In this episode, topics include:
* Drug therapy for patients that fail standard therapy; including surgery and RAI
* Not all patients have same behavior for their cancer
* Some cancers are aggressive
* Not many thyroid cancer patients are affected by this; maybe a few thousand in the U.S., but not tens of thousands
* What is the treatment protocol for therapy?
* Lenvatinib or Sorafenib is the treatment for refectory thyroid cancer
* Lenvatinib tends to be more effective
* Sorafenib is tolerated by the patient better
* Other options to consider include, molecular profiling or some thyroid cancers carry mutation that is targetable, or BRAF
* BRAF inhibitors used with thyroid cancer patients
* Molecular profiling
* DNA sequencing
64: Managing Indeterminate Thyroid Nodules, with Dr. Kimberly Vanderveen from Denver Center for Endocrine Surgery
Kimberly Vanderveen, MD is a Colorado native and graduate of Bear Creek High School in Lakewood, CO. She received her bachelor’s degree with honors from Muhlenberg College in Allentown, PA. She then earned her medical degree from Northwestern University in Chicago, IL in 2001.
In this episode, the following topics are discussed:
* Two roads of tests: rule out and malignant markers
* Rule-out tests picks up innocent behavior pattern. Most common is Afirma
* Malignant markers, or rule-in tests, are useful at determining extent of surgery, and help avoid a second or third surgery. ThyroSeq, ThyraMIR, Rosetta
* Do patients get both tests? Rule out and behavior?
* Approximately 15% of FNA’s come back indeterminate. Some centers as high as 30%
* Managing indeterminate nodules when a patient chooses no surgery.
* Taking into account emotional, financial, and lifestyle goals of the patient.
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 marker technologies
Gene expression classifier
62: Treating Thyroid Patients For 40 Years ⇒ Lessons Learned from Two Patients, with Dr. Elaine Kaptein from USC
In this interview, Dr. Kaptein discusses the need to consider each patient before making treatment decisions. In some cases, this may mean foregoing the removal of cancerous lymph nodes.
Carmelo Nucera, M.D., Ph.D., is currently an Assistant Professor at Harvard Medical School, Boston, in the Division of Cancer Biology and Angiogenesis (Department of Pathology), Beth Israel Deaconess Medical Center. Dr. Nucera received his M.D. and Ph.D. in Experimental Endocrinology and Metabolism from Italy.
In this episode, Dr. Nucera discusses a combination drug therapy using vemurafenib and palbociclib represents a novel therapeutic strategy to treat papillary thyroid carcinoma (PTC).
In this episode, the following topics are explained:
* Optimizing thyroid health prior to conception
* Thyroid issues that affect pregnancy
* Hypothyroid as result of surgery or Hashimotos
* Hyperthyroidism and pregnancy
* Adjusting current thyroid treatment, meaning optimizing thyroid levels by adjusting dosage of thyroid medication
* TSH levels in light of pregnancy
* Planned pregnancy usually means a dose increase