bigjan1

Hi,
I've had 3 "real cancers": melanoma, angiosarcoma, & a Gastrointestinal Stromal tumor.

And numerous "only".. pretend cancers, sort of cancers, or nice cancers:
Skin...at least 6 of those, one was burnt off half my nose! The rest left nasty scars
1 thyroid removal... no problem except I am freezing cold for most of the year
1 pre-cancer of my parotid gland.. cut the nerves on my jaw & face leaving permanent damage
1 pre-cancer of uterus, no biggie except for my biggie floppy tummy muscles

So I guess only "Good cancers" are just a bit of a problem, please feel free to tell your family all about the lasting effects of such!

does your phone have a calender? Mine is a little crazy, and works different ways at times. I have a Sony-but this is a common thing to do. If you don't see calendar on your screen-go to home. You see the little box of dots? touch those, and it opens built in Apps. You see a calender. Press down on the calender and slide it to the house at the botton for home. Then it will be on your home page. Maybe calender is already on your home page. It has a big date 31 and says calender. You can open it and tell me what it says. If it just has today's date, press the upper right hand corner, and a drop box on the left opens up. It says year, month, week, day, agenda.

You press down to open. Mine opens to my agenda for the month, or it might open to the month. . scroll to the month-like yesterday I scrolled to March 2016. There are several ways to do it. Click on the date Look for a plus sign click that then tou enter the information. You get a page of who- where, time, do you want an alarm, list anybody going with you. I do the time first, as that seems to be the hardest to do. You see the hours and you take your thumb or stylus, and roll it to the hour you want. Then you do the minutes you want. Then you AM or PM. Click done. I do the time first, as that seems the trickiest. when done -hit set. then who and where--The top says event- fill in name or what-- like scan-then name of lab, maybe who you are going with. Then push done.

Another way is the upper left corner says calender, date, agenda. it has a teeny tiny arrow triangle. touch the triangle fo aganda. It opens anything you have anf has a big plus sign. You press the plus sign- and it opens with the page to the device calender-where you enter the appt-event, then down to the time and date. Mine says Dec 1, but I just press on the time and put in in the new date. If you scroll down after you enter event- time-location you can have a reminder set. You can do it from minutes to hours. It also has a second alarm.

Seriously we can do this one step at a time--first find your calender app and set the app on your home page by pressing and pulling down to the house on the bottom of you page. then press home and you will see it on your home page. My homepage is 3 wide. Scrolling tip-- wet the end of you finger tip, press and slide finger to where you want.

Contact me, if you want help after opening the calender app on your home page. Do you have FB? If you do, we can chat on that and work through. It just takes some playing around sometimes. It was lots easier for me after I learned how to do everything on the agenda-which gives you a listing----I even schedule calls to the lab to make sure the doctor sent it in, and whats. in the labs.

One of the problems with Thyroid is how is screws with your entire system. It is is tied to your metabolism, your emotions, your immune system and when I forget my dose, I lose my sense of smell and balance (where does it say that?). I hate the fact that I see these kinds of issues in my daughter now as well. The best thing you can do is to learn as much as you can about your own body. Please let me know if I can help - Tracy

We need to talk, I know what you are going through because I am there too - Tracy

hi i was diagnosed in march 29 2012 had 40 needles in my throat
6 hours of biospys not al;l at once if u would like to talk write to me and ill write back i know your scared i gave it up to God found great peace and made it threw everything and looking really good so far brighter day are coming the one thing i found is laughter watching funny movies help alot get u away from the cancer .denise

Hope all is going well! As a fellow thyroid cancer survivor i know it can be scary and frustrating at times, i am here if you need me!

Bigjan, Last night while going through my emails, i came across an article just released that addressed your concern. It was so weird that I had just posted a response to your non-RAI-avid question and then here is this article. So I am forwarding it to you.

Selumetinib-Enhanced Radioiodine Uptake in Advanced Thyroid Cancer

N Engl J Med. 2013 Feb 14;368(7):623-632, AL Ho, RK Grewal, R Leboeuf, et al







TAKE-HOME MESSAGE

In a small pilot study, the MEK inhibitor selumetinib enhanced radioiodine uptake in patients with radioiodine-refractory metastatic thyroid cancer. A total of 8 patients with adequate uptake received a therapeutic radioiodine dose resulting in 5 durable partial responses.






EXPERT COMMENTARY


Lee S. Schwartzberg, MD, FACP



The therapeutic strategy of choice for metastatic differentiated thyroid cancers (papillary and follicular) has long been radioactive iodine (RAI). Some patients become refractory to this treatment, leaving few good therapeutic options. Progress in biology has identified the MAPK pathway as a critical cellular pathway regulator of thyroid hormone and iodine uptake. Many thyroid cancers have mutually exclusive mutations in regulator genes upstream of the MAPK/MEK axis, including BRAF, the RAS family, and RET, making them potential drug targets. Investigators at Memorial Sloan-Kettering Cancer Center utilized a short course of the tyrosine kinase inhibitor selumetinib in an attempt to induce sensitization of refractory metastatic thyroid cancer to iodine, as measured by I-124 PET/CT. If activity was seen on the diagnostic scan, therapeutic RAI would be given. Of 20 patients enrolled in this study, 12 had increased I-124 imaging uptake and 8 went on to receive RAI. Remarkably all of the 5 patients with a documented NRAS mutation responded to selumetinib and RAI, and 4 of the 9 patients with BRAF had some uptake, and 1 of these patients received RAI. Other mutations or wild-type genes responded occasionally. This small, but influential, proof-of-principle study suggests that targeting appropriate oncogenic pathways can alter important downstream signaling, resensitizing cancer cells to previously effective therapy. The tyrosine kinase inhibitor is not being used for its direct anti-oncogenic effect in this case, but is used to reverse resistance of other pathways. This strategy could have potential in other cancers in which cytotoxic chemotherapy–resistant cells could be resensitized with appropriate upstream blockade—a clinical scenario demonstrated long ago in colon cancer, for example, showing improved response to treatment with cetuximab and irinotecan compared with cetuximab alone after refractoriness to single-agent irinotecan.


SUMMARY

OncologySTAT Editorial Team


Patients with metastatic thyroid cancers that are refractory to radioiodine (iodine-131) due to poor radioiodine uptake have a decreased 10-year survival rate (10% vs 60% when the cancer retains radioiodine avidity).

Approximately 70% of papillary thyroid cancers have gene mutations of RET, RAS, or BRAF. When activated, these mutated genes stimulate mitogen-activated protein kinase (MAPK) signaling. This, in turn, inhibits expression of the sodium–iodide symporter, a thyroid hormone biosynthesis gene that facilitates iodine uptake. Animal studies have shown that selective MAPK pathway antagonists can boost iodine uptake by increasing the expression of the sodium–iodide symporter.

Researchers at Memorial Sloan-Kettering Cancer Center conducted a pilot clinical study of the selective MAPK kinase (MEK) 1 and MEK2 inhibitor selumetinib to determine if it could reverse radioiodine resistance in patients with refractory metastatic thyroid cancer.

Iodine avidity was assessed with thyrotropin alfa–stimulated iodine-124 PET-CT) scans. The use of these scans rather than traditional whole-body iodine-131 scintigraphy allowed for precise measurement of iodine uptake in individual metastatic lesions.

Of 24 patients enrolled, 20 were evaluable. Of these, 9 patients had tumors with a BRAF mutation, and 5 had tumors with mutations of NRAS. After 4 weeks of treatment with selumetinib 75 mg twice daily, 8 patients had an inadequate response based on iodine-124 PET-CT scans and discontinued the study. A total of 12 patients (60%) had new and/or increased iodine-124 uptake (4 of 9 with BRAF mutations and 5 of 5 with NRAS mutations).

Of the 12 responding patients, 8 reached the dosimetry threshold for radioiodine therapy (ie, the iodine-124 PET study predicted tumor uptake of 2000 cGy or more to the metastatic lesion or lesions with 300 mCi of radioiodine or less). All 5 patients with NRAS mutations reached this threshold compared with only 1 of the 4 patients with BRAF mutations.

The reason for the greater likelihood of response in the RAS-mutated tumors compared with the BRAF-mutated tumors remains unknown. The authors speculated that MAPK signaling may be incompletely inhibited in some BRAF-mutated tumors because of higher flux through the pathway.

The 8 patients who met the dosimetry threshold received a therapeutic dose of radioiodine after preparation with thyrotropin alfa; selumetinib was continued until 2 days after administration of the radioiodine dose.

Of these 8 patients, 5 had a partial response and 3 had stable disease as their best response. At 6 months of follow-up, 7 of the 8 responses were durable. Analysis of every lesion in all 8 treated patients showed that nearly all lesions had increased radioiodine uptake, and that the increase was 100% in most lesions. Of note, enhanced iodine uptake was seen in both bone and lymph node metastases, sites that are comparatively refractory to treatment with kinase inhibitors.

All 8 of the patients treated with radioiodine had a reduction in thyrotropin-suppressed thyroglobulin levels, compared with baseline.

The study results provide proof of principle that MEK inhibitors can induce radioiodine uptake and retention in radioiodine-refractory metastatic thyroid tumors. The MEK inhibitor was well tolerated with no adverse events of grade 3 or higher. An advantage of this treatment strategy is that requires only a short course of drug therapy, unlike use of kinase inhibitors alone.

In case you want more info, I am also pasting the link. It comes from an online journal called oncologystat. I hope this helps you. Print it and see what your oncologist might think, Carm.

http://www.oncologystat.com/journals/journal_scans/Selumetinib_Enhanced_Radioiodine_Uptake_in_Advanced_Thyroid_Cancer.html

Hi, I finished my treatment, and it isn't that bad. I hope you have good luck. I had the fine needle biopsy, surgery, and have gone for Radioactive Iodine 3 different times since 2011. At the present time there is no more cancer showing up. Go to thyca.org for lots of good support and information.

Hi there. Just wanted to let you know you are not alone. What is the plan of treatment? Are you having a thyroidectomy? You may want to check out my personal experiences on my thyroid cancer blog at www.papillarythyroidcancerguide.com. Please do not be shy. You can personal message me with questions and if I do not know the answer I can help direct you to where you can.

Hope your treatment goes well, I had my thyroid removed 1 year and 10 months ago. I am doing great. Keep me posted and feel free to ask any questions. Make sure you keep your calcium levels up right now.

Hello! Welcome to the site ! There are some wonderful people here just waiting to connect. If you have questions go to the QUESTIONS tab and ask there so everyone can see them and help.

Here's a link to our cancer page for your type cancer, which has some of our active users there. If you see any conversations just join right in.


http://www.whatnext.com/conditions/cancer/thyroid-cancer

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