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Nature Reviews Endocrinologypresents a new form of article, a Viewpoint, which provides a forum for a number of researchers to discuss important ongoing issues in endocrinology. In this Viewpoint article, experts from the field of thyroid cancer discuss and offer insight into the controversy surrounding the changing trends in thyroid cancer incidence.

Health-related quality of life (HRQOL) is an index of the perceived effects of disease and therapy on the individual patient. HRQOL is a multi-dimensional concept and debate continues about the utility of generic versus disease-specific questionnaires for assessing HRQOL. The authors of this Viewpoint examine the position of the health economist in HRQOL analysis.

This Perspectives re-evaluates the role of radioiodine treatment following surgery in low-risk patients with undetectable serum thyroglobulin levels after TSH stimulation and without evidence of disease. Moreover, the authors discuss the methods used for preparing low-risk patients for the administration of radioiodine after surgery and the activity of radioiodine that should be administered.

Describing anaerobic short chain alkane degrading archaea at a newly discovered cold seep, the authors here suggest that these organisms play much more important roles in submarine carbon cycling globally than previously thought.

Recombinant human TSH (rhTSH) is now available for use in patients with thyroid cancer. As discussed in this article, it is used as preparation before radioiodine-mediated thyroid-remnant ablation and to stimulate serum thyroglobulin levels. Using rhTSH avoids many of the unwanted effects caused by withdrawal of levothyroxine therapy.

Striatal neural circuits control reward-associated behaviors but the role of astrocytes is still unclear. Here, the authors show that chemogenetic manipulation of striatal astrocyte in mice restore obesity-associated cognitive defect and exert a control on whole-body metabolism.

Here, five of our Advisory Board Members look back at the past decade of endocrinology research, highlighting key advances and identifying roadblocks. They also discuss where effort and money should be invested now and speculate on where progress might be made in the coming decade.

The 2004 Sumatra earthquake was one of the largest events to occur in a subduction zone in the past 50 years. Seismic reflection data for this subduction zone reveal thrust faults cutting across the entire oceanic crust. This observation, coupled with the hypocentres of aftershocks, suggests that the megathrust—the interface between the Indo-Australian plate and the Sunda plate—currently lies in the oceanic mantle.

The impacts of carbon capture and storage (CCS) on subsurface microorganisms are poorly understood. Here, the authors show that deep ecosystems respond quickly to CO2 injections and that the environmental consequences of their metabolic activities need to be properly assessed for sustainable CCS in basalt.

This review describes the use of 2-[¹⁸F]-fluoro-2-deoxyglucose (FDG)-PET to localize recurrence of differentiated thyroid carcinoma. It focuses on patients with persistent disease and normal results from conventional imaging, on changes in therapeutic management because of FDG-PET results and on the role of TSH stimulated FDG-PET scanning, Finally, it focuses on the prognostic significance of FDG uptake in patients with differentiated thyroid carcinoma.

As discussed in this Review, thyroid cancer tissue alters the metabolism of iodide by affecting gene expression and post-transcriptional processes and can thereby decrease delivery of radioiodide during screening and therapy. This Review details these processes and discusses the clinical implications for different patient groups.

Although surgery cures most patients who have early-stage medullary thyroid carcinoma, disease can persist, recur or metastasize. This affects both quality of life and mortality. This article outlines current treatment strategies as well as various novel targets that are being investigated for therapies, especially for patients with distant metastases.

Radioactive iodine (RAI) treatment is used in patients with thyroid cancer to treat disease and to eradicate normal thyroid remnants. Routine post-operative administration of RAI is no longer indicated in patients with low risk thyroid cancer and might instead be used selectively in patients with a post-operative high serum level of thyroglobulin.

Alterations of RET kinase have been found in diverse thyroid cancer subtypes. This Review describes the RET mutations and gene fusions that can occur in thyroid cancer and highlights specific RET kinase inhibitors that are in clinical and preclinical use.

Calcitonin is produced by the parafollicular C cells and represents the classical clinical marker for medullary thyroid carcinoma. Here, the authors describe how measurement of basal and stimulated serum calcitonin levels can be used for screening, differential diagnosis, prognostic assessment, and follow-up monitoring in patients with medullary thyroid carcinoma.

The NADPH oxidase family of enzymes produce hydrogen peroxide (H₂O₂), a critical substrate for thyroid hormone synthesis. However, H₂O₂is also a potent oxidant that can cause DNA damage, which might lead to thyroid carcinogenesis. Here, the authors discuss the physiological attributes of thyroid NADPH oxidases and their pathological involvement in thyroid cancer.

This Review summarizes clinical practice for differentiated thyroid cancer, highlighting advances in therapy, including surgery and the use of radioactive iodine, as well as improved diagnostic tools and prognostic classifications. Different management strategies for patients with low-risk, intermediate-risk and high-risk differentiated thyroid cancer are discussed.

Treatment protocols for thyroid cancers range from active surveillance to total thyroidectomy followed by radioiodine remnant ablation. In this Review, the authors discuss the strengths and weaknesses of the surveillance tools and follow-up strategies used by clinicians in the treatment of thyroid cancers.

Thyroid-cell proliferation depends on TSH; suppression of TSH with levothyroxine decreases progression and recurrence rates for thyroid cancer. Long-term TSH suppression benefits patients at high risk of cancer recurrence but not low-risk patients, so TSH levels should be targeted accordingly.

Extreme temperatures and fluid pressures are measured, and their causes modelled, in a borehole into the Alpine Fault, where an earthquake rupture is expected within the next few decades.

The PtdIns(4,5)P₂ 5-phosphatase OCRL, mutated in Lowe syndrome, is implicated in trafficking and associates with Rab GTPases. OCRL function is now extended to cytokinesis, where it controls abscission of the intercellular bridge downstream of Rab35 through the local reduction of both PtdIns(4,5)P₂ levels and actin accumulation.

Ciliated neurons sited at the interface between the CNS and the cerebrospinal fluid (CSF) are present in many species; however, it is only in recent years that these ‘CSF-contacting neurons’ have been investigated in detail. Wyart et al. here discuss the features of these neurons and our current understanding of their varied contributions to CNS function.