title: Optimal differentiated thyroid cancer management in the elderly.
abstract: The incidence of differentiated thyroid cancer is increasing worldwide across all age groups. While most patients with differentiated thyroid cancer have a good prognosis, aggressive disease is more common in the elderly and disease-specific mortality is higher. Treatment options for differentiated thyroid cancer include surgery, levothyroxine, radioactive iodine, external beam radiotherapy and kinase inhibitors. Rational and evidence-based management is particularly important in older individuals because they may experience greater toxicities from the therapeutic options. We advocate an explicit risk-benefit analytic approach to thyroid cancer care that emphasises individual patient factors, likely disease biology and progression, and age-dependent treatment characteristics to ensure optimal treatment. In particular, this risk-benefit approach should seek to identify patients with aggressive disease, and, within a multidisciplinary setting, balance the likelihood of treatment success with the probability of treatment-related adverse effects.
authors.affiliation: Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Level 1, Dr James Mayne Building, Herston, QLD, 4029, Australia, donald.mcleod@qimrberghofer.edu.au.
authors.forename: Donald S A
authors.initials: DS
authors.lastname: McLeod
authors.forename: Kelly
authors.initials: K
authors.lastname: Carruthers
authors.forename: Dev A S
authors.initials: DA
authors.lastname: Kevat
mesh_terms: D000368:Aged; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome
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