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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37: 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

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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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55: 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?

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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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61: Drug Resistant Thyroid Cancer, with Dr. Carmelo Nucera from Harvard Medical School

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). 

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60: Pregnancy and Thyroid⎥Hypothyroidism and Hyperthyroidism, with Dr. Angela Leung from UCLA

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

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53: Hypothyroidism — Diagnosis, Treatment, and Medication with Dr. Leonard Wartofsky from MedStar

Dr. Wartofsky is Professor of Medicine, Georgetown University School of Medicine and Chairman Emeritus, Department of Medicine, MedStar Washington Hospital Center.  He trained in internal medicine at Barnes Hospital, Washington University and in endocrinology with Dr. Sidney Ingbar, Harvard University Service, Thorndike Memorial Laboratory, Boston.   In this episode, Dr. Wartofsky discusses the following: * Hypothyroidism causes * When is replacement thyroid replacement hormone necessary? * The history of replacement thyroid hormone going back to 1891 * The early treatment included a chopped up sheep thyroid and served as a 'tartar', often resulting in vomiting * Myxedema coma

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65: Thyroid Cancer Does Not Respond to RAI⎢Treatment Options

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

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49: Thyroid and Pregnancy⎥Why It Matters, with Dr. Elizabeth Pearce from Boston University

In this episode, topics include: * Hypothyroidism and hyperthyroidism during pregnancy * Pregnant and without a thyroid * Avoiding T3 during pregnancy, including concerns with desiccated thyroid * If being treated for hypothyroidism already, the importance of upping dose while pregnant * Pregnant with auto-immunity * Pregnant with Graves' disease * The dangers of pregnancy and overt hypothyroidism or hyperthyroidism

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