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Out Treatment Approach

Endocrine Cancers

International Reputation
Papillary and Follicular Thyroid Cancer
Medullary Cancer
Endocrine Pancreas Tumors
Adrenal Tumors
Voice and Vocal Nerve Preservation

International Reputation
The Siteman Cancer Center is a world leader in the treatment of cancers of the endocrine system, the network of glands that produce hormones in the body. This includes tumors of the thyroid, parathyroid, pancreas and adrenal glands as well as carcinoid tumors. These tumors my occur as the result of an inherited disorder called multiple endocrine neoplasia (MEN). Because of the strong genetic component of these cancers, our program has a dedicated clinical nurse on staff who keeps in touch with families from around the world affected by MEN.

In order to focus the maximum expertise available on each patient’s problem, we discuss our cases at a biweekly conference that is attended by endocrinologists, endocrine surgeons, medical and radiation oncologists, radiologists and pathologists. This multidisciplinary approach allows us to offer customized care for each patient.

Papillary and Follicular Thyroid Cancer
Thyroid cancer arising from the follicular cells of the thyroid – such as papillary, follicular or differentiated thyroid cancer – is among the most curable of all cancers. The required operation, however, can have significant complications if it is not performed expertly. Our endocrine surgeons have extensive experience in performing this surgery and in counseling patients about selecting the operative procedure that is best for them.

After the thyroid gland is removed, many patients are treated by a radiation oncologist who uses radioactive iodine to kill any residual cancer cells. Patients then take synthetic thyroid hormone to replace the hormone formerly produced by their thyroid gland and to keep the body from stimulating the growth of any new cancer cells. Follow-up often can be done by scanning with low doses of radioactive iodine, a study that is made more efficient and comfortable for patients by treating them with newly available synthetic thyroid-stimulating hormone before the scan.

Medullary Cancer
Cancer from the parafollicular cells of the thyroid, or medullary cancer, is rarer and is often associated with the inherited MEN2 syndrome. Siteman has more experience in treating medullary cancer than any other center in the world, and we have pioneered several aspects of its management. This disease requires meticulous removal of the thyroid gland and the lymph nodes around it, but radioactive iodine is not useful for treatment.

For patients who have been operated on previously, Siteman surgeons have developed a new technique. Using a minimally invasive procedure called laparoscopy, they first look for undetected spread of cancer to the liver, and if none is present, they examine the lymph nodes of the neck and remove any tumor in the nodes. Patients with MEN2 also can develop tumors of the adrenal glands and parathyroid glands, and our research has demonstrated the best ways to evaluate and treat these problems.

Endocrine Pancreas Tumors
Tumors of the pancreatic tissue that makes hormones such as insulin, gastrin or glucagon are very rare, but they represent an area of special expertise at Siteman. These tumors are often quite small but still cause devastating problems because of the large amount of hormones they may produce. Our team is experienced in diagnosing and identifying these rare tumors so they can be removed. Surgeons frequently use ultrasound to find tumors within the pancreas that cannot otherwise be seen or felt.

In some patients with endocrine pancreas tumors, the disease is associated with MEN1 syndrome, which also can cause problems with the parathyroid glands and pituitary gland. Siteman’s team has developed many of the methods for diagnosing and treating these patients, and they follow many families from around the country with MEN1.

Adrenal Tumors
Tumors of the adrenal glands – such as pheochromocytoma, aldosteronoma and cortisol-producing adenoma – often cause life-threatening problems because of the hormones they make. Our team is experienced in managing these hormonal issues before and after surgery. In most cases, these tumors are removed using a minimally invasive laparoscopic approach, which means a much faster recovery for the patient.

Voice and Vocal Nerve Preservation
The thyroid gland is wrapped around the voice box, airway and vocal cord nerves. These structures often are affected by cancer or its treatment. Siteman’s head and neck surgeons offer expertise in voice and vocal nerve preservation and reconstruction for thyroid cancer patients.