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FOOD AND DRUG ADMINISTRATION - page 147 / 263

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cancer, it's frequently thought of as one of those really unusual cancers you never see, but if you look at the actual number of cases, the number of new cases being 22,000 isn't that much different from other more, I suppose, popular cancers, multiple myeloma, kidney cancers, leukemia and lymphoma.  1,400 deaths this year are expected from thyroid cancer.  Fortunately, the overall survival in thyroid cancer is 90 percent which means the vast majority of patients with thyroid cancer will be long-term survivors and will require levothyroxine therapy.

Now, I'm a clinician, and to me, what matters is how we take care of patients.  Initially in thyroid cancer, we usually start with a total thyroidectomy, surgically removing the entire thyroid.  We use radioactive iodine as a very targeted therapy to destroy any residual normal tissue or any metastatic thyroid cancer and that functionally leaves the patient with no thyroid tissue.  That is the goal of our therapy.

Now, if you think about that at first blush, you'd think the real role for levothyroxine is what you've been hearing this morning, which is just to replace that

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