Novel Medicine For Thyroid Cancer May Slow Disease Progression

Recently incorporated into the list of procedures by the National Health Agency (ANS), Lenvima (lenvatinib mesylate ) is the new medication for thyroid cancer intended for patients who have already undergone radioiodine therapy and were unsuccessful in combating the disease. According to the World Health Organization (WHO), about 750 million people worldwide suffer from some form of thyroid disease and approximately 60% of that number are unaware that they have problems with the gland. In the State of São Paulo, there are about 8 thousand cases per year.

common thyroid problems
According to Marco Aurélio Kulcsar, head of the Head and Neck Surgery Service at the Cancer Institute of the State of São Paulo (Icesp), the most common thyroid problem is hypothyroidism, an inflammation of the thyroid that can happen after a viral process or periods of long stress. The problem of hypothyroidism is followed by nodules in the neck: “Most of them are benign and those that are malignant are the smallest part of the nodules, they are less than 20%. In human ergonomics, thyroid cancer represents 3%”.

These problems, as well as thyroid cancer, can be identified in routine exams. Kulcsar also points out that they are curable and have several treatment options available to the patient.

cancer identification
A fundamental part of discovering the disease is the doctor’s role in knowing how to examine their patients: “When doing the thyroid exam, the important thing is for the doctor at the basic health unit to know how to examine the neck, feel a neck, not do random ultrasound”, says Kulcsar. From this first analysis by the doctor, if a nodule is found, he should refer the patient to an ultrasound scan and, if the nodule is suspicious on an ultrasound scan, a puncture should be performed. In identifying cancer it is necessary to do surgery.

“Surgery is essential. There are exceptions that will use lenvatinib. It is the case of that patient who has a more serious illness from the beginning. This patient probably had a small nodule that grew very quickly, metastasized to the lung or even to the bone and did not respond to traditional treatment for this distant metastasis. In the lung and bone, radioiodine works very well or sometimes even external radiotherapy, mainly for the bone, but when there is no response and it continues to evolve, these immunobiological drugs go there and block it through an immune activity”, he explains.

The incidence of thyroid cancer is higher in women. However, when it affects men, it can be more aggressive. For Kulcsar, more important than approving drugs as treatment is approving molecular tests to measure the severity of diseases, changing the form of treatment or even anticipating the use of medications like Lenvima. That would be the next step in advancing cancer treatments.

Lenvima and life expectancy
The new drug does not provide a cure, but slows down the progression of the cancer. “There are patients who underwent surgical treatment, sometimes the disease returned, sometimes they underwent a second surgical treatment, they underwent radioactive iodine once or twice. When you have already taken this dose and this lung disease or some neck disease, despite being operated on, continues to grow, you use this drug, lenvatinib or Lenvima, and it blocks the growth of the disease”. Kulcsar explains that when performing this blockade, there is an increase in the patient’s quality of life and the drug does not cause as many side effects as other drugs previously used.