THYROID CANCER – Digital Conference

Under the auspices of the Department of Medical Sciences of the Croatian Academy of Sciences and Arts, ther Croatian Thyroid So- ciety and the Croatian Head and Neck Society organized a digi- tal conference entitled Thyroid Cancer on November 20th.2020 in Zagreb. Articles that had been prepared for oral presentations at the Conference have been published as a supplement to the Acta Clinica Croatica. Thanks to the support of the Central State Office for the Development of the Digital Society, this virtual conference demonstrated how even small countries like Croatia can initiate and lead digital dialogues among experts on this topic in order to im- prove the prevention treatment of thyroid cancer even in the midst of this pandemic. If it had not been for the coronavirus pandemic, this gathering of the most eminent Croatian experts in this field would have been held at the Renaissance Hall of the National Hall of the Croatian Academy of Sciences and Arts, which had been the first seat of the Croatian Academy of Sciences and Arts before the Zrinjevac palace was built.

On behalf of the patron of the event – the Croatian Academy of Sciences and Arts, Professor Vida Demarin, Fellow of the Acad- emy, sent a strong and valuable message during her introductory speech about the significance of this conference despite the pan- demic. She emphasized our mission to fight cancer, to improve treatment outcomes, and to invest in the prevention. The Croa- tian Academy of Sciences and Arts has always supported scientific projects and research.

In recent years, there has been a major increase in the incidence of malignant thyroid tumors worldwide. Croatia recorded a con- siderable increase in the number of new cases of thyroid cancer in the past 15 years, from 308 patients in 2001 to over 600 a year in the recent years. The main reasons are the improvement and avail- ability of diagnostic procedures such as ultrasound and fine needle aspiration cytology (FNAC), which have become gold standard in diagnostics; increased health awareness among patients; and longer life expectancy.

At the same time, there have been significant changes in the treatment of thyroid disease. The extent of thyroid surgery, the management of the clinically negative neck, and indications for the use of iodine-131 are procedures that today provoke a lot of debate in order to apply more sparing procedures with the best possible therapeutic effect.

Major attention was paid to the development of targeted therapies in the treatment of more aggressive forms of the disease with a poorer prognosis probably due to protein mutations, mainly ty- rosine kinase enzyme that plays a significant role in tumor growth and proliferation. The discovery of new, targeted therapies and improved understanding of thyroid carcinogenesis has led to great interest in the use of biologically targeted drugs and in the treat- ment of thyroid cancer, primarily in the treatment of medullary thyroid cancer, as well as differentiated thyroid cancer refractory to radioactive iodine.

Genetic testing and a personalized approach that takes into ac- count variability in genetic characteristics, environment and lifestyle are increasingly present in the treatment of tumors in general, and have their place in the treatment of thyroid cancer. Optimal treatment of thyroid tumors is possible only by a mul- tidisciplinary approach that includes a variety of specialists such as nuclear medicine specialists, head and neck surgeons, endocri- nologists, radiologists, oncologists, geneticists, phoniatrics, speech therapists, and others.

All of the above reasons encouraged both Professor Zvonko Kusić, Fellow of the Academy, as president of the Croatian Thyroid So- ciety and Professor Drago Prgomet as president of the Croatian Head and Neck Society to organize this conference. Regardless of different work conditions during this pandemic, it is of utmost importance to continue to exchange knowledge and experiences, improve treatment methods, educate us, and form guidelines for the treatment of patients with head and neck tumors, in this case thyroid. In a way, they wanted to send out a message to our pre- sent and future patients that we continue to conduct research, projects, diagnose and operate, and that we continue to care for our patients. Our patients with tumors cannot and should not wait for health care!

Zvonko Kusić
Drago Prgomet