21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies

You have been diagnosed with thyroid cancer, and contrary to your doctor’s advice, you choose to not proceed with surgery. Is this a patient trend, and how often are patients making this decision?

In a qualitative analysis, Dr. Louise Davies reports on the experience of US patients who self-identify as having an over-diagnosed thyroid cancer.

How likely is death as result of thyroid cancer? In a study by H. Harach, he sites that when reviewing random autopsies, thyroid cancer was prevalent in 34% of the cadavers.

Continue Reading

What Happens When Thyroid Surgery Turns Out Bad?

How often does thyroidectomy result in surgical errors or unwanted outcomes? The answer is much more often than reported. The reported surgical error rate for papillary thyroid cancer is 2 – 3%, however, research reveals errors are nearly six-times that number.

Continue Reading

66: Five Important Things Your Thyroid Surgeon Maybe Not Telling You, with Dr. Akira Miyauchi

During this episode, the following topics are discussed:
1. Financial burden of surgery versus total cost of active surveillance over ten years. 
2. Stretching Exercises for Neck
3. Setting patient expectations prior to FNA to manage anxiety
4. When the laryngeal nerve is severed during thyroid surgery, it can and should be repaired, with proper surgeon skill and training. 
5. The most common question asked to Dr. Miyauchi by surgeons from around the world. 

Continue Reading

51: What Do You Do For a Living?⎥Why It Matters, with Dr. Ashok R. Shaha from MSKCC

Dr. Shaha specializes in head and neck surgery, with a particular interest in thyroid and parathyroid surgery. He uses an algorithm of selective thyroid tumor criteria (the size, location, stage and type of cancer, along with the patient’s age), to tailor therapy to each individual’s circumstances.

In this interview, topics include:
* The first question a surgeon should ask and why.
* When talking active surveillance or observation, changing the language to deferred intervention,  ‘we are going to defer’.
* Understanding the biology of the cancer
* The biology of thyroid cancer is a friendly cancer.

Continue Reading

50: Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist? with Dr. Michael Tuttle from Sloan Kettering

Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist?
Often, surgery is not necessary to treat thyroid cancer, but much of the decision will depend on the patient characteristic.
During this interview, Dr. Tuttle discusses the following points:
Challenges of managing thyroid cancer as outlined by the guidelines
Scaling back care for insurance-challenged patients, and adopting a plan that gets the same result without needing the expensive tests
Desired outcome is survival and no recurrence, a third is for no harm that would be caused by an unnecessary surgery
Unwanted side affects of thyroid cancer include nerve damage, parathyroid damage, and infections

Continue Reading

48: Innovaciones en el Tratamiento del Cáncer de Tiroides, con el Dr. Hernán Tala desde Santiago, Chile

Dr. Hernán Tala es endocrinólogo de la Clinica Alemana en Santiago, Chile. Su area especialidad incluye cáncer de tiroides avanzado, endocrinologia general, y enfermedades tiroides.
Los temas presentados incluyen:
* Una mejor comprensión de la biología del cáncer de tiroides, y que no todo el cáncer de tiroides es igual. La enfermedad es única en cada paciente.
* La importancia de entender el perfil del cáncer en cada paciente.
* Diagnóstico del nódulo.
* Perfil molecular del nódulo tiroideo.
* Una pausa en la exploración universal del cáncer de tiroides.
* Vigilancia activa

Continue Reading

36: 1 in 3 People Die With Thyroid Cancer — Not From with Dr. Seth Landefeld from UAB

1 in 3 People Die With Thyroid Cancer
The USPSTF upholds its 1996 recommendation against screening for thyroid cancer among asymptomatic adults.

The USPSTF commissioned the systematic review due to the rising incidence of thyroid cancers against a background of stable mortality, which is suggestive of over-treatment. And in view of the results, the task force concluded with “moderate certainty” that the harms outweigh the benefits of screening.

Continue Reading

35: Rethinking Thyroid Cancer – When Saying No to Surgery Maybe Best for You with Dr. Allen Ho from Cedars-Sinai in Los Angeles

Weighing treatment options for thyroid cancer, with deep consideration for the patient’s lifestyle, could become the new norm in assessing whether surgery is the best path.

Dr. Allen Ho states, “if a patient is a ballerina or an opera singer, or any other profession that could be jeopardized due to undesired consequences of thyroid cancer surgery, then the best treatment path maybe active surveillance.” Undesired consequences of thyroid cancer surgery could be vocal cord paralysis, damage to the parathyroid glands resulting in calcium deficiencies, excessive bleeding or formation of a major blood clot in the neck, shoulder nerve damage, numbness, wound infection, and mental impairment due to hypothyroid-like symptoms.

Continue Reading
Close Menu

Subscribe to Doctor Thyroid with Philip James Newsletter

No spam. Your information is safe.
It will not be shared with any third party.
You can unsubscribe at any time.