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
47: Treatment of Thyroid Cancer in Japan, with Dr. Takahiro Okamoto from Tokyo Women’s Medical University
A different approach to treating thyroid cancer compared to the U.S.
Dr. Takahiro Okamoto helped write the Japanese guidelines on thyroid cancer. He is Professor & Chair of the Department of Surgery at Tokyo Women’s Medical University.
Key points from this episode include:
* Most Western countries carry out total thyroidectomies, whereas in Japan, the approach is more conservative with a fundamental practice of hemithyroidectomy whenever possible.
* By not doing a total thyroidectomy, this allows the patient to not avoid taking thyroid replacement medication.
* Complete thyroidectomy is conducted when 80-90% of lymph nodes have metastasis.
* I-131 treatment is decreasing despite cases of cancer increasing
* For I-131 treatment, patients wait more than 6 months post surgery.
* When receving I-131 treatment, patients be admitted to hospital for several days.
* TSH suppression therapy is common in Western countries, whereas in Japan, measures are taken to avoid TSH suppression by not removing all of the thyroid.
* Normal TSH in Japan is 4.3 or less.
Dr. Özer Makay is an expert in nerve monitoring during thyroid surgery, and has been a guest faculty member in South Korea, Italy, France, the Netherlands, Germany, Belgium and Bulgaria.
This episode covers the following topics:
* Protecting the recurrent laryngeal nerve (RLN) and superior laryngeal nerve during thyroid surgery.
* Outcomes of damaging these nerves during surgery include no voice, hoarseness, shortness of breath, problem with drinking water or aspiration, impaired physical exertion with something as simple as climbing a flight of stairs.
* Why some centers have a higher occurrence of damage during thyroid surgery and include an error rate as high as 10%
* The cause of the damaged nerve include stretching or traction, and cutting or stitching.
* How to reduce risk.
* Is it possible to reattach a cut nerve?
Cáncer de Tiroides, con la Dra Ines Califano de Universidad de Buenos Aires
Reduzca la ansiedad durante el tratamiento del cáncer de tiroides
En esta entrevista, discutimos lo siguiente:
1. ¿Qué es un nódulo?
2. ¿Qué sucede durante ecografia?
3. ¿Qué sucede durante la oja fina?
4. Si es cáncer, ¿siempre hace la cirugía?
5. Si no es cáncer, ¿algunas veces hace cirugía?
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.
40: New Research Reveals Thyroid Surgery Errors 5x More Frequent Than Reported with Dr. Maria Papaleontiou from Michigan Medicine
Scheduled to publish next month, the statistics show thyroid surgery much less safe than thought.
The findings that 12% of patients overall had thyroid surgery specific complications is concerning, but more concerning is surgeons quote a 1 to 3 percent rate of error.
In the case of surgery for metastatic thyroid cancer, the error rate skyrockets to 23%.
Dr. Maria Papaleontiou is an Assistant Professor of Internal Medicine with an appointment in the Division of Metabolism, Endocrinology and Diabetes.