Thyroid Cancer Treatment, Prognosis Depends On Type

On Oct. 23, Rehnquist had his thyroid gland removed because to cancer. He has left the door open for returning to work, but what is known of his illness could make a return to the bench unlikely.

When Rehnquist announced he had

thyroid cancer

, the question became what type of cancer could it be?

The thyroid gland surrounds the throat and secretes hormones that control how the body uses energy. There are four types of thyroid cancer -- papillary, follicular, medullary and anaplastic.

With all four, the thyroid gland is surgically removed. With radioactive iodine and hormone suppression therapy, the prognosis for the papillary and follicular forms are good.

"So it's a very slow growing, nonaggressive cancer," said Dr. Susan Spratt, a Duke endocrinologist.

Spratt said medullary and anaplastic thyroid cancers are much more serious.

Medullary typically occurs within families, and anaplastic most commonly appears in the elderly.

"Anaplastic cancer is very aggressive. The median survival is about five to seven months," Spratt said.

Rehnquist's situation points to anaplastic cancer. He is receiving chemotherapy and radiation. His surgeon also performed a tracheotomy to help him breath.

"What happens is the tumor grows aggressively and can compress structures in the neck that are important, like the trachea, the breathing tube, or the esophagus," Spratt said.

Treatment for anaplastic thyroid cancer typically is not aimed at curing the disease, but at making the patient more comfortable.

So any thought of getting better and returning to a normal routine -- even returning to the bench of the Supreme Court, is unlikely.