Thyroid Tumors Treatment Program

Overview

The Elizabeth and Michael Ruane Center for Endocrine Tumors at the Massachusetts General Hospital Cancer Center is a comprehensive program specializing in the treatment of thyroid enlargement (goiter) and all types of thyroid tumors, including:

• Enlargement of the thyroid gland (goiter)
• Thyroid nodules and cysts of the thyroid
• Thyroid cancers including papillary, follicular, poorly differentiated, medullary, anaplastic, and metastatic thyroid cancer

Although many thyroid nodules are benign (non-cancerous), our program combines the resources of the Massachusetts General Hospital Cancer Center and the Mass General Thyroid Unit to provide advanced treatment for all patients with thyroid tumors. Read frequently asked questions about thyroid nodules, including causes, diagnosis and treatment options.

Innovative Approaches

Our program is one of the largest and most specialized in the country. Thyroid specialists at Massachusetts General Hospital have greatly advanced the care and treatment of thyroid conditions and provide:

• Highly specialized expertise in goiters and thyroid tumors, including advanced ultrasound techniques and ultrasound guided fine needle and core biopsies
• State-of-the art technology for diagnosing thyroid tumors including molecular genetic testing
• The most advanced surgical techniques
• High volume surgical expertise in thyroid surgery
• Radioactive active iodine therapy for benign overactive thyroid nodules and for well-differentiated thyroid cancer

Advanced clinical trials to find better therapies for thyroid cancers

Expertise in Diagnosing and Staging Cancers

• An accurate diagnosis is the key to planning the right treatment. Our expert pathologists are highly sub-specialized in diagnosing thyroid conditions. Our program also has the most state-of-the-art diagnostic technologies available, including:
• Imaging technologies, such as radioactive iodine and pertechnetate nuclear scans, ultrasound, CT, PET/CT and MRI scans
• Fine-needle aspiration biopsy
• Ultrasound guided fine-needle aspiration and core needle biopsy
• Radioactive iodine administration including dosimetry
• Endocrine (Medical) Oncology

The majority of thyroid nodules are benign; however, many need to be evaluated in the event that they could be cancerous. For those that do turn out to be cancer, our program includes an expert team of oncologists, cytologists, pathologists, endocrine surgeons, thoracic surgeons, thyroidologists, radiation oncologist and nuclear medicine physicians, who accurately diagnose and treat these diseases. Some thyroid cancers are less aggressive than other forms of cancer whereas others are more aggressive. With appropriate treatment, the vast majority of patients with thyroid cancer achieve positive outcomes.

The major types of thyroid cancer are:

• Papillary
• Follicular
• Poorly differentiated
• Medullary
• Anaplastic

The standard of care for most types of thyroid or other endocrine cancer is surgery, which in some cases of well-differentiated thyroid cancer is followed by radioactive iodine therapy. This therapy, first developed at Massachusetts General Hospital in 1936, has been shown to be highly effective in improving outcomes for patients.

More aggressive types of cancer, as well as metastatic cancers, may be treated with chemotherapy in conjunction with radiation therapy and surgery. Our program is one of only a few in the country that specialize in treating these cancers. Our team has helped increase treatment options for thyroid cancer patients by demonstrating that there are a variety of effective chemotherapies. In addition, our physicians are engaged in ongoing clinical trials of targeted therapies to find new, targeted treatments.

Excellence in Surgical Care

Our endocrine surgery program is one of the oldest and most innovative in the country, and is recognized for having among the most specialized surgeons in treating thyroid and endocrine disorders. This high level of expertise has resulted in a high volume practice and research has shown that centers that perform a higher volume of surgical procedures have better outcomes.

Our surgeons use the most up-to-date technologies, including recurrent laryngeal nerve monitoring, and have pioneered and continue to advance minimally invasive techniques. Our goal is to be as conservative as possible with surgery without compromising care. Extreme attention is paid to the cosmetic appearance of the incision and to make the approach as minimally invasive as possible.

Among the surgical procedures that may be indicated for the treatment of thyroid conditions are:

• Thyroid lobectomy, which involves removal of one half of the thyroid
• Total thyroidectomy, which removes all of the thyroid
• Lymph node removal, for cancer that has spread outside the thyroid to the surrounding lymph nodes

Learn more about Endocrine Surgical Care.

Surgical Outcomes & Performance

The Center for Outcomes & Patient Safety in Surgery (COMPASS) ensures that surgical data is transparent and accessible for patients. Watch the video to view Mass General's performance for procedures to treat conditions of the adrenal, thyroid and parathyroid glands.

Pioneering Radiation Therapies

External radiation is not a common treatment for thyroid tumors, but it may be used to treat poorly differentiated, medullary, anaplastic and some cases of well-differentiated thyroid carcinoma. The most commonly used technique is external beam radiation therapy. Some patients with metastatic cancer may receive proton beam therapy, a technique pioneered at Mass General, which is able to target a very precise region while helping to spare surrounding tissues.

Developing Better Therapies through Research

In addition to leading clinical trials, our researchers are working to produce animal models that mimic human forms of these diseases. All these levels of research will work to advance therapies for thyroid and endocrine conditions and improve the lives of our patients.

Multidisciplinary Patient Care

Patients in the Center for Endocrine Tumors are cared for by a coordinated team of experts, which may include:

• Thyroidologists (endocrinologists specializing in thyroid disease) with expertise in diagnosing and treating goiters and thyroid tumors
• Endocrine surgeons who are leading the way in performing and developing the most advanced surgical approaches for thyroid tumors
• Diagnostic and interventional radiologists who utilize an array of medical imaging techniques to image the thyroid
• Radiation oncologists who specialize in delivering the optimal therapeutic dose while protecting healthy tissue
• Nuclear medicine physicians with expertise in radioactive iodine whole body scanning and dosimetry
• Endocrine oncologists who prescribe the most effective chemotherapy and medications
• Endocrine cytologists and pathologists who examine tissue biopsies and fine needle aspiration samples from the thyroid
• Support services, including specialized nursing staff, social workers, psychiatrists and others

Advanced Thyroid Cancer Center

The Massachusetts General Hospital–Massachusetts Eye and Ear Infirmary Advanced Thyroid Cancer Center provides unique multidisciplinary tertiary care for patients with advanced thyroid malignancy.

Learn more about the Advanced Thyroid Cancer Center.

Clinical Trials

Up until five or six years ago, medicine had little to offer advanced or aggressive forms of thyroid cancer. Today, that has changed thanks to much of the work being done in our program. Our physicians are leading or enrolled in numerous clinical trials aimed at discovering targeted therapies for these cancers.

View our open clinical trials.