DOCTOR INTERVIEWS
Surgery
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 no resulting deaths of patients who choose no surgery for thyroid cancer Dr. Akira Miyauchi
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? About Dr. Tuttle, in his words: I am a board-certified endocrinologist who specializes in caring for
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.