ThyCa News

ThyCa JOURNEYS NEWSLETTER - January 2006

01/2006

IN THIS ISSUE

Letter from the Editor

As I write this, 2006 is just beginning. It’s time to take stock of the last 12 months and think about the year ahead.

Of course, taking stock isn’t relegated to January 1 alone. Birthdays also do the trick. And not surprisingly, so does a thyroid cancer diagnosis. I particularly remember one “ah ha!” moment in the midst of my treatment. I decided that I thought too much about the future. I needed to be more engaged in the present. I’d always wanted to learn to play the piano. Why not do it now? I planned to become more physically fit. No sense delaying. There was little point in putting things off for some amorphous future.

So let’s take stock: This year, I took things for granted. Another 365 days gone, and I still can’t play a note on the piano. I have yet to visit continental Europe, and I worked more than I should have. There’s a list of books I want to read that only gets longer (though I think that’s a good thing).

I’m still putting a lot of things off for that amorphous future. And I’ve decided that’s okay. Thyroid cancer gave me “ah ha!” moments that I wouldn’t trade back. But six years on, few things make me happier than knowing that I am once again taking things for granted. Though this year, I really do plan to start those piano lessons…..

May the New Year bring you health and happiness.
Barbara Weinstein,
Editor

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2005 Conference Overview and Highlights

Highlights from the 8th International Thyroid Cancer Survivors’ Conference in Denver, Colorado, on October 21-23, 2005:

  • More than 400 thyroid cancer survivors, caregivers, and health care professionals gathered from 37 states, District of Columbia, Canada, and the Philippines.
  • Attendees ranged from people newly diagnosed to survivors of more than 30 years, from children through seniors, as well as caregivers. Numerous physicians, nurses, and other medical professionals also attended for the 3 days to share in the conference experience.
  • The 100-plus sessions included 35 physician presentations and Ask-a-Doctor sessions about the latest advances in thyroid cancer care and research, including promising clinical trials. The 22 physician speakers came from the Cleveland Clinic, University of Colorado Health Sciences Center, Duke University, University of Florida, University of Texas M.D. Anderson Cancer Center, Washington University School of Medicine, and other major centers.
  • Featured speakers also included three pharmacists, a dentist, 5 nurses, a dietitian, 3 attorneys, a psychologist, specialists in complementary approaches to well-being, survivors of each type of thyroid cancer (papillary, follicular, medullary, anaplastic, and variants), and caregivers. Also speaking were Denver 7News Anchor Theresa Marchetta and National Memory Champion Scott Hagwood, both of whom are thyroid cancer survivors.
  • Feedback was uniformly positive. Sample comments:
  • Great job EVERYONE!!! We just wanted to let you know how much the conference means to us. We appreciate all the hard work, time and sacrifice by all. It was really worth it,” wrote an attendee from Illinois.
  • This was my first conference and I am so glad that I went,” wrote a thyroid cancer survivor from Nevada. “When I was diagnosed 20 years ago, I felt very alone. Well, I didn't feel alone this weekend. Everyone (survivors, caregivers, doctors, etc.) was very compassionate.”
  • “This conference has made me look at my disease in a whole new way,” another attendee reported.
  • This unique educational and supportive event is sponsored by ThyCa: Thyroid Cancer Survivors' Association, Inc. (www.thyca.org) and organized and run by ThyCa volunteers.

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Dinner/Auction a Big Success

During the Denver conference weekend, Friday evening’s Dinner/Auction to benefit thyroid cancer research drew a large attendance. The evening featured inspirational talks by ThyCa volunteers Jeff Klaas, Bob Legler, and Barbara Gockenbach Mosley. The evening was a tremendous success, netting more than $23,000 for ThyCa’s research funds to support thyroid cancer research grants open to investigators who are less than 6 years from completion of their post-doctoral fellowships and who have never been a principal investigator on an NIH RO1 or equivalent grant.

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Thank You from the 2005 Conference Team

Our volunteer conference team expresses our special thanks to all the conference speakers, the roundtable leaders, and the wonderful ThyCa volunteers who helped before and during our 2005 conference.

We also extend our appreciation to these generous supporters:

  • The conference exhibitors and resource material donors, including the American Cancer Society, American Thyroid Association, Colorado Cancer Control Program, Genzyme, Gilda’s Club of Denver, Mental Health Association of Denver, and National Alliance for Mental Illness Denver Chapter.
  • Massage USA for the free chair massages given during the conference.
  • Denver Reiki Practitioners and Reiki Session Coordinator Betty Solbjor for the free Reiki sessions for conference attendees.
  • Genzyme for providing representatives to answer questions about insurance coverage and access to Thyrogen
  • AstraZeneca for the refreshments at our Volunteer Appreciation Reception and Annual Meeting.

Thank you from our 2005 Conference Planning Team: Tina Anders, Bryan Benesch, Gary Bloom, Cathy Bruce, Jody Campbell, Ron Grafman, Jan Halzel, Cheri Wallace Lindle, Peggy Melton, Pattie Scott, Megan Stendebach, and Cherry Wunderlich

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Come to Orlando, Florida on October 27-29 2006 for the 9th International Thyroid Cancer Survivors' Conference

For details visit www.thyca..org
Or e-mail to conference@thyca.org

Invitation

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SESSION HIGHLIGHTS

Four-Time National Memory Champion Scott Hagwood Shares Tips that Improve Memory

“We tend to think that we have terrible memories. Actually, they’re extraordinary,” said Scott Hagwood during the session he led at our 2005 conference in Denver.

Scott Hagwood spoke from his own experience. Following his diagnosis with thyroid cancer in 1999, he learned extensive memory techniques to transform himself from mediocre student to international memory champion.

At his conference session, he demonstrated his skills, taking just 82 seconds to memorize 26 cards from a shuffled deck, correctly calling them out as ThyCa Raleigh, NC, Support Group Facilitator Ann Maddox showed the cards, one by one, to the attendees.

He also explained and demonstrated how to use our 3-dimensional spatial sense to improve our ability to remember facts and instructions. Two more of his memory tips:

  • Review what you’ve just leaned after 1 hour, 1 day, 1 week, and 1 month.
  • Learn how to reduce and manage stress, because stress is the main factor that harms memory.

His book “Memory Power” was published in December 2005.

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Care of the Caregiver

(About the author: Patricia Scott, B.S., R.N., M.B.A., started her nursing/research career 20 years ago. She specialized in women’s and infants’ health care at the University of Colorado Hospital, Denver, Colorado, until her husband David was diagnosed with Anaplastic Thyroid Cancer in March 2002. She turned her energy toward learning and researching about thyroid cancer and became her husband's primary caregiver and advocate, until his passing on February 28, 2003. Patricia continues to be involved as a volunteer for ThyCa: Thyroid Cancer Survivors’ Association, Inc., supporting and helping survivors, caregivers, and families.)

The word “extraordinary” comes to my mind, to say the least, whenever I think of a caregiver.

For the most part you inherit this position. It shows up at your doorstep, sometimes unannounced due to a series of circumstances. Or you may freely volunteer for this position.

No matter how you acquire this position, it will partially or totally change your life forever….

Once we’re placed in this position, for most of us, it totally changes the focus of our lives. In other words, we put our needs, wants, goals, and dreams aside, for the needs, wants, goals, and dreams of our loved one.

You sometimes, without even knowing it, become part of that loved one….You eat, sleep, breathe, and feel every physical and emotional change with that person….You become that person’s advocate and put your personal needs aside.

(For the full text of this presentation, visit www.thyca.org and go to the ThyCa Conference 2005 notes and handouts in the Conferences/Workshops section.)

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Notes from Medical Presentations

(The notes below are a small sample of the notes from the 2005 conference. For further details on the topics covered, plus many more topics and session handouts, visit the ThyCa web site. Go to the Conferences/Workshops section and scroll down to ThyCa 2005.)

Notes are grouped by topic. Many notes come from more than one session and speaker, and from several notetakers. Our thanks to the more than 15 volunteers who submitted their notes. It’s not too late to submit your conference notes! You can mail a copy to P.O. Box 1545, New York, NY 10159-1545, fax them to 630-604-6078, or e-mail them to conference@thyca.org. We will continue to add details to ThyCa’s web site www.thyca.org

The notes presented below are intended for educational purposes only. They are not intended, and should not be interpreted, as medical advice or directions of any kind. Any person reading these notes is strongly advised to consult their own medical doctor(s) for all matters involving their health and medical care.)

THYROID CANCER AND TREATMENT: GENERAL COMMENTS

  • There are large thyroid cancer treatment centers throughout the United States.
  • Only a small fraction of thyroid cancer patients are treated by specialists.
  • There's a real shortage of physicians trained to handle thyroid cancer.

DIAGNOSIS

  • More than half of people over age 50 have a thyroid nodule. Most thyroid nodules are benign, not cancerous.
  • The Fine Needle Aspiration (FNA) takes representative samples from multiple locations. Biopsies are not as effective as FNA. A core biopsy removes only a single chunk, and may miss important areas.
  • It’s often helpful to use ultrasound to guide the Fine Needle Aspiration (FNA). Using ultrasound to guide the needle produces an improvement of one third to a half.
  • Benign is the most common diagnosis after FNA. Overall, about 10% of nodules are cancer.
  • Tissue analysis after surgery: The pathologist determines types, stages, malignancy, spread, presence of other disease, etc. The pathology report will state the type and any variant identified. Hurthle cell is a variant of follicular thyroid cancer (some think it is a separate variety). Variants of papillary thyroid cancer include tall cell, insular, and columnar.
  • Second Opinions on Diagnosis: Your endocrinologist and you are the best people to decide whether a second pathological opinion is needed.

SURGERY

Neck Dissection

  • Adding a central neck dissection to surgery is now a common step. 30% to 50% of patients have lymph node metastases. Central neck dissection adds 30 to 60 minutes to the surgery. It’s done through the same incision made for the thyroidectomy. It may reduce recurrence. It may increase hypocalcemia.
  • The neck has several "compartments" delineated by muscle and other structures. When the surgeon removes lymph nodes, an entire compartment of lymph nodes is removed. The surgeon should not leave some lymph nodes behind. The body has thousands of lymph nodes.

Further Surgery

  • Complex Surgery. Multidisciplinary care is needed when neighboring structures are involved.
  • Re-Operation Principles. The team needs to agree regarding the extent of disease. There should be a complete records review plus biopsy confirmation prior to surgery. There may be a pre-operative laryngoscopy to examine the larynx. A principle regarding surgery is "less is better."

Voice Issues

  • Voice disorders associated with thyroid cancer may have three types of causes: Presurgical (benign lesions or malignant invasion of the laryngeal nerve or larynx), surgical (intubation trauma, neural trauma sign as ligation or stretching or disruption, and intentional sacrifice of the nerve), and postsurgical (vocal fold trauma/edema or hypothyroidism). Reasons for voice changes that remain after 6 months include damage to strap muscles, laryngeal nerve, or superior nerve.
  • Voice therapy through appropriate exercises can be helpful and maximizes medical treatment before surgical intervention.
  • Treatment options include vocal fold injection with a substance such as gelfoam or collagen or fat (fat injection can be repeated; the fat is taken from the body); thyroplasty (can be adjusted, is reversible; its complications can include migration of the graft and airway compromise); and re-innervation.

PAIN MANAGEMENT

  • Pain is now considered one of the vital signs.
  • Doctors need to aggressively treat pain, because pain becomes a disease in itself. Pain reduces autonomy, hinders functioning, reduces quality of life, and challenges dignity.
  • Untreated pain can also lead to the inability to tolerate the primary therapies.
    -Nobody has to live in out-of-control pain. The three steps in the ladder of pain treatment are:
    (1) for low levels: aspirin and other over the counter medications; anti-depressions, and anti-convulsants;
    (2) when pain is out of control, options include opioids (narcotics) either sustained release or nonsustained release, NSAIDs, and adjuvants;
    (3) for refractory pain, the most extreme pain, which occurs in 15-20% of patients with advanced cancer, options include spinal/epidural opioids, clonidine, local anesthetic, selective nerve blocks, neuroablation procedures, ketamine, or total sedation.

THYROID CANCER RESEARCH: BASIC, CLINICAL, TRANSLATIONAL.

  • Basic research focuses on molecular and cell biology, biophysics, pharmacology, and physiology.
  • Clinical research studies patients. It includes drug trials, clinical outcomes, national and regional tumor registries, population studies, studies on quality of life, and studies on diagnosis.
  • Translational research means going from the lab bench to the patient bedside and back to the lab.
  • Clinical trials are using new agents to treat advanced thyroid cancer.

ANAPLASTIC THYROID CANCER

  • Treat Anaplastic Thyroid Cancer (ATC) as you would treat a heart attack: immediately. The diagnosis should be made quickly if ATC is suspected. Doctors should not say "there's nothing we can do." It helps just to have the doctor check on the patient on a regular or daily basis.
  • Advances have occurred in recent years in tracheostomy procedures.
  • External beam radiation therapy has advanced and made treatment more precise.
  • IMRT can target the radiation and has really helped treatment.
  • Doctor-to-doctor calls may be the most effective in getting advice; doctors have both front lines and back lines.
  • ATC needs a team approach; the patient should go to a center where a team works together on ATC.
  • Follow-up for ATC: PET scans are useful. PET scans should be repeated every 3-4 months.
  • For more information, see the ATC web site on ThyCa’s web site: www.thyca.org

MEDULLARY THYROID CANCER

  • Medullary thyroid cancer patients need long-term follow-up. Lack of monitoring has proved to be detrimental to their health and longevity.
    -Medullary thyroid cancer patients need CT scans and ultrasounds periodically for follow-up monitoring.
  • External beam radiation has been effective in cases of medullary recurrence. Survival rate has increased for these patients with EBRT.
  • Prophylactic (preventive) surgery is now recommended for children shown by direct DNA analysis to have inherited MEN2A, MEN2B, or Familial medullary thyroid cancer.
  • Sporadic and hereditary cases of medullary thyroid cancer have the same protein mutations that allow the pursuit of similar methods for treatment. Phase 1 clinical trials look at the dosage and safety, Phase 2 trials look at whether the drug works, and phase 3 trials compare different drugs and/or different dosages.
  • It's difficult to conduct effective clinical trials given the rarity of medullary thyroid cancer. Physicians are trying to formulate preventive methods, including thyroidectomy. Also are attempting to improve regulation of the production of calcitonin.
  • A clinical trial with ZD6474 is being done to treat patients with locally advanced metastatic hereditary medullary thyroid cancer. It was well tolerated in oral doses. Adverse events were generally mild. Bothersome complications are diarrhea and dehydration.
  • Medullary thyroid cancer patients met to discuss the development of a medullary thyroid cancer web site to add to the ThyCa web site www.thyca.org, just as has been done for anaplastic thyroid cancer by the participants in ThyCa’s Anaplastic Thyroid Cancer E-mail Support Group.

PAPILLARY AND FOLLICULAR AND THEIR VARIANTS

  • The last 5 years have changed our concepts of long-term care of papillary and follicular thyroid cancer.
  • With the introduction of Thyrogen, there also now are new follow-up tools.
  • There should be lifelong surveillance.
  • Currently, the doses of radioiodine used are often smaller (such as 50 millicuries) than in previous years.
  • Ultrasound is replacing much of the whole-body scan procedures when only the neck area is of concern.
  • A whole-body scan is needed to find distant metastases. Distant metastases show up on a post-ablation whole body scan. Also, Thyrogen can be used to artificially stimulate thyroid cells for a short time to get Thyroglobulin measurements that are more accurate than when the TSH is suppressed.
  • Ultrasound and stimulated Thyroglobulin measurements are better than a whole body scan for detecting disease in the neck. If free of disease, the patient should have a yearly Thyroglobulin measurement. If there is any detectable Thyroglobulin, then ultrasound should be done also. For patients who are TSH-suppressed and high-risk, in general, do TSH-stimulated Thyroglobulin once a year.

Radioiodine (RAI) Ablation

  • Standard dosage of radioiodine for ablation has been reduced to 50 millicuries from 100 millicuries.
  • Radioiodine is not free of risks. This must be considered, especially in patients at low risk of persistent or recurrent thyroid cancer. Even when only given 100 millicuries of radioiodine, 3 per 10,000 can be at risk of leukemia. There's a linear dose relationship to secondary malignancy.
  • Secondary malignancies are a concern when the dosage of radioiodine is 600-800 millicuries. If a patient receives more than 500 millicuries of RAI, there are higher rates of bladder, colon, breast, and parotid cancers in addition to the added risk of leukemia
  • Which patients should receive RAI? According to the American Thyroid Association guidelines, all patients with Stages III and IV disease, most patients with Stage II, and selected patients with Stage I. For patients with a solitary tumor less than 1 cm to 1.5 cm, radioiodine is of questionable utility.
  • Thyrogen-assisted remnant ablation is recommended by the American Thyroid Association (Thyrogen is approved for use in testing but is not yet approved by the U.S. Food and Drug Administration for use in ablation in the USA); the outcome is equal to using withdrawal from thyroid hormone.
  • The American Thyroid Association also recommends Thyrogen if the patient has other medical issues that make hypothyroidism a risk, or if delayed treatment might be deleterious, or if withdrawal is unable to raise the TSH.

Low-Iodine Diet

  • ATA guidelines recommend the low-iodine diet, which should be under 50 micrograms (mcg) of iodine per day, to increase the effectiveness of the RAI dose.
  • Urine iodine measurement can determine whether patient’s iodine intake could interfere with RAI.
  • ATA recommends 1-2 weeks on the diet; some specialists recommend 2 weeks, especially if given Thyrogen, and also recommend skipping thyroid hormone 2 days before and 2 days after RAI.
  • To stay below 50 mcg per day: Choose foods low in iodine (fresh fruits, fresh vegetables, unsalted nuts and seeds). In moderation, you may eat meat, and breads and cereals. Select foods without iodized salt or sea salt. Avoid seafood, dairy, egg yolks, foods with red dye #3, and processed and fast foods. For more information visit www.thyca.org

Thyroglobulin Testing

  • Wait for 3 months after radioactive iodine to check Thyroglobulin.
  • Using Thyrogen (rhTSH) with the blood test reduces the patient's exposure to radiation.
  • A doubling of the Thyroglobulin over time indicates disease. Any time there is a 100% increase in Thyrogobulin, it is time for further testing. The time frame of this rising does not matter. What is important is the 100% value increase. This is when it's time for an ultrasound, CT scan, or PET scan to help determine the cause of this rising Thyroglobulin.
  • A stimulated Thyroglobulin (with TSH raised by Thyrogen or by withdrawal from thyroid hormone) over 2 is cause for more studies, but not necessarily for more treatment.
  • Even with an undetectable Thyroglobulin, Doppler ultrasound can sometimes still find tumors.
  • In a patient with Tg Antibodies, if the Tg Antibody level falls over time, the patient is probably disease-free.

Ultrasound

  • An ultrasound should be one of the first tests in monitoring a patient for recurrence, especially in patients where TgAntibodies are an issue.
  • Ultrasound is much more sensitive than a diagnostic radioiodine whole-body scan.
  • Ultrasound's advantages include its low cost, that it doesn't require radiation, and that the clinician can view the tumor in real time.
  • The device needs to be a Power Doppler and Color Doppler in order for the entire spectrum to be seen properly. Doppler ultrasound detects the movement of blood around tumors. Increased blood flow can be a strong marker for a tumor.
  • The scanning procedure should take at least 45 minutes in order to be thorough.
  • A typical protocol is to perform ultrasound scans at 6 months and 12 months after surgery, and then annually for at least 3 to 5 years depending on the risk for recurrent disease. In addition to ultrasound, Thyroglobulin measurements (by blood test) should also be taken regularly.
  • The average ultrasonography technician may be very good at other ultrasounds, but requires special training for thyroid examination.
  • Thyroglobulin plus ultrasound is better than Thyroglobulin alone, because Thyroglobulin can be undetectable with a small positive lymph node.

TSH Suppression in Papillary and Follicular and Variants

  • The American Thyroid Association recommends a gradation of TSH suppression, not one TSH suppression level for all patients. The reason is to rule out the worst possibilities: osteoporosis is worse than thyroid cancer. If suppressed below 0.1, there also is an added risk of atrial fibrillation, whereas at TSH of 0.2 to 0.3, the patient is free of risk. If a patient is over age 60, suppression to 0.1 triples the risk of atrial fibrillation.
  • About 85% of patients can be kept at 0.5 rather than 0.1. If a patient is "clean" of thyroid cancer (disease free), the TSH can be kept at or just below 0.5. However, high-risk patients need further TSH suppression. About 15% of patients are high risk and need the lower TSH level.

Children and Adolescents with Papillary or Follicular Thyroid Cancer

  • Pediatric thyroid cancer often presents at a more advanced stage than adult thyroid cancer. Up to 80% of children and adolescents with papillary and follicular have lymph node metastases. Up to 20% can have lung metastases. However, the prognosis is still good. Even when there is a recurrence, the outcomes for children and adolescents are very good.
  • Because pediatric thyroid cancer has an excellent survival rate, the treatment goal must be to achieve the highest success rate with the lowest morbidity rate to offset the long-term effects of treatment.
  • Treatment is similar to that for adults. Doctors tend to use lower doses of radioiodine than for adults, with doses given a year apart or more.
  • When becoming hypothyroid for a RAI scan or treatment, or being hypothyroid in general, they may not show any symptoms. They may be fully active despite being hypothyroid.
  • The main follow-up marker for papillary or follicular thyroid cancer in children and adolescents is Thyroglobulin.

American Thyroid Association Guidelines for Differentiated Thyroid Cancer

  • The guidelines will be published in 2006.
  • The guidelines committee of thyroid cancer experts looked at research literature and used a process similar to the process used in the NIH Consensus Development Conferences to determine whether the evidence was good, fair, or insufficient.
  • The recommendations range from A (strongly recommend for) to F (strongly recommend against) and I (no recommendation: not enough data).
    (Follow-up notes on the Guidelines:
    (1) The 10 members of the ATA Guidelines Task Force included 5 ThyCa medical advisors: Bryan R. Haugen, M.D., Stephanie L. Lee, M.D., Ph.D., Ernest L. Mazzaferri, M.D., Steven I. Sherman, M.D., and R. Michael Tuttle, M.D., as well as 3 additional ThyCa conference and workshop speakers: David S. Cooper, M.D., Susan J. Mandel, M.D., and Richard L. Kloos, M.D.)
    (2) The guidelines are being published in the February 2006 issue of the ATA journal Thyroid. In January they were published on the web site of the journal’s publisher, at this location:http://www.liebertonline.com/doi/pdf/10.1089/thy.2006.16.ft-1?cookieSet=1)

PHYSICIANS’ SUGGESTIONS ABOUT PATIENT-DOCTOR RELATIONSHIPS

  • You as the patient are Number One. Each patient has unique circumstances, stories, and experience. Ask questions, ask questions, ask questions!
  • Keep your own file with all your medical records and test results in case you move or change doctors.
  • Doctors need to pay attention to the patient and not just the scans. They also need to pay attention to the patient’s risk level.
  • Doctors are responsible for professionalism, including always doing what is right for the patient, making sure that information is presented, and helping patients cope with the system.
  • Communication methods include office visits, telephone calls (less useful due to time issues), written communication, and e-mail.
  • The C word is stressful; patients need to learn how to cope with it after hearing the results.
  • Make sure all your questions are answered before you leave the doctor's office.
  • If you're not satisfied with your current physician, go somewhere else.

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ThyCa News Nuggets

  • Free One-Day Spring Workshops Planned. The Midwest Thyroid Cancer Survivors’Workshop will take place in St. Louis, Missouri, on Saturday, April 22, 2006. The Mid-Atlantic Workshop will take place in the Maryland/Virginia/DC area. ThyCa volunteers are also planning workshops in other locations. Visit our web site and go to the Conferences/Workshops and Calendar sections for more information.
  • More than 60 ThyCa Local Support Groups meet in 35 states coast to coast. Each group has its own web page. Plan to attend a meeting in 2006, or contact the volunteer facilitator nearest you, to become part of your local network of thyroid cancer support. Or, if you’d like help in starting a group, contact our volunteer Support Groups Coordinator Sara Gorrell Brenner.
  • For one-to-one communication and support with a ThyCa volunteer matched with the same diagnosis as you have, contact our Person-To-Person Network. Our TPPN Coordinator Peggy Melton will connect you with a ThyCa volunteer who will be in communication with you.
  • Thank you to our financial supporters during 2005.
  • ThyCa’s members and individual donors
  • The many volunteers who organized special Rally for Research events
  • The following organizations:
    • Genzyme Therapeutics
    • AstraZeneca
    • Abbott Laboratories
    • King Pharmaceuticals
    • KRONUS
  • The grants from organizations are unrestricted educational grants, and the donors are not involved in any decisions about the content of our programs and publications.
  • Congratulations, Karen! We’re proud to announce that Karen Ferguson of South Carolina (near Charlotte, NC) has been named ThyCa Board Member Emeritus. Karen is one of ThyCa’s co-founders and is the ThyCa volunteer who first reached out over the Internet nearly 11 years ago in the spring 1995, to bring thyroid cancer survivors together for the first time. She has been facilitating Monday evening online chats since the fall of 1995. She also facilitates ThyCa Charlotte, NC and volunteers for our Toll-Free Number and our Membership Committee. Congratulations and thank you, Karen!
  • Research Grants for 2006-2007. Two new Thyroid Cancer Research Grants for 2006-2007 will be sponsored by ThyCa: Thyroid Cancer Survivors’ Association. ThyCa’s research grants are open to thyroid cancer researchers and institutions worldwide. We proudly awarded our first research grant in 2003. Our web site has more details about our Rally for Research, our past grant awards, and our 2006-2007 grants.
  • Web Site continues to grow! It has more than 500 pages of thyroid cancer information and received more than 200,000 hits each month during 2005. We thank the dozens of specialists, including the 22 members of our Medical Advisory Council and numerous other physicians and other specialists, who provide ongoing review and input for the web site. The web site is the only resource that receives this ongoing review. We thank also the many volunteers who continue to contribute material for the web site. ThyCa’s web site is expanded every week. Visit it often for the latest information:www.thyca.org.

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More about This Newsletter and ThyCa

The articles in this newsletter represent the opinions of their authors and are not official positions of ThyCa: Thyroid Cancer Survivors' Association, Inc. The articles by laypeople do not offer medical advice, as the authors are not doctors and have no medical training. Articles by physicians are educational and not intended to offer medical advice, as physicians cannot diagnose through the Internet. If you have medical questions, please consult with your physician.

ThyCa: Thyroid Cancer Survivors' Association, Inc. (www.thyca.org) is an all-volunteer nonprofit 501(c)(3) service organization advised by nationally recognized thyroid cancer specialists and dedicated to support, education, communication, awareness for early detection, and thyroid cancer research fundraising and research grants.

Throughout the year ThyCa offers free resources, including education through the web site, our low-iodine cookbook downloadable from the web site, several e-mail support groups, local support groups coast to coast, the person-to-person network for one-to-one support, newsletters, and the survivors' toll-free telephone number.

Copyright (c) 2006 ThyCa: Thyroid Cancer Survivors' Association, Inc. (www.thyca.org). We encourage you to send this newsletter to your family and friends. For permission to reprint in another electronic or print publication, please contact ThyCa.

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An Open Invitation from ThyCa

ThyCa invites thyroid cancer survivors, families, and friends to tell their friends and relatives about ThyCa’s free year-round support services and publications, including our award-winning educational web site, our free thyroid cancer awareness brochures, and our conference and other special events.

Your gifts of your time and your financial support help ThyCa sustain our support services, our education and outreach programs, and the continuing expansion of our research grants to support our dream of a future free of thyroid cancer. Visit our web site www.thyca.org to find out ways you can help.

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Help Us Help Each Other

We want your comments on this newsletter! Do you like it? What would you like us to print? Send your comments to newsletter@thyca.org or ThyCa: Thyroid Cancer Survivors' Association, Inc. P.O. Box 1545, New York, NY 10159-1545

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