Higher thyroid hormone levels and cancer
- 1 March 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in European Journal of Nuclear Medicine and Molecular Imaging
- Vol. 48 (3), 808-821
- https://doi.org/10.1007/s00259-020-05018-z
Abstract
Purpose This narrative review aims to summarize the relationship between hyperthyroidism, upper reference range thyroid hormone (TH) levels, and cancer, and to address the clinical management of hyperthyroidism in cancer patients. Methods A comprehensive search was performed by an independent reviewer through Google Scholar and PubMed Electronic databases. All searches were restricted to English language manuscripts published between 2000 and 2020. Results Numerous in vitro, in vivo, and population-based studies suggest cancer-stimulating effect of triiodothyronine and thyroxin. THs are presented as mediators for tumor growth, proliferation, and progression. Many population and case-control studies suggest an increased risk of several solid but also hematologic malignancies in relation to hyperthyroidism and upper normal range TH levels. However, results are not unambiguous. In this review, we will summarize population and case-control studies that investigated the relationship between hyperthyroidism, upper reference range TH levels, lower thyrotropin (TSH) levels, lower reference range TSH levels with cancer risk, cancer prognosis, and cancer outcome. The vast majority of evidence suggests an association between clinical and subclinical hyperthyroidism with the risk of developing several types of cancer. Furthermore, hyperthyroidism is also linked with a poorer cancer prognosis. In this review, we will also discuss the diagnosis of hyperthyroidism in patients with pre-existing cancer and cover the management of hyperthyroidism in cancer patients, with special attention on the role of nuclear medicine. Conclusions It is crucial to emphasize the importance of the rapid establishment of euthyroidism, and consequently, the importance of radioiodine therapy, as the therapy of choice in most cancer patients. We want to show that in this day and age there still is a high relevance for I-131 to achieve a permanent solution and thus likely reduce the risk of adverse influence of hyperthyroidism on the occurrence of new and course of existing cancer cases.This publication has 64 references indexed in Scilit:
- Graves' Disease and Toxic Nodular Goiter Are Both Associated with Increased Mortality But Differ with Respect to the Cause of Death: A Danish Population-Based Register StudyThyroid®, 2013
- Impact of moderate vs stringent TSH suppression on survival in advanced differentiated thyroid carcinomaClinical Endocrinology, 2012
- Transcriptional regulation by nonclassical action of thyroid hormoneThyroid Research, 2011
- Prospectively measured triiodothyronine levels are positively associated with breast cancer risk in postmenopausal womenBreast Cancer Research, 2010
- Defining the role of hypoxia-inducible factor 1 in cancer biology and therapeuticsOncogene, 2009
- Thyroid Function and Cancer Risk: A Prospective Population StudyCancer Epidemiology, Biomarkers & Prevention, 2009
- Is thyroid autoimmunity a risk factor for developing primary myelodysplastic syndrome?Cancer Causes & Control, 2007
- Pancreatic cancer and medical history in a population-based case–control study in the San Francisco Bay Area, CaliforniaCancer Causes & Control, 2007
- The evolution of phosphatidylinositol 3-kinases as regulators of growth and metabolismNature Reviews Genetics, 2006
- Antithyroid DrugsThe New England Journal of Medicine, 2005