“Some of these tumors don’t grow, and surgery on the thyroid comes with risks, so why not observe them instead?"

— Wendy Sacks, MD

For patients with tiny, localized thyroid cancers, the standard of care is surgery. But Cedars-Sinai investigators are exploring the benefits of a different approach.

Cedars-Sinai is one of just two medical centers conducting a clinical trial that gives patients the option of active surveillance. The study will estimate the rate of thyroid cancer progression inpatients over periods of three, five and 10 years.

“Some of these tumors don’t grow, and surgery on the thyroid comes with risks,” explains Cedars-Sinai endocrinologist Wendy Sacks, MD. “So why not observe them instead?”

For high-volume surgeons, complications are rare. But more than 80% of thyroid surgeries nationwide are performed by low-volume surgeons. In these cases some 10% of surgeries lead to complications such as vocal cord paralysis, scarring and nerve damage.

Allen Ho, MD, director of Cedars-Sinai’s Head and Neck Cancer Program, says the patient’s general health or lifestyle should be considered when assessing the optimal treatment.

“We are realizing that not all cancers are built the same,” he says. “Some thyroid cancers chart a slow, indolent course and are nonlethal. For an opera singer or any other profession that could be jeopardized due to undesired consequences of thyroid cancer surgery, the preferred treatment path may be active surveillance.”