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The treatment for metastasised medullary thyroid cancer is still a topic of discussion. One of the main challenges remains to find effective adjuvant and palliative options for patients with metastatic disease. The diagnostic and treatment strategies for this tumour are discussed and possible new developments commented. Approaches that target rearranged during transfection (RET) are preferable to those that target RET downstream proteins as, theoretically, blocking RET downstream targets will block only one of the many pathways activated by RET. Combining several agents would seem to be more promising, in particular agents that target RET with those that independently target RET signalling pathways or the more general mechanism of tumour progression.

Objective: Discussing prognosis is often confronting and complex for cancer patients. This study investigates bow patients' psychological characteristics relate to their preferences concerning the disclosure of prognosis. Methods: One hundred and seventy-six esophageal cancer patients participated in the study. They had undergone esophagectomy within the past 28 months and did not have evidence of cancer recurrence. Patients completed a questionnaire eliciting their preferences for prognostic information. Sociodemographic characteristics, involvement preferences, anxiety, depression, fear of recurrence, striving for quality of life (QOL) or quantity of life and trust in physicians were explored as predictors for (a) wanting to be informed about prognosis and (b) the initiation of discussion about prognosis. Results: Patients wanting all prognostic information had more fear for the disease to recur (p < 0.05) and were inclined to be more actively involved during consultation (p < 0.001). Post hoc analyses showed that patients with worse QOL scores reported more fear of recurrence. Anxiety, depression, trust and tendency to strive for QOL or quantity of life were not related to preferences concerning prognostic information. Conclusions: The more fear patients have for esophageal cancer to recur, the more information they want about prognosis. Thus, patient's fear for recurrent disease is not a reason for withholding prognostic information. Results also suggest that there is no harm in asking patients what information they want. Copyright (C) 2009 John Wiley & Sons, Ltd.