In Reply We stand by our statement in our article,(p957) referring to observation of known thyroid cancers, that "at the present time, this approach is not the standard of care in the United States." We are currently witnessing many paradigm shifts in US clinical oncology with respect to approaches to breast and prostate cancer. Whether an observational shift occurs in thyroid cancer remains to be seen. Therefore, in the interim, we think the observation of thyroid or any other cancers should be done circumspectly, judiciously, and with a consent or contract.
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