Advancing Thyroid Cancer Research and Care

Living History
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Monday, February 29, 2016
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The incidence of thyroid cancer is growing every year — and it’s increasing at a faster rate than any other kind of cancer. Half of the people struck by the disease are are between 15 and 45 years old.

The Department of Medicine’s Professor Emeritus Paul G. Walfish is a thyroid disease trailblazer helping improve detection and treatment for people with thyroid cancer.

Walfish, who is also a clinican-scientist at Mount Sinai Hospital, was instrumental in introducing fine needle aspiration biopsy (FNAB) to North America to detect thyroid cancer early. FNAB was already being used in Europe, but in North America, there was concern about the possibility of implanting cancer into the needle tract. Working with with Professor Harry Strawbridge of the Department of Laboratory Medicine and Pathobiology as well as the head of Mount Sinai Hospital’s Department of Laboratory Medicine and Pathology and the Director of the Michener Institute for Applied Health Sciences, they disproved this idea and helped people with benign nodules avoid unnecessary surgery. Today, fine needle biopsy is the number one test in the world for examining thyroid nodules. 

Walfish also pioneered the use of a blood biomarker called Thyroglobulin to help distinguish which patients need post-thyroidectomy radioactive iodine treatment and which don’t. Prior to this discovery, a patient’s age or a tumour’s size determined the need for radiation. But, Walfish and his team proved that measuring Thyroglobulin in a person’s blood and combining that information with ultrasound findings to could more accurately assess a person’s individual post-operative residual cancer risk. The application of this protocol has saved many patients with low-risk thyroid cancer from being hospitalized for treatments that have a potential for long-term side effects and has become the new standard of care.

Walfish has broadened his focus to other kinds of thyroid cancer biomarkers, as well as biomarkers for oral cancer. In collaboration with the Department of Otolaryngology — Head and Neck Surgery’s Professor Ranju Ralhan, Walfish identified a protein called S100A7 that can determine the aggressiveness of an oral dysplastic lesion, predict which lesions might lead to cancer and identify patients who would benefit from early intervention.

Walfish’s work has been recognized by a number of organizations. He was named the first recipient of the Council Award from the College of Physicians and Surgeons of Toronto. In 1990, Walfish was appointed to the Order of Canada. In 2002, he was presented with a 50th Anniversary Jubilee Medal on the Reign of Queen Elizabeth II. Walfish later became the first Canadian to receive the Paul Starr Award fro the American Thyroid Association and was presented with the Canadian Medical Association Medal of Service and the Sidney H. Ingbar Distinguished Lectureship Award of the American Thyroid Association. In 2008, Walfish was appointed to the Order of Ontario. In 2009, Walfish was recognized again by the American Thyroid Association with the John B. Stanbury Medal in Thyroid Pathophysiology. He is also a Fellow Emeritus of the Canadian Academy of Health Sciences and a recipient of the Queen Elizabeth II Diamond Jubilee Medal.