Doctor Interviews

Pathology

Endocrine
Philip James

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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Endocrine
Philip James

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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Pathology
Philip James

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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Endocrine
Philip James

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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Pathology
Philip James

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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Endocrine
Philip James

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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