Thyroid Cancer: Implications of Genomics for Care and Practice

Some families have a germline risk for developing thyroid and other cancers. An understanding of the genomic alterations that occur in these tumors will help to explain the diverse clinical characteristics of thyroid tumors, provide diagnostic information, and direct therapy. This article reviews the classification, genetics, and risks and management of hereditary cancer syndromes, as well as the somatic gene variants found in thyroid epithelial tumors, with clinical implications.

AT A GLANCE

• The identification of benign tumors and clinically insignificant thyroid tumors is important because it can prevent partial or complete removal of the thyroid and lymph node dissection with radiation therapy.
• Identifying individuals at risk for hereditary thyroid cancer syndromes, referring them for germline evaluation, and ensuring follow-up, complete with prevention and early detection recommendations, are responsibilities of the oncology nurse. 
• Oncology nurses can provide support and education to patients and families to help them manage their diagnosis and understand how genomic testing of the germline tissue and tumor guides treatment.