['Medullary thyroid cancer (MTC) is a rare form of thyroid cancer comprising approximately 4% of all thyroid cancers. The majority of patients have a relatively good prognosis; however, a subgroup of patients will require systemic therapy. Large phase III randomized trials led to the approval of two drugs--vandetanib and cabozantinib--for progressive or symptomatic MTC. The decision regarding which drug to initiate first is not entirely clear and is a common concern amongst treating physicians.', 'A review of the literature in English was conducted, and data were summarized and integrated into a decision matrix.'] Are medullary thyroid cancer in the era of tyrosine kinase inhibitors : to treat or not to treat -- and with which drug -- those the questions?