DOCTOR INTERVIEWS
Surgery
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
73: Innovaciones en el Tratamiento del Cáncer de Tiroides, con el Dr. Hernán Tala desde Santiago, Chile
Dr. Hernán Tala es endocrinólogo de la Clinica Alemana en Santiago, Chile. Su area especialidad incluye cáncer de tiroides avanzado, endocrinologia general, y enfermedades tiroides.
Los temas presentados incluyen:
* Una mejor comprensión de la biología del cáncer de tiroides, y que no todo el cáncer de tiroides es igual. La enfermedad es única en cada paciente.
* La importancia de entender el perfil del cáncer en cada paciente.
* Diagnóstico del nódulo.
* Perfil molecular del nódulo tiroideo.
* Una pausa en la exploración universal del cáncer de tiroides.
* Vigilancia activa
72: 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.
70: 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?
69: For Some Thyroid Cancer Patients, No Surgery is the Best Treatment – Dr. Allen Ho from Cedars Sinai
Undesired consequences and a patient’s profession should weigh heavily in the decision to have thyroid surgery, or not. Dr. Allen Ho is a fellowship-trained head
68: Is There a Stigma to Choosing Active Surveillance? Dr. Louise Davies from The Dartmouth Institute
The past year has been fascinating and highly fruitful year for Dartmouth Institute Associate Professor Louise Davies, MD, MS. A 2017-2018 Fulbright Global Scholar, Davis