9/11-Related Thyroid Cancer

9/11 caused thyroid cancer in over one thousand first responders and downtown NYC residents, workers, students, and others. In the most recent report, the World Trade Center Health Program certified 534 cases of thyroid cases in first responders and 533 cases in lower Manhattan residents, workers, and students — all linked to the toxic 9/11 fallout that blanketed lower Manhattan on 9/11 and the many months afterward.

While thyroid cancer is a relatively rare type of cancer that predominantly affects women, studies of male first responders who were present at Ground Zero on 9/11 or during the rescue and recovery efforts in the weeks that followed have revealed a rate of thyroid cancer that is three times that of men who were not present at the terrorist attack site on or around 9/11.

While some medical experts suggested that the abnormally high numbers of individuals diagnosed with the disease resulted from over-diagnosing or false-positive results, a study revealed no false positives among the first responders diagnosed with the disease and all of those diagnosed had biomarkers that indicated that their tumors were malignant.

The increased screenings provided by the WTC Health Program, which provides monitoring and medical treatment of 9/11-related conditions, actually resulted in more early stage diagnoses, when treatments are often less invasive and more effective.

The World Trade Center dust did not cause cancer in the first responders. In fact, as stated above, hundreds of cases of thyroid cancer in downtown residents and workers have been definitively linked to people being present in lower Manhattan on or during the many months after September 11, 2001. If you were there in 2001 or 2002  and you have since been diagnosed with thyroid cancer, the federal WTC Health Program and the September 11th Victim Compensation Fund can provide important benefits, including free lifetime medical treatment and monitoring, as well as substantial cash compensation for wage loss and pain and suffering.

It’s worth noting that thyroid cancer has many potential causes unrelated to 9/11, and we’ll discuss many of them below. But if you were present during the September 11th atrocities or its aftermath—whether as a first responder or a survivor—the law presumes that exposure to the toxins unleashed by 9/11 caused your cancer. Consequently, you may qualify for healthcare benefits, but you may need help with the complicated application process.

The experienced 9/11 assistance lawyers at Hansen and Rosasco can help you understand the process of applying and filing for these programs.

The Thyroid’s Function in the Body

The thyroid gland is a small, butterfly-shaped organ that is located beneath the Adam’s apple in your neck. Running along the windpipe, the thyroid has two side lobes that are connected by a bridge, known as the isthmus. If your thyroid is the normal size, you probably can’t feel it. The thyroid owes its brownish-red color to the number of blood vessels it has.

The nerves needed for voice quality pass through the thyroid, and a change in a person’s voice is often one of the early signs that something is awry with the thyroid. The thyroid is responsible for producing hormones that the body needs to function, including thyroxine, known as T4, the most prevalently produced of the thyroid hormones. These hormones influence metabolism, growth and development, and body temperature.

Types of Thyroid Cancer

Although rare, several types of cancer can afflict the thyroid, including:

• Papillary thyroid cancer, which is the most common type of thyroid cancer and occurs within the follicular cells which produce and store thyroid hormones.
• Follicular thyroid cancer, which also occurs within the follicular cells. This type of thyroid cancer is often aggressive.
• Anaplastic thyroid cancer, which also occurs within the follicular cells and is known to spread rapidly.
• Medullary thyroid cancer, which begins in a type of thyroid cell known as a C cell, which produces the hormone calcitonin.
• Thyroid lymphoma, which begins in the thyroid’s immune system cells.
• Thyroid sarcoma, which begins in the connective tissue cells within the thyroid.

Symptoms of Thyroid Cancer

Thyroid cancer occurs when abnormal cells begin to grow within the gland.

While this condition does not always present discernible signs in the early stages, symptoms experienced as the disease progresses include:

• Pain in the neck or throat.
• Difficulty swallowing.
• A lump, or nodule, in the neck that can be felt through the skin.
• Increasing hoarseness or other changes to the voice.
• Swollen lymph nodes in the neck.

In the general population, thyroid cancer is most prevalent among women. While experts have not completely pegged down the cause of this type of cancer, genetic factors, as well as radiation exposure, can lead to a higher risk of the disease.

Diagnosis and Common Treatments for Thyroid Cancer

There are several procedures used to diagnose thyroid cancer, including:

• A physical examination of the neck to feel for thyroid nodules or other physical changes that would indicate thyroid cancer. During your examination, your doctor will likely inquire about past exposure to radiation as well as family history.
• Blood tests to help determine if the thyroid gland is working as it should.
• Ultrasound imaging, which allows your medical provider to see the structure of the thyroid and determine if a nodule appears to be benign or malignant.
• Removing a sample of thyroid tissue through a procedure called a biopsy, in which doctors insert a long needle through the skin into a thyroid nodule, and withdraw a small amount of the nodule’s tissue to analyze under a microscope to detect cancer cells.
• Other imaging tests such as a CT or MRI can help the doctor to determine if the cancer has spread to other parts of the body.
• Genetic testing that will look for genes that increase one’s risk of cancer.

Treating the Cancer

There are several options for treating thyroid cancer. The option your doctor recommends will depend on how far the disease has progressed and your overall health.

Treatment options can include:

• Monitoring the cancer. Many thyroid cancers are small and extremely slow to grow. Your doctor may recommend simply monitoring the cancer through annual blood tests and ultrasounds, with treatment only being necessary if and when the tumor begins to grow or the cancer begins to spread.
• Surgery to remove the thyroid. Surgery is among the most common forms of treatment for this disease. There are different surgical procedures available, including complete removal of all thyroid tissue, only the diseased portion of the thyroid, or the lymph nodes in the neck.
• Thyroid hormone therapy that supplies the missing hormones that your body can no longer produce due to the cancer, and also suppresses the thyroid-stimulating hormones your body makes that could be causing cancer cells to grow.
• Radioactive iodine, which is often used after surgery to remove the thyroid to destroy any remaining thyroid tissue or cancer cells that weren’t removed in surgery.
• External radiation therapy, in which an external beam of radiation is aimed at the cancerous area. This treatment is often used when cancer continues to grow after radioactive iodine treatment or after surgery if there is a high risk that the cancer will recur.
• Chemotherapy, which is a drug treatment that uses chemicals to kill the cancer cells. While this is an uncommon treatment for thyroid cancer, it is sometimes used for anaplastic thyroid cancer, in combination with external radiation therapy.
• Targeted drug therapy, with medications that specifically block the development of abnormal cancer cells.
• Injecting alcohol into small tumors, which will cause the tumors to shrink. Doctors use this treatment when surgery is not an option and the tumor is small, or if the cancer recurs in the lymph nodes after surgery.
• Palliative care, which provides pain relief to support the patient through other, more aggressive treatments. Provided by a team of doctors and other professionals, palliative care has been found to increase the quality of life for those fighting cancer.

Obtaining Medical Care for 9/11-Related Thyroid Cancer

The WTC Health Program was initially funded through the James Zadroga 9/11 Health and Compensation Act, and was since reauthorized and funded through 2090. This program uses healthcare partners from across the U.S. to provide medical treatment and health monitoring to first responders, general responders, volunteer cleanup workers, and those living, working, or attending school in the part of lower Manhattan that was exposed to the toxic dust plume from the World Trade Center attack.

Applying for the WTC Health Program

To apply for the WTC Health Program, you must:

• Ensure you are eligible. Eligible groups include FDNY first responders, WTC general responders, WTC survivors who lived, worked, or attended school in the area, and responders to the Pentagon attack and the plane accident in Shanksville, Pennsylvania.
• Review the supporting documentation you will need. This documentation includes proof of presence at an affected site from September 11, 2001, to July 31, 2002, such as timesheets or other work-related proof, a student ID or mail addressed to an address in the area during that time, or even testimony from a union or an individual who can verify your presence at a covered site.
• Apply online or submit your application and required documentation by mail or fax.

Obtaining Compensation for Your Thyroid Cancer Diagnosis

Also included in the Zadroga Act and reauthorized for funding until 2090 is the September 11th Victims Compensation Fund. This fund provides compensation for job loss, out-of-pocket medical expenses, and pain and suffering associated with 9/11-related medical conditions.

The compensation is available to workers and individuals who were in an impacted area during the 9/11 terrorist attacks or the rescue, recovery, or cleanup procedures at those sites in the following months. Compensation is also available for the survivors whose loved ones were exposed to 9/11 toxins and subsequently were diagnosed and died from a 9/11-related condition.

Impacted individuals can file a claim through the following steps:

• Register with the VCF by your registration deadline. Registering for the VCF is not the same as filing a claim. However, your registration reserves the right to file a claim at some point between now and 2090. The registration deadline is not the same for everyone. For those who obtained certification of their 9/11-related condition by the WTC Health Program before the programs’ reauthorization on July 29, 2019, the deadline to register with the VCF is July 29, 2021. Those who had a condition certified by the WTC Health Program after that date have two years from the latest date of certification to register with the VCF. For those applying for wrongful death compensation due to the loss of a loved one from a 9/11 related condition, the deadline to register with the VCF is July 29, 2021, if the death occurred before July 29, 2019. If the death occurred after that date, the deadline to register is two years after the date of death.
• If you have not done so already, have your 9/11-related medical condition certified by the WTC Health Program.
• File your claim and supporting documentation by October 1, 2090. Some of the supporting documentation that is necessary to file a claim for compensation from the VCF includes the authorization of the release of medical records that will allow the program to obtain information from the WTC Health Program about your eligible condition, a waiver of your right to file a lawsuit seeking compensation for your 9/11-related condition, documentation that proves your presence at a 9/11 attack site during or shortly after September 11, 2001, and other documentation as needed depending on whether you’re seeking compensation for your 9/11 illness or injury or a loved one’s 9/11-related death.

Those who were exposed to the toxins at one of the 9/11 terrorist attack sites do not have to already be sick with a related condition to register. Many individuals register before receiving a diagnosis.

Once you file a claim, the claim goes through an initial review process to ensure you submitted all necessary documentation. A more in-depth review will then take place to meet all eligibility criteria. A 30-day appeal period comes after the program renders a decision on your claim.

If the decision is not appealed, payment on the claim is generally submitted around 20 days later.

Contact Hansen & Rosasco, LLP today for a free consolation to learn more about your legal options.