Marcia S. Brose, MD, PhD: The Stigma Of Thyroid Cancer

Dr. Marcia Brose sits down with Selma Schimmel in The Group Room where they discuss the little talked about stigma associated with thyroid cancer — aka “the good cancer.”

This interview was filmed at the American Society of Clinical Oncology Annual Meeting in Chicago 2013.

Marcia S. Brose, MD, PhD is an Asst. Professor at the Abramson Cancer Center at the University of Pennsylvania.

Advocacy and educational support provided at ASCO 2013, in part, by:

TGR ASCO 2013 Sponsor

VIDEO TRANSCRIPT

Selma Schimmel, Founder & CEO, Vital Options International:

This is Selma Schimmel and you are looking live at the great city of Chicago which is once again playing host to the American Society of Clinical Oncology: ASCO. This is ASCO’s 49th annual meeting and this year’s theme could not be more appropriate, Building Bridges to Conquer Cancer. More than 30,000 of the world’s foremost cancer specialists are here and so is The Group Room making our 15th appearance at ASCO, and one of our very best. Joining me now is Dr. Marcia Brose: Assistant Professor at the Abramson Cancer Center at the University of Pennsylvania. Welcome, Dr. Brose.

Marcia S. Brose, MD, PhD, Asst. Professor, Abramson Cancer Center, University of Pennsylvania:

Thank you for having me.

Selma Schimmel:

You are one of the really important voices clinically dealing with thyroid cancer. One of the things we want to talk about, firstly, how we treat thyroid cancer, but some of the really intense psycho-social issues unique to thyroid cancer because for a lot of people so happily it’s a highly treatable, curable cancer. So, it’s very easy for someone to say, ‘hey how lucky are you, that’s the kind of cancer you got.’ So okay, it’s true that if you have to look at, if you’re going to have to have cancer one might say, ‘I’d rather have thyroid cancer, at least it’s highly treatable’ but it doesn’t go that well for everybody. And I don’t care how early a diagnosis is, as far as it being curable or treatable, it’s still cancer. And people with thyroid cancer often feel like they don’t get acknowledged and the intensity of their experience is really negated and we need to stop that because in some way then it’s stigmatized.

Marcia S. Brose, MD, PhD:

I think there’s been a two-edged sword actually around that. So, the first side of it is that it often affects people, young women actually is the very common group of people who get affected; it’s 3:1, women to men. And in the earlier stages it can be obviously a very scary thing. The good news is that when they do well and things are all going well, the vast majority of people will do well. And I think that a lot of thyroid cancer patients, because they do do well early and there hasn’t been a lot of chemotherapy and heavy things associated with their care, they are able to push it away maybe a little bit easier than patients who have had more chemotherapy and have more sequelae that really affect their lives. However, the other side of that, there are a couple of issues related to that. Of course, there’s always anxiety that can come back no matter who you are and no matter how treatable your cancer is. But the other side of it is, if you are in the group of people who have the more, the type that isn’t cured by surgery and radioactive iodine, it is devastating and, in maybe some ways, even more devastating because they were told they had the good kind. So, it’s bad enough to get cancer but you hold onto that hope and you’re like, ‘oh you have the good kind. You’re going to be fine, you’re going to be fine.’ And then when they find out that they don’t have the good kind it can make the transition to therapy, in a way, almost harder because they weren’t in that world from the beginning like a lung cancer… some of them aren’t even in an oncologist’s office. So, before we actually got the data that we’ve been getting just recently these patients weren’t even in the hands of an oncologist. So, it has a little bit more, still many more bumps. The patients are experiencing some of those same growing pains as far as figuring out, how do you transition to an oncologist? You want to do it, but endocrinologists are afraid to send me their patients because I’m actually, I’m the death doctor as opposed to the not-death doctor. That’s actually a conceptual hurdle that we’re going to be dealing with. And there are several things that happen when you’re developing a new therapy in a place that had no therapies; that another oncologist that’s just adding another treatment to an already well defined patient population doesn’t actually have to deal with.

Selma Schimmel:

Hearing this it makes me so sad because I realize really we don’t talk very much about thyroid cancer and how alienating and isolating it has to be for patients.

Marcia S. Brose, MD, PhD:

Well, I think even more so because they weren’t even in the, they don’t even have some of the psychosocial support we have in an oncologist’s office that could help them. Many times they’re just in an endocrine’s office and on their own.

Selma Schimmel:

You seem like such a warm and really passionate about your area of expertise. Patients are very lucky to have you.

Marcia S. Brose, MD, PhD:

Oh, that’s nice. Thank you.

Selma Schimmel:

There’s a real gentleness about you, like you really must take time to listen to what your patients say.

Marcia S. Brose, MD, PhD:

Well, when you’re treating a rare cancer an interesting thing is there are not many of them, and I will say that they’ve taught me. I wouldn’t be the expert in thyroid cancer if I didn’t have patients who have taught me what it’s like and what matters, because we had to actually address their concerns. And there wasn’t another doctor who was going to teach it to me. It was the patients.

Selma Schimmel:

Dr. Marcia Brose: Assistant Professor at the Abramson Cancer Center at the University of Pennsylvania. Thank you, Dr. Brose.

Marcia S. Brose, MD, PhD:

Thank you for having me.

Selma Schimmel:

Pleasure.

END OF VIDEO

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