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. 

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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.

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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.

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34: What Happens When Thyroid Cancer Travels to the Lungs? with Dr. Fabian Pitoia from the Hospital of University of Buenos Aires

What Happens When Thyroid Cancer Travels to the Lungs? In this interview, Dr. Fabian Pitoia discusses the treatment for distant metastatic thyroid cancer. Topics discussed include: 10% of thyroid cancer patients will have distant metastatic disease The disease will travel to lungs, bones, or both Treatment with RAI is most effective for those under 40 years old Evaluation of metastatic thyroid cancer in the lungs is a CT scan In 2006, there was a change in the treatment of the disease

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33: ¿Qué Sucede Cuando el Cáncer de Tiroides va a los Pulmones? con el Doctor Fabian Pitoia del Hospital de Clínicas de la Universidad de Buenos Aires

Bienvenido al episodio 33 de Doctor Thyroid con Philip James.    El invitado de hoy es Dr. Fabian Pitoia.  El Dr. Pitoia es un experto endocrino mundial, que aparece en muchas publicaciones y conferencias mundiales, donde habla de cáncer de tiroides. El Dr Pitoia es médico endocrinólogo, está encargado de la Sección Tiroides de la División Endocrinología del Hospital de Clínicas de la Universidad de Buenos Aires. En este episodio, el Dr. Pitoia responde las siguientes preguntas: * ¿Qué es la enfermedad metastásica en relación con el cáncer de tiroides?   * Hay una tendencia de este enfermedad? * ¿cómo se descubre la enfermedad metastásica? * cuando se trata de cáncer de tiroides es un procedimiento típico para los médicos para detectar la enfermedad metastásica? * si un paciente no responde a RAI (radioactiva), ¿qué es una opción de tratamiento? ¿Podemos hacer vigilancia activa

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32: Thyroid Cancer Surgery? The Single Most Important Question to Ask Your Surgeon with Dr. Gary Clayman

This is a candid interview with Dr. Gary Clayman about thyroid cancer surgery and making sure a patient gets the best available care. If someone is considering surgery, Dr. Clayman discusses related topics, including: Do not let a doctor operate on you unless the surgeon can prove to you that he/she has done a minimum of 150 annual thyroid surgeries, and for a minimum of ten years. This means, do not see a surgeon unless he/she has completed a minimum of 1500 thyroid surgeries. Damage to voice box nerves is preventable, when surgery is done right. 90% of thyroid surgeries done in the U.S. are by doctors doing fewer than fifteen thyroid surgeries per year

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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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