Welcome to Doctor Thyroid with Philip James
This is a meeting place to hear from top thyroid doctors and healthcare professionals.
The Doctor Thyroid interviews are intended to be a resource for those wanting to thrive, regardless of setbacks related to thyroid disease. Seeking good health information can be a challenge, hopefully this platform provides you with better treatment alternatives as related to endocrinology, surgery, hypothyroidism, thyroid cancer, functional medicine, pathology, and radiation treatment.
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6-Steps to RFA procedure success! → for doctors & patients → Dr. Roberto Valcavi
🔹 Roberto Valcavi 🔹 MD, FACE, ECNU Reggio Emilia, Italy
Treating Thyroid Cancer with No Surgery → RFA → Radiofrequency Ablation for Malignant Thyroid Nodules
Looking for a radiofrequency ablation doctor? 🔹www.rfamd.com🔹 Dr. Leonardo Rangel
RFA and Protecting the Nerves for Best Outcomes → Dr. Julia Noel → Stanford University → Thyroid Radiofrequency Ablation
RFA is a relatively safe procedure; ultrasound and protecting the
Radiofrequency Ablation (RFA) and Thyroid Nodules → Dr. Babak Larian
Top 3 patient questions about RFA RFA Doctor Directory: www.rfamd.com
Radiofrequency Ablation → REMOVE Thyroid Nodules → with NO SURGERY → Dr Ralph Tufano
Avoid surgery for thyroid nodules → benign and malignant Looking
97: 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.
6-Steps to RFA procedure success! → for doctors & patients → Dr. Roberto Valcavi
🔹 Roberto Valcavi 🔹 MD, FACE, ECNU Reggio Emilia, Italy
Treating Thyroid Cancer with No Surgery → RFA → Radiofrequency Ablation for Malignant Thyroid Nodules
Looking for a radiofrequency ablation doctor? 🔹www.rfamd.com🔹 Dr. Leonardo Rangel
RFA and Protecting the Nerves for Best Outcomes → Dr. Julia Noel → Stanford University → Thyroid Radiofrequency Ablation
RFA is a relatively safe procedure; ultrasound and protecting the
Radiofrequency Ablation (RFA) and Thyroid Nodules → Dr. Babak Larian
Top 3 patient questions about RFA RFA Doctor Directory: www.rfamd.com
Radiofrequency Ablation → REMOVE Thyroid Nodules → with NO SURGERY → Dr Ralph Tufano
Avoid surgery for thyroid nodules → benign and malignant Looking
97: 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.
96: 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.
94: 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
93: The Results of 30 Years of Patients Receiving Active Surveillance Instead of Surgery; Dr. Akira Miyauchi from Kuma Hospital in Kobe, Japan
The result of over 1000 cases of active surveillance shows
92: Your Patient Type May Determine Your Thyroid Cancer Treatment → Dr. Michael Tuttle from Sloan Kettering
What type of patient are you, a minimalist or maximalist?
91: What Do You Do For a Living?⎥Why It Matters, with Dr. Ashok R. Shaha from MSKCC
Dr. Shaha specializes in head and neck surgery, with a particular interest in thyroid and parathyroid surgery. He uses an algorithm of selective thyroid tumor criteria (the size, location, stage and type of cancer, along with the patient’s age), to tailor therapy to each individual’s circumstances.
In this interview, topics include:
* The first question a surgeon should ask and why.
* When talking active surveillance or observation, changing the language to deferred intervention, ‘we are going to defer’.
* Understanding the biology of the cancer
* The biology of thyroid cancer is a friendly cancer.
94: 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
90: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University
A little T3 can make a world of difference for some thyroid patients.
Antonio Bianco, MD, PhD, is head of the division of Endocrinology and Metabolism at Rush University Medical Center. Dr. Bianco also co-chaired an American Thyroid Association task force that updated the guidelines for treating hypothyroidism.
Dr. Bianco’s research has revealed the connection between thyroidectomy, hypothyroidism symptoms, and T4-only therapy. Although T4-only therapy works for the majority, others report serious symptoms
89: 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.
88: Has anything changed in the past 50 years of treating thyroid disease? (including thyroid cancer) The answer is yes. → Dr. Leonard Wartofsky from MedStar
Thyroid replacement therapy has been around since 1891, when patients
86: Thyroid Cancer Treatment and Surgery Explained⎥Dr. Gerard Doherty from Harvard Medical School
* Imaging has increased thyroid nodule discovery.
* Following patients with small thyroid cancer ? analogous to prostate cancer. Better followed than treated.
* Tiny thyroid cancers can be defined by those nodules less than 1/4 inch in size.
* Less RAI is being used as a part of thyroid cancer treatment. This means, less need to do total thyroidectomy or thyroid lobectomy.
* Dry mouth and dry eyes are risks to doing RAI. Also, there is risk to developing a second malignancy. Most of the secondary cancers are leukemia.
* Risks to operation include changes to voice and calcium levels. Thyroid surgery is a safe operation but not risk free.
* Best question for a patient to ask is, who is my treatment team?
84: 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.
96: 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.
95: Thyroid Cancer Patients Experience Quality of Life Downgrade with Dr. Raymon Grogan and Dr. Briseis Aschebrook from the University of Chicago Medicine
“The goal of this study is to turn it into a long-term, longitudinal cohort,” said Grogan, who hopes to develop a tool that physicians can use to assess the psychological wellbeing of thyroid cancer survivors. “But, there was no way to do that with thyroid cancer because no one had ever studied quality of life or psychology of thyroid cancer before.”
93: The Results of 30 Years of Patients Receiving Active Surveillance Instead of Surgery; Dr. Akira Miyauchi from Kuma Hospital in Kobe, Japan
The result of over 1000 cases of active surveillance shows
92: Your Patient Type May Determine Your Thyroid Cancer Treatment → Dr. Michael Tuttle from Sloan Kettering
What type of patient are you, a minimalist or maximalist?
81: Recovering From Thyroid Cancer Surgery, Faster, Better, and Stronger with Evan Simon, Head Strength & Conditioning Coach at Oregon State University
In this episode, we hear from Evan Simon, Head Strength and Conditioning Coach at Oregon State University. Evan was diagnosed with advanced Stage IV thyroid cancer, which resulted a 13 hour surgery.
At the end of his surgery, Evan was told he would not be able to lift his hands overhead for 3 months, instead he broke the odds, taking him only 3 weeks.
80: Everything You Need to Know About Thyroid Nodules with Dr. Regina Castro from Mayo Clinic
60% of people in the U.S. have thyroid nodules, and
94: 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
89: 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.
84: 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.
79: 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
67: 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.
57: 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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Doctor Thyroid with Philip James