63: Take a Step Back⎢Thyroid Surgery with a Clear Mind, with Dr. Bryan McIver from Moffitt Cancer Center

Bryan McIver, MD, PhD Dr. McIver contributes to Moffitt Cancer Center almost 20 years of clinical experience in the care of patients with endocrine diseases, specializing in the evaluation of patients with thyroid nodules and thyroid cancer. He has a particular interest in the management of patients with advanced and aggressive forms of cancer and the role of genetic and molecular techniques to improve the accuracy of diagnosis. Most nodules are benign When to do a biopsy How to interpret the results of biopsy Advances in thyroid cancer Ultrasound technology advancements Molecular markers Cytopathology categorizations Molecular marker technologies Gene expression classifier

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59: No Biopsia es 100% Exacta⎥Exámenes Moleculares son los Mejores, con Dr. Paul Y. Casanova

Dr. Paul Y. Casanova-Romero, M.D., M.P.H., F.A.C.P., F.A.C.E, E.C.N.U, que se unió a Palm Beach Diabetes y Endocrine Specialists en 2012, recibió su grado médico con honores (Summa Cum Laude) y Doctor en Ciencias Médicas (DMSc), de la Universidad de Zulia, la Escuela de Medicina en Venezuela. * ¿Cómo se identifican los nódulos y por qué ocurren? autoexamen o en la oficina del médico * La mayoría de los nódulos son benignos pero ocurren porque en mas de 70% de la población * ¿Qué tests puede realizar un médico para evaluar el nódulo? * Ninguna test es 100% * Ultrasonido - qué están buscando en general * Que es ojo fina y el proceso general * Tests moleculares * ¿Qué tipos de resultados se pueden obtener de la citología y qué significan? * La mayoria de ojo finas son benigno

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58: No Biopsy is 100% Accurate⎥Molecular Testing Gets Close, with Dr. Bridget Brady from Austin Thyroid Surgeons

Dr. Bridget Brady is Austin's first fellowship-trained endocrine surgeon. In this episode the following topics are discussed: Austin Thyroid Surgeons sees 30 patients per week with thyroid nodules Up to 80% of US population could have a thyroid nodule(s) less than 5% of Dr Brady's thyroid nodule patients test positive for cancer How relevant is what I don’t know won’t hurt me in thyroid cancer and biopsies of nodules? BETHESDA system or the middle category, also known as indeterminate For thyroid nodules that are indeterminate, historically a surgery would be performed  With molecular testing, surgery can be decreased by up to 50% Afirma molecular testing uses messenger RNA If Afirma comes back suspicious it does NOT necessarily mean it is cancer

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42: Flame Retardants Connected to Thyroid Cancer, with Dr. Julie Ann Sosa from Duke University

This is an in depth discussion about the connection between flame retardants and plastics, and thyroid cancer.  These chemicals, also known as endocrine disruptors, have a clear connection to thyroid cancer occurrence. The research is presented by Julie Ann Sosa, MD MA FACS is Chief of Endocrine Surgery at Duke University and leader of the endocrine neoplasia diseases group in the Duke Cancer Institute and the Duke Clinical Research Institute. She is Professor of Surgery and Medicine. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. 

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41: Molecular Profiling and Unnecessary Thyroid Surgeries with Jennifer Kuo from Columbia University

One-third of all thyroid nodule fine needle aspirations come back indeterminate. When surgery is performed on these cases, pathology of the thyroid reveals that many times the nodule is benign.  Through molecular profiling, patients with indeterminate thyroid nodules, can now avoid unnecessary surgery and get more accurate pathology results from the fine needle aspiration. Are you a patient and your doctor has said your thyroid nodule is indeterminate and is recommending surgery as an option?  The key is, to confirm that molecular profiling was performed.    Jennifer Kuo, MD is Director of the Thyroid Biopsy Program, Director of the Endocrine Surgery Research Program, and Instructor in Surgery, at the Columbia University Medical Center. 

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39: Thyroid Cancer Web Sites Confuse Patients with Dr. Rashika Bansal from St. Joseph’s Regional Medical Center

In this episode Dr. Bansal shares the research she presented at AACE 2017 and ENDO 2017, regarding the poor readability scores for thyroid cancer web sites. The challenge for these web sites and health institutions is to translate thyroid education from complex to simple and easy to understand. Currently, many patients are not following up with treatment, citing confusion after being exposed to the various thyroid cancer education resources.

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31: Información Importante Sobre los Nódulos Tiroideos con la Dra Regina Castro de la Clínica Mayo

M. Regina Castro, MD es consultor en la División de Endocrinología de la Clínica Mayo de Rochester, MN. En entrevista 31 de Doctor Thyroid con Philip James, el Dr. Castro explica los siguientes temas: * ¿Qué es un nódulo tiroideo? * ¿Cuáles son los síntomas de un nódulo tiroideo? * ¿Cómo se diagnostica el nódulo tiroideo? * Punción de la tiroides con aguja fina * Ecografía de la tiroides * ¿Cómo se tratan los nódulos de la tiroides? * Cuando la observación activa es la opción de tratamiento en lugar de una tiroidectomía * Niños con nódulos tiroideos

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30: Thyroid Cancer and Children with Dr. Andrew Bauer from the Perelman School of Medicine, U of Pennsylvania

Managing thyroid cancer in children, sometimes more complex than adults In this episode Dr. Bauer shares the complexities of managing children with thyroid nodules, and differentiated thyroid cancer. This is a must listen interview for parents whose child has a thyroid nodule or thyroid cancer diagnosis. There are a several important differences in how pediatric thyroid nodules and differentiated thyroid cancer (DTC) present and respond to therapy. Kids are less frequently diagnosed with a thyroid nodule; however, the risk for malignancy is four- to fivefold higher compared with an adult thyroid nodule.

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23: You Have a Thyroid Nodule, What Happens Next? with Dr. Regina Castro from The Mayo Clinic

Dr. M Regina Castro is an endocrinologist in Rochester, Minnesota and is affiliated with Mayo Clinic. This episode details the medical approach to thyroid nodules. Topics include: • 60% of the U.S. population has thyroid nodules • Discovered when evaluating other neck issues such as an unrelated pain • What happens when you are told you have a thyroid nodule? • How to know if your thyroid nodule is cancerous?

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22: Avoiding Thyroid Cancer Surgery, Depending on the Size with Dr. Miyauchi from Kuma Hospital in Kobe, Japan

You have been diagnosed with thyroid cancer, and choose no surgery. Although thyroid cancer diagnosis has spiked around the world, a trend is to pass on surgery if the cancer is identified as low risk. In doing so, mortality rate does not increase and it avoids unfavorable events sometimes related to surgery, such as vocal chord paralysis, hypothyroidsm, financial costs, and lifelong thyroid hormone treatment. In this episode, we visit with Dr. hypothyroidism, a pioneer in prescribing active surveillance in place of immediate surgery.

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