its target gene in human papillary thyroid cancer.
Table of Contents
1
UI - 11289751
AU - Lawal O; Agbakwuru A; Olayinka OS; Adelusola K
TI -
Thyroid malignancy in endemic nodular goitres: prevalence, pattern and
treatment.
SO - Eur J Surg Oncol 2001 Mar;27(2):157-61
AD - Department of Surgery, College of Health Sciences, Ile-Ife, Osun State,
Nigeria. olawal@oauife.edu.ng
AIMS: The epidemiology of thyroid cancers in goitre endemic zones has
not been recently reviewed, and changes being currently reported have
been from studies in non-endemic areas. The aims of this study were to
present the clinical pattern of thyroid malignancy in a goitre endemic
area and identify recent changes, if any. METHODS: The study was
conducted at Obafemi Awolowo University Teaching Hospitals Complex,
patients with nodular goitres treated with thyroidectomy were reviewed,
and the clinical features, laboratory parameters, treatment, outcome and
follow-up of histologically-proven malignant cases were studied.
RESULTS: Thirty-six of 279 (12.9%) patients, aged 13-85 years
(mean)=43.7+/-14.7 years), carried malignant goitres, and most (80%)
were young or middle-aged women. Of the well-differentiated cancers,
follicular type was the most prevalent, being six- and 12-fold as
frequent as papillary and medullary cancers (69%vs 11% and 5.6%),
respectively. Lymphoma accounted for 5.6%, fibrosarcoma, 5.6% and
anaplastic, 2.8%. No relationship was demonstrable between cancer type,
duration of goitre and age at diagnosis (r=0.06 and 0.17, respectively).
CONCLUSIONS: Thyroid cancers afflict comparatively young women in our
environment, and follicular cancer remains the predominant type, partly
as a result of persisting dietary iodine deficiency. Copyright Harcourt
Publishers Limited.
2
UI - 11669600
AU - Mishra A; Mishra SK
TI -
Thyroid malignancy in endemic nodular goitres: prevalence, pattern and
treatment (EJSO 2001; 27:157-161).
SO - Eur J Surg Oncol 2001 Nov;27(7):699
3
UI - 11952857
AU - Mai KT; Bokhary R; Yazdi HM; Thomas J; Commons AS
TI -
Reduced HBME-1 immunoreactivity of papillary thyroid carcinoma and
papillary thyroid carcinoma-related neoplastic lesions with Hurthle cell
and/or apocrine-like changes.
SO - Histopathology 2002 Feb;40(2):133-42
AD - Division of Anatomical Pathology, Department of Laboratory Medicine, The
Ottawa Hospital-Civic Campus, Ontario, Canada.
ktmai@ottawahospital.on.ca
BACKGROUND: We have recently observed that Hurthle cell tumours and
papillary thyroid carcinoma with tumour cells showing decapitation of
luminal portion of the cytoplasm (apocrine-like changes) display
negative or decreased immunoreactivity for HBME. The purpose of this
study is to correlate papillary thyroid carcinoma with positive and
negative immunoreactivity for HBME with the histopathological features.
METHODS AND RESULTS: Two hundred and five thyroid neoplasms including
carcinoma and adenomas were grouped into Hurthle cell tumours, tumours
with or without some features of Hurthle cells, tumours with
apocrine-like changes and adenomas with or without limited nuclear
features of papillary thyroid carcinoma but not diagnostic for papillary
thyroid carcinoma. All neoplasms were submitted for immunostaining with
cytokeratin 19 (CK19) and HBME. Papillary thyroid carcinoma, follicular
carcinoma and follicular adenoma that have areas of limited nuclear
features but not diagnostic for papillary thyroid carcinoma showed
stronger immunostaining for HBME than their respective counterparts with
Hurthle cell changes. All Hurthle cell tumours showed negative to focal
reactivity. This decrease of reactivity for HBME was proportional to the
levels of Hurthle cell changes. In addition, focal to extensive
apocrine-like changes were seen in most Hurthle cell neoplasms and
rarely seen in non-Hurthle cell neoplasms. Apocrine-like changes
abolished or decreased HBME immunoreactivity of papillary thyroid
carcinoma and tumours with limited nuclear features. Immunostaining for
cytokeratin AE3 was not affected by Hurthle cell or apocrine-like
changes. CONCLUSIONS: All papillary thyroid carcinomas without Hurthle
cell or apocrine-like differentiation are reactive for HBME. Hurthle
cell tumours and tumours with Hurthle cell or apocrine-like changes show
negative or focal reactivity for HBME. Except for this limitation, HBME
is a sensitive marker for papillary thyroid carcinoma and tumours with
limited nuclear features.
4
UI - 11914470
AU - Albores-Saavedra JA; Krueger JE
TI -
C-cell hyperplasia and medullary thyroid microcarcinoma.
SO - Endocr Pathol 2001 Winter;12(4):365-77
AD - Department of Pathology, UT Southwestern Medical Center, 5323 Harry
Hines Blvd. Dallas, TX 75390-9073, USA.
Since the discovery of the thyroid C-cell, considerable progress has
been made regarding its origin, function, and pathology. In this article
an attempt is made to summarize and update our knowledge about
physiologic or reactive C-cell hyperplasia, neoplastic C-cell
hyperplasia (medullary carcinoma in situ), and medullary microcarcinoma.
Seldom recognized preoperatively, physiologic C-cell hyperplasia is
associated with inflammatory, metabolic, and neoplastic thyroid
disorders as well as with hypercalcemia. However, the pathogenesis is
still unclear. Although physiologic C-cell hyperplasia may progress to
medullary carcinoma, the full malignant potential is unknown. Problems
related to the definition of physiologic C-cell hyperplasia are
discussed. Immunohistochemistry and quantitative analysis are required
for the diagnosis. By contrast, C-cell hyperplasia associated with MEN
II syndromes or familial medullary carcinoma can be diagnosed
preoperatively in asymptomatic children or adolescents by the detection
of germline mutations of the RET protooncogene. Morphologic and genetic
abnormalities support the idea that C-cells in the familial form of
C-cell hyperplasia are neoplastic and can be recognized with
conventional stains. Therefore, the number of C-cells is irrelevant for
the diagnosis. Medullary microcarcinoma is a neoplasm that measures < 1
cm. The sporadic variant is usually an incidental microscopic finding,
whereas the familial form can be diagnosed by genetic testing. Its
morphologic features and biologic behavior differ from those of larger
medullary carcinomas. The frequency of medullary microcarcinoma will
probably increase with the use of genetic testing.
5
UI - 11914475
AU - Heffess CS; Thompson LD
TI -
Minimally invasive follicular thyroid carcinoma.
SO - Endocr Pathol 2001 Winter;12(4):417-22
AD - Department of Endocrine and Otorhinolaryngic-Head & Neck Pathology,
Endocrine Division, Armed Forces Institute of Pathology, Building 54,
Room G066-09, 6825 16th Street NW, Washington, DC 20306-6000, USA.
heffess@afip.osd.mil
Infiltration of the capsule, vascular invasion, and/or neoplastic
extension into the adjacent parenchyma are regarded as prerequisites for
the diagnosis of follicular carcinoma. In modern practice, most of these
tumors fall into the category of follicular carcinoma, minimally
invasive (FCMI) characterized by evidence of limited capsular or
vascular invasion with an excellent long-term prognosis and a good
patient outcome. Notwithstanding the wide acceptance of the diagnostic
criteria established by the World Health Organization for the
classification of follicular carcinomas in particular, they have been
difficult to apply and have led to a great deal of confusion. This
confusion is compounded when applied to "low-grade" or "minimally
invasive" follicular carcinoma because of the poor reproducibility of
the classification and the variable results reported in the literature.
Our surgical colleagues face a similar lack of a standardized treatment
for low-grade follicular carcinomas, which leads to unnecessary surgical
treatment. Standardization of histologic criteria is necessary to
promote confidence and uniformity in the therapeutic approach of these
tumors. We believe that a FCMI is defined as an encapsulated follicular
tumor (not papillary), with only small to medium vessel invasion within
or immediately adjacent to the tumor capsule and/or up to full-thickness
capsular transgression without accompanying extension into the thyroid
parenchyma with intervening fibrosis. By using these criteria, patients
can be managed with conservative surgical excision to yield an excellent
long-term patient outcome.
6
UI - 11914476
AU - Melhus H; Li Q; Nordlinder H; Farnebo LO; Grimelius L
TI -
Expression of cellular retinol- and retinoic acid-binding proteins in
normal and pathologic human parathyroid glands.
SO - Endocr Pathol 2001 Winter;12(4):423-7
AD - Department of Medical Sciences, Uppsala University Hospital, S-751 85
Uppsala, Sweden. Hakan.Melhus@medsci.uu.se
We have previously reported data establishing the human parathyroid
gland as a target organ for vitamin A. In the present study, we
identified Ito-like cells in parathyroid glands, suggesting local stores
of vitamin A. Furthermore, we used immunohistochemistry to investigate
the expression of the cellular retinol-binding protein type 1 and the
cellular retinoic acid-binding protein type 1 (CRABP I) in
histologically normal glands, in remnants of "normal" glandular tissue
adjacent to adenoma, in adenomas, and in hyperplastic glands of chief
cell type. All normal and abnormal glands displayed immunoreactivity to
the two antibodies. CRABP I appeared in the cytoplasm, cell membranes,
and nuclear membranes in normal glands, but only exceptionally in the
nuclear membranes in abnormal glands. Since retinoic acid inhibits the
secretion of parathyroid hormone and CRABP I is thought to play a key
role in regulating the amount of retinoic acid available to interact
with specific nuclear receptors, these data may suggest impaired
transport of retinoic acid to cell nuclei, thus contributing to the
development of hyperparathyroidism.
7
UI - 10740604
AU - Kumar PV; Hodjati H; Monabati A; Talei A
TI -
Medullary thyroid carcinoma. Rare cytologic findings.
SO - Acta Cytol 2000 Mar-Apr;44(2):181-4
AD - Department of Pathology, Shiraz Medical School, Shiraz University of
Medical Sciences, Iran.
OBJECTIVE: To describe some rare cytologic findings in medullary thyroid
carcinoma. STUDY DESIGN: Review of the fine needle aspiration smears
from 15 cases of medullary thyroid carcinoma that were confirmed on
histologic sections. The ages ranged between 31 and 67 years; 10 were
female and 5 male. Thirteen were sporadic forms, and two were familial
forms. RESULTS: Eight cases were classified as pleomorphic cell type and
seven as monomorphic cell type. The smears revealed round, oval,
triangular, polygonal and spindle-shaped cells, intracytoplasmic red
granules, occasional intranuclear inclusions, amyloid, binucleated and
multinucleated cells, and thick, granular chromatin. CONCLUSION: The
rare cytologic findings in this study were grape cells, cytoplasmic
nippling, elongated cytoplasmic processes, carrot-shaped nuclei, nuclear
buddings, mast cell-like cells and a Burkitt's lymphoma-like appearance.
These findings were rarely reported before.
8
UI - 11917600
AU - Us-Krasovec M; Flezar M; Kloboves-Prevodnik V
TI -
Rare cytologic findings in medullary thyroid carcinoma.
SO - Acta Cytol 2002 Mar-Apr;46(2):434-6
9
UI - 11963755
AU - Mann K
TI -
[Diagnosis and therapy of differentiated thyroid gland carcinomas]
SO - Internist (Berl) 2002 Feb;43(2):174-85
AD - Abteilung fur Endokrinologie, Zentrum fur Innere Medizin,
Universitatsklinikum Essen, Hufelandstrasse 55, 45122 Essen.
klaus.mann@uni-essen.de
10
UI - 12050199
AU - Malchoff CD; Malchoff DM
TI -
The genetics of hereditary nonmedullary thyroid carcinoma.
SO - J Clin Endocrinol Metab 2002 Jun;87(6):2455-9
AD - Department of Medicine, University of Connecticut Health Center, 263
Farmington Avenue, Farmington, CT 06030-1850, USA.
malchoff@nso2.uchc.edu
11
UI - 11114619
AU - Brink JS; van Heerden JA; McIver B; Salomao DR; Farley DR; Grant CS;
TI -
Thompson GB; Zimmerman D; Hay ID
Papillary thyroid cancer with pulmonary metastases in children:
long-term prognosis.
SO - Surgery 2000 Dec;128(6):881-6; discussion 886-7
AD - Division of General and Gastroenterologic Surgery, Mayo Clinic and Mayo
Foundation, Rochester, MN 55905, USA.
BACKGROUND: Papillary thyroid cancer (PTC) in young patients may rarely
be encountered with pulmonary metastases. Previous studies have
suggested that, in the pediatric population, this may not portend a
lethal outcome. Our present study, children with pulmonary metastases,
was designed to clarify this issue. METHODS: Fourteen children and young
adolescents (mean age, 13.5 years; range, 9.8-17 years) with PTC and
pulmonary metastases were treated at our institution between 1937 and
1998. Surgical treatment consisted of total thyroidectomy (n = 10
patients), subtotal thyroidectomy (n = 3 patients), and a biopsy only
procedure (n = 1 patient). All patients who underwent thyroidectomy also
underwent a variety of cervical lymph node dissections, and all patients
proved to have regional nodal disease. After the operation, 12 patients
were treated with ablative doses of (131)I, 1 patient was treated with
external beam irradiation, and all patients were placed on suppressive
thyroid hormone therapy. The mean length of follow-up was 19.3 years
(range, 1-45 years). RESULTS: Regional recurrent disease developed in 2
patients (15%). No patient experienced the development of worsening
pulmonary disease or extra-pulmonary metastases. All patients with
recurrent disease underwent selective nodal resections. No patient died
of metastatic PTC. Seven patients (50%) remain completely free of
disease and are probably cured; 7 patients (50%) are asymptomatic with
residual pulmonary disease. CONCLUSIONS: A stepwise treatment approach
allows long-term survival and frequent cure for young patients with PTC
and concomitant pulmonary metastases.
12
UI - 11303892
AU - Melloul M; Paz A; Koren R; Cytron S; Feinmesser R; Gal R
TI -
99mTc-MIBI scintigraphy of parathyroid adenomas and its relation to
tumour size and oxyphil cell abundance.
SO - Eur J Nucl Med 2001 Feb;28(2):209-13
AD - Department of Nuclear Medicine, Hasharon Hospital, Rabin Medical Center,
Petah Tikva, Israel. adrian-p@inter.net.il
The aim of this study was to assess the correlation between
technetium-99m methoxyisobutylisonitrile (MIBI) uptake by parathyroid
adenomas, oxyphil cell content and volume of the lesions. Thirty-one
patients with parathyroid adenomas were evaluated prospectively.
Preoperative double-phase 99mTc-MIBI scintigraphy was performed in all
patients and tracer uptake by parathyroid lesions was assessed
semi-quantitatively employing region of interest ratios to normal
adjacent neck areas. Surgical specimens underwent histological
evaluation and oxyphil cell content was determined. The intensity of
tracer uptake was compared with oxyphil cell content, volume of the
lesions and serum levels of calcium and parathormone. 99mTc-MIBI tracer
uptake was correlated with oxyphil cell content, volume of parathyroid
lesions and the functional status of the parathyroid adenomas. Tracer
accumulation in oxyphil cells might partially explain the preferential
99mTc-MIBI retention in parathyroid lesions.
13
UI - 11504097
AU - Gabriel M; Erler H; Bacher-Stier C; Kendler D; Donnemiller E;
TI -
Decristoforo C; Moncayo R
Methodological considerations influence the clinical value of
parathyroid localisation diagnostics.
SO - Eur J Nucl Med 2001 Jul;28(7):942-3
14
UI - 11601131
AU - Renshaw AA
TI -
Accuracy of thyroid fine-needle aspiration using receiver operator
characteristic curves.
SO - Am J Clin Pathol 2001 Oct;116(4):477-82
AD - Department of Pathology, Baptist Hospital of Miami, Miami, 8900 N
Kendall Dr, Miami, FL 33176, USA.
Although many large series demonstrate the effectiveness of thyroid
fine-needle aspiration (FNA), measuring its accuracy has been suboptimal
owing to inappropriate statistical methods. All thyroid fine-needle
aspirates were correlated with corresponding histologic and cytologic
follow-up for a 4-year period, and the accuracy was determined using
receiver operator characteristic curves, which allow inclusion of
nondiagnostic and indeterminate cases. There were 1,085 cases, 291 with
follow-up. The overall accuracy was 0.90 +/- 0.02 for a single
aspiration session. A nondiagnostic aspirate was associated with a
significant risk of malignancy (16%). However, 70% of patients who
underwent reaspiration had adequate and negative results, and
reaspiration significantly increased overall accuracy. Subcategorizing
the nondiagnostic category did not affect accuracy, but did define
categories with a significantly different change of a negative diagnosis
on repeated aspiration. Although subcategories of papillary carcinoma
were associated with significantly different risks of carcinoma (40% vs
81%), they did not significantly improve overall accuracy. Receiver
operator characteristic curves can be used to define the accuracy of
thyroid FNA. This method demonstrates significantly increased accuracy
with repeated aspiration of nondiagnostic cases and demonstrates that
subcategorization does not improve the overall accuracy of the test.
15
UI - 12064873
AU - Pomorski L; Bartos M
TI -
Histologic changes in thyroid nodules after percutaneous ethanol
injection in patients subsequently operated on due to new focal thyroid
lesions.
SO - APMIS 2002 Feb;110(2):172-6
AD - Clinic of Endocrinological and General Surgery, Institute of
Endocrinology, Medical University of Lodz, Poland.
This paper reports macro- and microscopic changes in hyperfunctioning
thyroid nodules (HTN), initially diagnosed as solitary, in patients
treated with percutaneous ethanol injection (PEI). In 78 patients,
benign solitary HTN were diagnosed by clinical and hormonal examination.
High resolution ultrasonography confirmed the solitary nodule. The
results of fine needle aspiration biopsy (FNAB), performed twice, ruled
out malignancy of the nodule. The patients were referred for PEI
treatment. At 1-year follow-up, newly formed thyroid nodules, whose
volumes increased, were detected in five patients (6.4%) with HTN,
initially diagnosed as solitary. Therefore, these patients were operated
on. Subtotal thyroidectomy was performed. At the intraoperative
macroscopic evaluation, a hard fibrous solid mass was found in place of
three nodules (n1, n2, n3) following PEI treatment. The middle area of
the cut surface of PEI-treated nodules (n4 and n5) in the other two
patients was firm and haemorrhagic, surrounded by a fibrous mass.
Histolopathologic examination of n1, n2 and n3 revealed fibrosis and
hyalinosis. Examination of n4 and n5 showed haemorrhagic necrosis in the
middle of the nodules surrounded by fibrous tissue.
16
UI - 12050949
AU - Zettinig G; Prager G; Kurtaran A; Kaserer K; Czerny C; Dudczak R;
TI -
Niederle B
[Value of a structured report for the interpretation of parathyroid
scintigraphy in primary essential hyperthyroidism]
SO - Acta Med Austriaca 2002;29(2):68-71
AD - Universitatsklinik fur Nuklearmedizin, Ludwig Boltzmann Institut fur
Nuklearmedizin, Universitat Wien. georg.zettinig@akh-wien.ac.at
The aim of the study was to evaluate whether a four-stage report scheme
increases the diagnostic accuracy of dual phase Tc-99 m sestamibi
scintigraphy (MIBI-scintigraphy) in patients with primary
hyperparathyroidism (pHPT). We analysed the scans of 35 patients with
primary hyperparathyroidism referred for Tc-99 m sestamibi scintigraphy
and compared them with the sonographic and surgical findings. All scans
were interpreted following a four-stage report scheme: Group A--typical
scintigraphic findings of a single gland disease, group B--scan
consistent with single gland disease, group C--multiple gland disease,
group D--non diagnostic scan. Twenty-three scans were ranked in group A.
In all these patients, scintigraphy diagnosed both the side and the
localization of the adenoma correctly. Sonography made the correct
diagnosis in 21/23 individuals and showed false-positive results in 2/23
cases. Group B included 10 scans. In 7/10 individuals, both the side and
the localization of the adenoma were diagnosed correctly, whereas in
2/10 patients only the side was diagnosed. The scan of a single patient
with hyperplasia of all 4 parathyroid glands was falsely interpreted as
"consistent with a left caudal single gland disease". Sonography made
the correct diagnosis in 8/10 cases, two individuals were diagnosed as
false positive and false negative, respectively. No scan was interpreted
as multiple gland disease (group C) and two scans were non diagnostic
(group D). Both patients of the last group were correctly diagnosed by
sonography. These findings suggest that in case of typical scintigraphic
findings of single gland disease, scintigraphy but not sonography should
be the primary localization technique for minimally invasive
parathyroidectomy.
17
UI - 11786411
AU - Hoos A; Stojadinovic A; Singh B; Dudas ME; Leung DH; Shaha AR; Shah JP;
TI -
Brennan MF; Cordon-Cardo C; Ghossein R
Clinical significance of molecular expression profiles of Hurthle cell
tumors of the thyroid gland analyzed via tissue microarrays.
SO - Am J Pathol 2002 Jan;160(1):175-83
AD - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York,
New York 10021, USA.
Hurthle cell tumors are rare thyroid neoplasms for which disease biology
is poorly understood and diagnosis of carcinoma can be challenging. The
aim of the study was to characterize molecular expression profiles of
Hurthle cell tumors and to determine the clinical significance of
identified phenotypes. Paraffin-embedded tissue cores of normal thyroid
(n = 18), and histopathologically well-defined Hurthle cell adenomas (n
= 27), Hurthle cell tumors of unknown malignant behavior (n = 7), and
minimally (n = 14) and widely (n = 21) invasive Hurthle cell carcinomas
were arrayed in triplicate on tissue microarrays. Expression profiles of
p53, mdm-2, p21, Bcl-2, cyclin D1, and Ki-67 were detected by
immunohistochemistry and correlated with clinicopathological data and
patient outcome using standard statistical methodology. Median follow-up
time was 8 years. High Ki-67 proliferative index was evident only in the
clinically aggressive widely invasive Hurthle cell carcinomas and was
associated with significantly reduced relapse-free (P = 0.001) and
disease-specific (P < 0.001) survival. The molecular phenotype of
Hurthle cell tumors, independent of histopathological subtype diagnosis,
was characterized by p53(-), mdm-2(+), p21(+/-), cyclin D1(-), and
Bcl-2(+/-). Normal thyroid tissue demonstrated a p53(-), mdm-2(-),
p21(-), cyclin D1(-), and Bcl-2(+) phenotype. The Bcl-2(+) phenotype was
associated with improved relapse-free survival (P = 0.04) and
disease-specific survival (P = 0.01) in widely invasive carcinomas and
the Ki-67(+)/Bcl-2(-) phenotype was associated with the diagnosis of
widely invasive Hurthle cell carcinoma (P < 0.001). This study
demonstrates that tissue microarray-based profiling allows
identification of molecular markers that are associated with patient
prognosis. High Ki-67 proliferative index was associated with adverse
outcome in Hurthle cell neoplasms. Together with down-regulation of
Bcl-2, high Ki-67 proliferative index may be useful for diagnosing
widely invasive Hurthle cell carcinomas. Molecular alterations in the
p53 pathway play a role in Hurthle cell tumorigenesis, but other
unidentified molecular changes seem to be required to induce the
malignant phenotype.
18
UI - 12067803
AU - Moysich KB; Menezes RJ; Michalek AM
TI -
Chernobyl-related ionising radiation exposure and cancer risk: an
epidemiological review.
SO - Lancet Oncol 2002 May;3(5):269-79
AD - Department of Cancer Prevention, Epidemiology, and Biostatistics,
Roswell Park Cancer Institute, Buffalo, NY 14226, USA.
kirsten.moyisch@roswellpark.org
The Chernobyl nuclear accident on 26th April, 1986, led to a massive
release of radionuclides into the environment. Although vast areas of
Europe were affected by Chernobyl-related ionising radiation, the
accident had the greatest impact in Belarus, Ukraine, and the Russian
Federation. Epidemiological studies that have investigated the link
between the Chernobyl accident and cancer have largely focused on
malignant diseases in children, specifically thyroid cancer and
leukaemia. There is good evidence to suggest that rates of thyroid
cancer in children from the countries that were formally part of the
Soviet Union have risen as a consequence of the Chernobyl accident. The
findings for childhood leukaemia are less conclusive. Overall rates for
this disease do not seem to have been affected by the Chernobyl-related
ionising radiation, but there may be a larger risk of infant leukaemia
in contaminated areas of Europe. Among adult populations, there is no
strong evidence to suggest that risk of thyroid cancer, leukaemia, or
other malignant disease has increased as a result of the Chernobyl
accident.
19
UI - 12027995
AU - Caraci P; Aversa S; Mussa A; Pancani G; Ondolo C; Conticello S
TI -
Role of fine-needle aspiration biopsy and frozen-section evaluation in
the surgical management of thyroid nodules.
SO - Br J Surg 2002 Jun;89(6):797-801
AD - Department of Clinical and Biological Sciences, University of Turin, San
Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy.
BACKGROUND: The role of routine frozen section (FS) in the surgical
management of thyroid nodules remains uncertain. This study reviewed the
role of FS in the presence of an adequate fine-needle aspiration biopsy
(FNAB). METHODS: FNAB and FS were evaluated in 206 patients who had
surgery for a thyroid nodule. Cytological specimens were classified as
benign, malignant or suspicious. The FS diagnoses were benign, malignant
or deferred. RESULTS: A cytological diagnosis was obtained in 93
nodules; the remaining 113 were classified as suspicious, of which 21
were malignant on definitive examination. The overall accuracy of FNAB
was 53 per cent. FS evaluation identified 165 lesions as benign; the
diagnosis was deferred until definitive histological evaluation in only
eight. The overall accuracy, therefore, was 96 per cent. Routine use of
FS was cost-effective; lowering the number of reoperations led to an
estimated saving of about 40 per cent. CONCLUSION: These data suggest
that FS remains an important tool in the surgical management of thyroid
nodules and can reduce the number of patients requiring reoperation.
20
UI - 12027996
AU - Tan MP; Agarwal G; Reeve TS; Barraclough BH; Delbridge LW
TI -
Impact of timing on completion thyroidectomy for thyroid cancer.
SO - Br J Surg 2002 Jun;89(6):802-4
AD - Endocrine Surgical Unit, Department of Surgery, University of Sydney,
Royal North Shore Hospital, St Leonards, New South Wales 2065,
Australia.
BACKGROUND: It has been stated that completion thyroidectomy for thyroid
malignancy should be performed either within 10 days of the primary
operation or after 3 months, to reduce the incidence of complications.
The aim of this study was to review the impact of timing on the rate of
complications following completion thyroidectomy. METHODS: Data were
obtained retrospectively from the Endocrine Surgery Thyroid Data Base,
to which the records of all patients have been entered since 1957. The
patients who had the last 100 consecutive completion thyroidectomies for
thyroid cancer comprised the study group. RESULTS: Sixty-three patients
had the second operation performed within 10 days or more than 90 days
after the initial operation (group 1). Thirty-seven patients had
reoperation between 10 and 90 days after the first procedure (group 2).
One patient (2 per cent) in group 1 and one patient (3 per cent) in
group 2 suffered a permanent complication (P not significant).
CONCLUSION: There was no definite impact of the timing of surgery on the
rate of complications after completion thyroidectomy.
21
UI - 12050333
AU - Meier DA; Brill DR; Becker DV; Clarke SE; Silberstein EB; Royal HD;
TI -
Balon HR; Society of Nuclear Medicine
Procedure guideline for therapy of thyroid disease with (131)iodine.
SO - J Nucl Med 2002 Jun;43(6):856-61
AD - William Beaumont Hospital, Royal Oak, Michigan, USA. dameier@comcast.net
22
UI - 12079713
AU - Basaria M; Graf H; Cooper DS
TI -
The use of recombinant thyrotropin in the follow-up of patients with
differentiated thyroid cancer.
SO - Am J Med 2002 Jun 15;112(9):721-5
AD - Division of Endocrinology and Metabolism, Sinai Hospital of Baltimore,
Maryland 21215, USA.
Many clinicians care for patients who have been treated for
differentiated thyroid cancer. Recombinant thyrotropin, which stimulates
iodine uptake in thyroid tissue, is a safe and effective diagnostic
agent for those patients who require radioiodine scanning for routine
follow-up. The combination of a whole body radioiodine scan and a serum
thyroglobulin measurement can identify virtually all patients with
distant metastatic disease. A serum thyroglobulin >2 ng/mL and/or a
positive whole body scan after recombinant thyrotropin stimulation
suggest residual thyroid tissue or neoplastic disease. The use of
recombinant thyrotropin has fewer adverse effects than does the
alternative, which is withdrawal of thyroid hormone replacement,
although nausea and headache have been reported. However, recombinant
thyrotropin is expensive.
23
UI - 12067667
AU - Kenyon G
TI -
US citizens exposed to radiation fallout during Cold War tests.
SO - Lancet Oncol 2002 Apr;3(4):197
24
UI - 12033961
AU - Herrmann ME; LiVolsi VA; Pasha TL; Roberts SA; Wojcik EM; Baloch ZW
TI -
Immunohistochemical expression of galectin-3 in benign and malignant
thyroid lesions.
SO - Arch Pathol Lab Med 2002 Jun;126(6):710-3
AD - Department of Pathology, University of Pennsylvania, Philadelphia, USA.
herrmannm@afip.osd.mil
CONTEXT: The expression of galectin-3, a human lectin, has been shown to
be highly associated with malignant behavior of thyroid lesions. DESIGN:
We studied the immunohistochemical expression pattern of galectin-3 in a
variety of follicular-derived thyroid lesions (13 benign and 62
malignant), including Hurthle cell and follicular carcinoma, papillary
carcinomas and variants, and anaplastic and poorly differentiated
carcinomas. RESULTS: Immunoreactivity was strongest in papillary thyroid
carcinomas, whereas staining was less intense in Hurthle cell and
anaplastic carcinomas, and even weaker in the follicular variant of
papillary thyroid carcinoma. Staining was absent or weak in the 3
follicular thyroid carcinomas and was negative in both insular
carcinomas. In several tumors, staining was stronger at the advancing
invasive edge of the lesion than in the central portion of the tumor.
Galectin-3 was also expressed focally and weakly in reactive follicular
epithelium and entrapped follicles in chronic lymphocytic thyroiditis. A
variety of thyroid lesions showed prominent endogenous, biotin-like
activity, which could cause flaws in interpretation if a
biotin-detection system were used. CONCLUSION: We conclude that
galectin-3 immunostaining, when used in biotin-free detection systems,
may be useful as an adjunct to distinguish benign from malignant thyroid
lesions.
25
UI - 12075176
AU - Stojadinovic A; Shoup M; Ghossein RA; Nissan A; Brennan MF; Shah JP;
TI -
Shaha AR
The role of operations for distantly metastatic well-differentiated
thyroid carcinoma.
SO - Surgery 2002 Jun;131(6):636-43
AD - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York,
NY 10021, USA.
BACKGROUND: The role of operations for distantly metastatic
well-differentiated thyroid carcinoma (DTC) is poorly defined. We review
the indications for operation for metastatic DTC. METHODS: This study
consists of 260 patients treated between 1941 and 2000 for metastatic
DTC, of which 59 (23%) underwent operations. Median follow-up was 7
years (range, 1 to 49 years). Metastases were identified clinically in
157 (60%) and radiologically in 103 (40%) patients. The disease-specific
survival was estimated with the Kaplan-Meier method. RESULTS:
Twenty-four patients (9%) were disease-free with resection. Palliative
resection was indicated for painful bone metastasis, pathologic
fracture, or symptomatic spinal cord involvement (35/260, 14%). Patients
who could undergo complete metastasectomy survived longer than those
having incomplete/palliative resection or nonoperative treatment for
metastatic DTC (5-year disease-specific survival, 78% vs 43% vs 46%, P
=.03). CONCLUSIONS: Solitary distant metastasis of DTC amenable to
complete resection is infrequent. Complete metastasectomy may be
associated with improved survival for localized distant disease.
Palliative resection is indicated to improve quality of life for
symptomatic distant metastasis.
26
UI - 11913107
AU - Smit JW
TI -
[The initial treatment of patients with differentiated thyroid
carcinoma; consensus and controversies]
SO - Ned Tijdschr Geneeskd 2002 Mar 9;146(10):454-7
AD - Leids Universitair Medisch Centrum, afd. Endocrinologie en
Stofwisselingsziekten, Postbus 9600, 2300 RC Leiden.
j.w.a.smit.endo@lumc.nl
Differentiated thyroid carcinoma has a low incidence and a relatively
good prognosis. As a consequence, treatment protocols are largely based
on retrospective analyses of heterogeneous patient groups, as no
randomised controlled trials with residual disease and survival as
outcome measures are available. In the Netherlands, guidelines for
initial therapy are based on a 1987 international consensus meeting.
These guidelines involve near-total thyroidectomy with a few exceptions
and routine radioiodide ablative therapy in all cases. Recent
publications still support the main measures as advised in this
consensus. Although randomised trials have not proven that the consensus
guidelines improve the prognosis in thyroid carcinoma, the guidelines
provide a base for uniform data collection and thus scientific research.
They also provide tools for health-practice quality surveys.
27
UI - 11913113
AU - Kuijpens JL; Hoekstra OS; Hamming JF; Haak HR; Ribot JG; Coebergh JW
TI -
[Surgery and referral for subsequent 131I therapy for patients with
differentiated thyroid carcinoma in the south-east of the Netherlands,
1983-1996, compared to the consensus guidelines from 1987]
SO - Ned Tijdschr Geneeskd 2002 Mar 9;146(10):473-7
AD - ArboUnie Zuidoost Nederland, Eindhoven.
OBJECTIVE: To evaluate the treatment of patients with differentiated
(papillary or follicular) thyroid cancer in general hospitals in the
south-east of the Netherlands during the period 1983-1996, in relation
to the 1987 national consensus recommendations. DESIGN:
Population-based, retrospective, descriptive. METHOD: For the period 1
treatment (hospital, specialist, type of operation, referral for 131I
therapy) of all 236 patients with differentiated thyroid cancer were
obtained from the cancer registry of the Comprehensive Cancer Centre
South, Eindhoven, the Netherlands. The treatment was compared with the
recommendations from the consensus meeting in 1987. RESULTS: Data on 219
patients (137 papillary, 82 follicular thyroid carcinoma) treated in the
general hospitals in the region were studied; the 17 remaining patients
had been referred from outside the region. Patients were treated at all
hospitals in the region; the number of specialists per hospital able to
treat thyroid carcinoma (internist and/or surgeon) was limited. In total
79% of the patients underwent a (near-)total thyroidectomy, half of them
in two phases, and in 12% of the cases combined with regional lymph node
dissection. In the majority of cases, surgical treatment was in
accordance with the consensus recommendations: 65-100% of the cases per
hospital. The proportion of patients referred for 131I therapy varied
from 17% to 90%; referral was more frequent in the case of larger
tumours and/or metastases. Of the 24 patients with a small papillary
carcinoma without metastases, 79% were not referred for 131I therapy.
CONCLUSIONS: The recommendations laid down in the consensus meeting in
1987 were known and appeared to be followed for surgical treatment but
for subsequent 131I therapy they appeared to be interpreted differently.
A review of the consensus guidelines seems to be worthwhile.
28
UI - 12034964
AU - Spieth ME; Gough J; Kasner DL
TI -
Role of US with supplemental CT for localization of parathyroid
adenomas.
SO - Radiology 2002 Jun;223(3):878-9; discussion 879
29
UI - 12077916
AU - Szakall S Jr; Bajzik G; Repa I; Miklovicz T; Dabasi G; Sinkovics I; Esik
TI -
O
[FDG PET scan of metastases in recurrent medullary carcinoma of the
thyroid gland]
SO - Orv Hetil 2002 May 26;143(21 Suppl 3):1280-3
AD - Debreceni Egyetem, Orvos- es Egeszsegtudomanyi Centrum, PET Centrum,
Debrecen. szakall@pet.dote.hu
Searching for metastases of medullary thyroid cancer (MTC), FDG PET was
applied. PET results were compared with those of conventional diagnostic
imaging procedures. After primary treatment, 52 MTC patients with
elevated serum tumor marker levels and/or general symptoms
(diarrhoea/flush) underwent radiological (CT/MRI), 131-iodine labeled
metaiodo-benzylguanidine (MIBG) whole-body scintigraphy and FDG PET
investigations. At least one pathological lesion was detected in 49
patients by PET, 35 by CT, 32 by MRI and 3 by MIBG. FDG PET was far
superior to the other methods in identifying metastases in the
supradiaphragmatic lymphatic regions. In the follow-up of MTC patients,
FDG PET was more sensitive in localizing tumorous LN involvement,
especially in the cervical, supraclavicular and mediastinal lymphatic
regions, compared to other imaging modalities.
30
UI - 12063398
AU - Bol S; Belge G; Rippe V; Bullerdiek J
TI -
Molecular cytogenetic investigations define a subgroup of thyroid
adenomas with 2p21 breakpoints clustered to a region of less than 450
kb.
SO - Cytogenet Cell Genet 2001;95(3-4):189-91
AD - Center for Human Genetics, University of Bremen, Bremen, Germany.
Structural rearrangements involving chromosome band 2p21 characterize a
cytogenetic subgroup of benign thyroid tumors. To narrow down the
breakpoints of these aberrations, we established two cell lines from
benign thyroid tumors showing translocations involving 2p21. These two
cell lines and one additional primary tumor were used for FISH-studies
with 18 BAC clones. All breakpoints were mapped to a cluster of about
450 kb. Copyright 2002 S. Karger AG, Basel
31
UI - 11849247
AU - Fugazzola L; Cerutti N; Mannavola D; Ghilardi G; Alberti L; Romoli R;
TI -
Beck-Peccoz P
Multigenerational familial medullary thyroid cancer (FMTC): evidence for
FMTC phenocopies and association with papillary thyroid cancer.
SO - Clin Endocrinol (Oxf) 2002 Jan;56(1):53-63
AD - Istituto Clinico Humanitas and Ospedale Maggiore IRCCS, Milan, Italy.
BACKGROUND: Occurrence in a familial setting is well established for
medullary thyroid carcinoma (MTC) and has been more recently reported
for papillary thyroid cancer (PTC). Germline mutations or rearrangements
of the RET proto-oncogene are the genetic background of the majority of
hereditary MTCs and of about 25-40% of PTCs. PATIENTS: A large
multigenerational familial medullary thyroid cancer (FMTC) family,
comprised of four generations and a total of 60 subjects, has been fully
evaluated. Studies on germline RET mutations and polymorphisms, on
somatic RET activation and on haplotyping with RET-linked markers, were
performed. RESULTS: RET mutational analysis revealed a rare missense
point mutation in exon 15 of RET (A891S), associated with FMTC.
Haplotype analysis showed a co-segregation between the allelic variant 5
of D10S578 marker (which is tightly linked to the RET locus) and the RET
mutation. Two patients, from different branches of the family, did not
harbour the point mutation A891S despite histological confirmation of
MTC. In these cases, haplotype analysis excluded the involvement of the
RET gene itself in the pathogenesis of the MTC. In three patients, the
coexistence, in different foci, of medullary and papillary thyroid
cancer was documented. The genetic studies did not show ret/PTC
rearrangements. The microsatellite analysis excluded co-segregation of
RET locus with the MTC/PTC phenotype. CONCLUSIONS: We report a full
clinical and molecular analysis of a large FMTC kindred with an uncommon
RET mutation. In two family members, phenotype and genotype were not
concordant, representing the first evidence of FMTC phenocopies.
Furthermore, the association of familial forms of medullary and
papillary thyroid cancers has been found in 30% of patients undergoing
thyroidectomy for MTC. In these situations, genetic analyses excluded
the possible germline involvement of RET. Though FMTC phenocopies are
likely to represent an exceptional finding, such a possibility should be
taken into account in the genetic counselling for MEN 2 syndromes.
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