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.

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46: Nerve Monitoring During Thyroid Surgery, with Dr. Özer Makay from Ege University – Turkey

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?

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44: Cáncer de Tiroides, con la Dra Ines Califano de Universidad de Buenos Aires

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?

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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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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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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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38: Thyroid Surgery? Be Careful, Not All Surgeons Are Equal and Here is Why with Dr. Ralph P. Tufano from Johns Hopkins School of Medicine

If you select carefully, the unwanted errors of thyroid surgery can be avoided. Dr. Ralph P. Tufano is the Director of the Division of Head and Neck Endocrine Surgery at The Johns Hopkins School of Medicine, and conducts thyroid and parathyroid surgery with a focus on optimizing outcomes. In this interview, items discussed include: * the emotional burden of being diagnosed with cancer and the haste that sometimes follows * the unnecessary damage of thyroid surgery, including the cutting of the laryngeal nerve resulting in vocal cord paralysis, low calcium levels and a need to supplement calcium and Vitamin D for life, and leaving residual disease behind * knowing your risk factor and finding the right medical team to address it

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36: 1 in 3 People Die With Thyroid Cancer — Not From with Dr. Seth Landefeld from UAB

1 in 3 People Die With Thyroid Cancer The USPSTF upholds its 1996 recommendation against screening for thyroid cancer among asymptomatic adults. The USPSTF commissioned the systematic review due to the rising incidence of thyroid cancers against a background of stable mortality, which is suggestive of over-treatment. And in view of the results, the task force concluded with “moderate certainty” that the harms outweigh the benefits of screening.

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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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