Episódios
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Innovations and Issues: from the RFAMD podcast hosted by Philip James
In recent years, a medical revolution has been quietly taking place in the treatment of thyroid conditions. Thyroid ablation, a procedure that offers an alternative to traditional surgery, is gaining popularity across the globe, particularly in the United States following its FDA approval. Dr. Giovanni Mauri , a leading interventional radiologist from Milan and recognized as one of the top 2% scientists by Stanford University, shares insights into the advancements and challenges of this transformative treatment.
The concept of thyroid ablation isn't new; Italy saw its inception 25 years ago with experimental treatments beginning in the year 2000. However, the last three years have marked a significant turn with rapid expansion and adoption of the technique worldwide. According to Dr. Mauri, this surge is largely thanks to procedural innovations and international collaborations, notably from South Korea, where specialized devices have propelled the practice forward.
Thyroid ablation works by using heat (or other methods) to destroy thyroid tissue, thus alleviating various thyroid-related conditions without the need for invasive surgery. This method preserves thyroid function and enhances patients' quality of life, a point Dr. Mauri emphasizes with great passion. The procedure is particularly appealing because it offers a quick recovery and significant reduction in health risks compared to traditional surgeries.
The technique's adoption has seen a parallel rise in educational initiatives, with training programs proliferating globally to ensure that practitioners can safely and effectively perform ablations. Dr. Mauri himself is involved in such programs, including the MIT group and the Savior Thyroid School, highlighting the importance of proper training and the use of high-quality simulation tools.
However, this rapid expansion is not without its problems. Dr. Mauri voices concerns about the steep learning curve associated with the procedure. He notes that many practitioners eager to incorporate thyroid ablation into their practice might not fully appreciate the complexities involved, particularly the critical role of ultrasound in guiding the ablation process. This can lead to suboptimal outcomes, making thorough training and patient selection paramount.
Moreover, the innovation in thyroid ablation tools has broadened, spanning from radiofrequency devices to newer, potentially more effective technologies like microwave ablation and non-thermal methods, which promise to treat without thermal damage. Such advancements underscore a dynamic field set on improving and refining therapeutic options for patients with thyroid conditions.
Yet, the allure of new technology also brings challenges. The push for rapid adoption can overshadow the necessity for comprehensive training and understanding of the intricacies involved. Stories of complications and inadequate patient selection serve as cautionary tales highlighting the need for regulatory frameworks and better educational resources for healthcare providers.
As thyroid ablation continues to grow, so does the dialogue around its practice. Dr. Mauri calls for more open discussions to explore the limits and possibilities of this technique, ensuring that it remains a safe and beneficial treatment option. Through these conversations, the medical community hopes to navigate the complexities of innovation while maintaining the highest standards of patient care.
While thyroid ablation stands as a beacon of progress in medical treatments for thyroid conditions, it requires a balanced approach of innovation, education, and ethical practice. As we look to the future, the contributions of pioneers like Dr. Mauri and ongoing global collaboration will be crucial in shaping the path forward for this promising medical advancement.
Are you an ablation doctor or searching for one?Get listed on the directory at www.rfamd.com ✅
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In a world where misinformation can spread as rapidly as legitimate data, discerning the truth becomes a critical skill—especially when it comes to our health. Dr. John Whyte, Chief Medical Officer at WebMD, shares his insights on how patients can navigate the sea of health information online to find trustworthy resources and take control of their personal health.
The Power of InformationDr. Whyte begins by emphasizing the importance of quality information, which he argues is more accessible than ever thanks to digital advancements. “Better information leads to better health,” he says, echoing WebMD’s philosophy. In the era of the internet, the adage “knowledge is power” holds particularly true in the realm of healthcare. Quality information equips patients with the power to make informed decisions about their health, turning them into advocates for their own care.
Sorting Fact from FictionThe challenge for many, Dr. Whyte notes, is the overwhelming amount of information available—an issue compounded by the rapid pace at which medical knowledge evolves. “Medical knowledge doubles about every 73 days,” he states, highlighting the difficulty for even the most diligent professionals to stay current. In this environment, patients must become their own advocates and learn to differentiate between reliable information and misleading data.
Whyte is concerned about the rise of misinformation, which can equate unverified opinions with scientific evidence. He stresses the importance of scrutinizing health information with the same rigor one might apply to financial decisions. This means considering the source’s credibility, transparency, and the replicability of the data. Reliable sites like WebMD help users navigate this by providing clearly dated and expert-reviewed content.
The Role of Technology in Personal HealthDr. Whyte is a strong proponent of using technology to enhance personal health management. From wearables that track physical activity to apps that monitor sleep and dietary habits, digital tools offer a wealth of personalized data that can lead to healthier lifestyle choices. He shares his personal experiences with biohacking gadgets like Lumen, a device that measures metabolic fuel use, to illustrate how specific tools can help tailor health strategies to individual needs.
DIY Health: A Blessing and a CurseThe abundance of health-related information and tools can empower patients but also overwhelm them. Dr. Whyte calls this the “DIY approach” to health, where individuals take on the role of managing their own care without sufficient medical guidance. While he champions the use of technology, he cautions against its pitfalls, particularly when individuals rely too heavily on unvalidated sources or misinterpret the data.
The Future of Health InformationLooking ahead, Dr. Whyte is optimistic about the potential of AI and machine learning to transform healthcare. He envisions a future where AI can provide empathetic, accurate support that complements traditional healthcare services. However, he acknowledges that the technology is not yet perfect and emphasizes the importance of continuing to refine these tools to avoid the spread of “hallucinated” misinformation.
Empowering Patients Through Trustworthy ResourcesIn conclusion, Dr. John Whyte advocates for a balanced approach to digital health information. By critically evaluating sources, utilizing technological tools judiciously, and always seeking professional advice when necessary, patients can take charge of their health confidently and safely. In an age where information is both a resource and a hazard, being a discerning consumer is perhaps the most important skill of all.
Dr. John Whyte is the Chief Medical Officer at WebMD, where he leverages his extensive background in both medicine and public health policy to enhance healthcare information accessibility and accuracy for the public. A passionate advocate for consumer-centered healthcare, Dr. Whyte is dedicated to empowering individuals with reliable and actionable health data. With a medical degree from the University of Pennsylvania School of Medicine and a master’s degree in public health from Harvard, he has served in leadership roles at the Food and Drug Administration and Discovery Channel Global Education Partnership, among others. Dr. Whyte is a prolific author and speaker, focused on improving patient education and health outcomes through innovation in digital health and media.
FIND MORE INFO ABOUT THYROID ABLATION, CLICK HERE
Are you an ablation doctor or searching for one?Get listed on the directory at www.rfamd.com ✅
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
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Durante una entrevista detallada en el podcast RFAMD, el anfitrión Philip James conversó con la Dra. Ana Voogd, una distinguida cirujana de cabeza y cuello con más de 30 años de experiencia, sobre la integración gradual de la terapia de ablación tiroidea en el panorama médico de Argentina.
La Dra. Voogd, que dirige el departamento de cirugía de cabeza y cuello en uno de los hospitales más grandes de Argentina, proporcionó perspectivas valiosas sobre el enfoque evolutivo del país hacia el cuidado del tiroides.
Un Paso Hacia Procedimientos Menos InvasivosLa Dra. Voogd explicó la ablación tiroidea en términos sencillos, destacando su carácter no quirúrgico y percutáneo, que utiliza agujas para crear necrosis dentro de los nódulos tiroideos. Este proceso detiene efectivamente el crecimiento del nódulo y mejora los síntomas sin necesidad de cirugía, marcando un avance significativo en la mejora de la calidad de vida del paciente y en la preservación de la glándula tiroidea.
A la Par con los Estándares InternacionalesLa adopción de técnicas de ablación tiroidea en Argentina, que han sido utilizadas durante décadas en países como Corea del Sur e Italia, es relativamente reciente. La Dra. Voogd señaló la llegada de equipos especializados para la ablación por radiofrecuencia hace dos o tres años como un punto de inflexión, lo que permitió a los proveedores de atención médica locales ofrecer este tratamiento. Aunque Argentina está poniéndose al día, la introducción de esta tecnología ha sido recibida con entusiasmo tanto por los profesionales médicos como por los pacientes, ofreciendo una opción no quirúrgica para tratar los nódulos tiroideos y, en algunos casos, el cáncer de tiroides.
Desafíos de Acceso y AsequibilidadLa conversación con la Dra. Voogd también abordó los desafíos de acceder a la ablación tiroidea en Argentina, donde la disponibilidad del procedimiento varía significativamente entre los sectores de salud pública y privada. En el sector público, la ablación tiroidea no es ampliamente aceptada, mientras que el sector privado ofrece más flexibilidad pero con costos variables. La Dra. Voogd señaló que, aunque el costo del procedimiento está influenciado por el precio de consumibles como las agujas, sigue siendo comparable a los precios internacionales, haciéndolo accesible para aquellos con seguro adecuado o los medios financieros para la atención privada.
Resultados Alentadores y Alta Satisfacción del PacienteLa Dra. Voogd compartió sus experiencias positivas con la ablación tiroidea, mencionando el tratamiento de más de 100 nódulos con reducciones notables en tamaño y alivio de síntomas. Estos resultados sugieren que la ablación tiroidea podría cambiar significativamente el paisaje del tratamiento tiroideo en Argentina, ofreciendo una alternativa efectiva a la cirugía convencional.
Una Perspectiva Más Amplia y Perspectivas FuturasAl concluir la entrevista, la Dra. Voogd enfatizó la importancia de crear conciencia sobre la ablación tiroidea entre los pacientes con nódulos tiroideos. Animó a los pacientes a considerar esta opción de tratamiento innovadora, que permite un rápido retorno a las actividades diarias, sin cicatrices visibles y con mínimas molestias post-procedimiento. Destacó un caso particularmente memorable de un paciente que experimentó una mejora significativa después de años de sufrimiento, ilustrando el profundo impacto de la ablación tiroidea en la vida de los individuos.
En resumen, las perspectivas compartidas por la Dra. Ana Voogd en el podcast RFAMD iluminan el abrazo gradual de Argentina hacia la ablación tiroidea como opción de tratamiento. Este cambio hacia métodos menos invasivos representa un desarrollo significativo en el sistema de atención médica del país, ofreciendo resultados de tratamiento mejorados y mejorando la calidad de vida para los pacientes con condiciones tiroideas.
FIND MORE INFO ABOUT THYROID ABLATION, CLICK HERE
Are you an ablation doctor or searching for one?Get listed on the directory at www.rfamd.com ✅
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
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As the medical community swiftly embraces thyroid ablation, a groundbreaking non-surgical treatment for thyroid nodules, concerns arise about the potential risks associated with its rapid adoption. Key among these concerns is the lack of ultrasound expertise among practitioners and the contentious decision to treat nodules that may be too small to warrant intervention. This article delves into the insights of Dr. Jagdish Dhingra, a seasoned thyroid surgeon, who highlights the crucial balance between leveraging medical innovations and ensuring patient safety through skilled application and judicious treatment decisions.
In the rapidly evolving field of medical treatments, thyroid ablation stands out as a significant advancement, offering a non-surgical option for patients with thyroid nodules. However, the quick adoption of this technique across the United States has raised concerns among experts about its application and the potential risks involved. In a recent interview on the RFAMD podcast, hosted by Philip James, Dr. Jagdish Dhingra, a seasoned thyroid surgeon with over 25 years of experience, shared his insights on the dangers of the rapid embrace of thyroid ablation and the critical importance of skilled ultrasound technique in its success.
Goodwill missions to AfricaDr. Dhingra, known for his extensive work and goodwill missions in Africa, particularly Rwanda, where he volunteers to perform surgeries on women affected by large goiters, emphasizes the need for caution. His annual trips to Africa highlight his commitment to addressing thyroid-related conditions and his expertise in managing complex cases.
Goiter in ColombiaThe conversation also touched upon the impressive work of Dr. Juan Pablo Dueñas in Medellín, Colombia, who successfully treated a patient with a very large goiter using ablation. This case exemplifies the potential of thyroid ablation when applied correctly and with the requisite skill.
Dangers of thyroid ablation and ultrasoundHowever, Dr. Dhingra pointed out the significant risks associated with the procedure, especially when used for nodules that are too small or by practitioners lacking in precise ultrasound-guided techniques. He warned against the treatment of small, benign thyroid nodules with ablation, arguing that observation rather than intervention is often the best approach in such cases. The risks, including major vessel and nerve injury, are heightened in the absence of expertise in ultrasound guidance.
The expertise required for safe and effective thyroid ablation extends beyond surgical skills, involving proficiency in ultrasound to avoid damaging vital neck structures. This underscores the importance of comprehensive training and experience in both ultrasound and surgery for those performing thyroid ablations.
Thyroid ablation guidelinesAs thyroid ablation gains popularity, Dr. Dhingra advocates for establishing and adhering to strict guidelines to ensure patient safety. These guidelines would ideally include rigorous training and qualification criteria for practitioners, akin to the well-defined protocols followed in countries like South Korea, which has successfully integrated thyroid ablation into their healthcare system.
How to find a thyroid ablation doctor?For patients considering thyroid ablation, finding a qualified and experienced practitioner is crucial. Dr. Dhingra suggests visiting www.rfamd.com, a resource that can help patients connect with skilled ablation doctors. This platform provides an avenue for patients to seek treatment from professionals who are not only proficient in ultrasound-guided procedures but also have a thorough understanding of when ablation is appropriate.
The rapid adoption of thyroid ablation in the United States represents a double-edged sword; it’s a promising treatment that can significantly benefit patients when applied judiciously and with the proper expertise. However, without careful consideration of the risks and strict adherence to guidelines, its potential benefits could be overshadowed by adverse outcomes. As the medical community continues to embrace this innovative treatment, the emphasis must remain on patient safety, thorough practitioner training, and the judicious application of thyroid ablation.
FIND MORE INFO ABOUT THYROID ABLATION, CLICK HERE
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
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In an enlightening episode of the RFAMD podcast, hosted by Philip James, Dr. Emad Kandil from Tulane University casts a new light on the treatment of thyroid conditions, challenging conventional surgical approaches and advocating for the pioneering method of thyroid ablation. This interview not only delves into Dr. Kandil’s personal journey into medicine but also explores the evolving landscape of thyroid treatment, highlighting the potential benefits of ablation over traditional surgery.
Personal Journey to MedicineThe episode begins with a personal anecdote from Dr. Kandil, tracing his initial passion for mathematics and critical thinking to a pivotal moment in his youth involving his brother’s seizure. This incident, occurring in his native Egypt, steered him away from engineering towards a career in medicine, driven by a newfound desire to make a tangible impact on people’s lives.
Thyroid Ablation: A Minimally Invasive AlternativeWith thousands of thyroid surgeries under his belt, Dr. Kandil is not your typical advocate against surgery. However, his pioneering work in thyroid ablation in the United States, with nearly a thousand procedures to his credit, positions him uniquely in this field. Thyroid ablation, he explains, is increasingly being used to treat a variety of thyroid conditions, ranging from benign nodules to certain thyroid cancers, offering a less invasive option with fewer complications and a lesser impact on patients’ quality of life.
Challenges in Adopting New Medical TechniquesThe conversation takes a critical turn as Dr. Kandil addresses the challenges in the widespread adoption of thyroid ablation. He emphasizes the need for proper training and expertise among physicians to prevent complications. His concerns extend to the rapid expansion of training programs, warning against unqualified practitioners who might cause more harm than good.
Patient-Centric Approach and RecoveryDr. Kandil also sheds light on the patient experience during and after thyroid ablation. He notes that most procedures are performed under local anesthesia, with some patients preferring sedation. The recovery is notably swift, with many patients able to leave the same day, which is a significant advantage over traditional surgery.
Navigating the Healthcare SystemA significant portion of the interview is dedicated to discussing the cost of thyroid ablation in the United States and the challenges patients face due to the lack of insurance coverage for this new procedure. Dr. Kandil stresses the importance of patient education and advocacy, urging patients to thoroughly research their options and seek second opinions.
Looking Towards the FutureIn his concluding remarks, Dr. Kandil reflects on the future of thyroid treatment. He envisions a shift towards fewer surgeries, enhanced by advancing technologies and precision techniques. His message is clear: the medical community must adapt to new, less invasive methods that prioritize patient well-being and quality of life. Dr. Emad Kandil’s interview with Philip James marks a significant step in bringing attention to thyroid ablation as a viable alternative to surgery. His insights and personal journey serve as a beacon for both medical professionals and patients navigating the complex world of thyroid treatment. As this method gains traction, it promises to reshape the landscape of thyroid care, prioritizing minimally invasive procedures that offer better outcomes and improved quality of life for patients.
Are you an ablation doctor or searching for one?Get listed on the directory at www.rfamd.com ✅
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
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Pioneering the Future of Thyroid Care: A Conversation with Dr. Julia Noel
Palo Alto, CA — In a recent episode of the RFAMD podcast, host Philip James welcomed a trailblazer in the field of thyroid treatment, Dr. Julia Noel of Stanford University School of Medicine. Known for her pioneering work in thyroid ablation, Dr. Noel shared insights on the evolving landscape of thyroid care, emphasizing innovative ablation technologies that are reshaping patient experiences.
From Mathematics to MedicineDr. Noel’s journey into the medical field was not typical. Initially drawn to mathematics, inspired by her father, she found her calling in surgery, where she could blend problem-solving skills with a hands-on approach. This unique blend of analytical thinking and surgical precision has defined her career.
Ablation Over Surgery: A Paradigm ShiftCentral to Dr. Noel’s practice is thyroid ablation, a technique that offers an alternative to traditional surgery. With over thousands of surgeries to her credit, she has been a vocal advocate for techniques like radiofrequency, ethanol, and microwave ablation. These methods, she notes, are crucial in reducing the need for invasive procedures, preserving thyroid function, and improving quality of life.
The Technology at the ForefrontDuring the interview, Dr. Noel highlighted the rapid advancement in ablation technology. She pointed out that while radiofrequency ablation is currently the most user-friendly and researched method, emerging technologies promise even more groundbreaking developments. These future techniques may not even rely on heat generation, opening new avenues for treatment.
Navigating the RisksWith any medical procedure come risks, and thyroid ablation is no exception. Dr. Noel candidly discussed potential complications like voice changes, discomfort, and nodal rupture. However, she reassured that most of these risks are minor and reversible, underlining the importance of skilled execution and patient awareness.
A Surge in Patient EducationAn interesting aspect of Dr. Noel’s work is her approach to patient education and outreach, particularly through social media. She stressed the importance of accurate, high-quality information in guiding both patients and physicians, acknowledging the growing role of digital platforms in patient advocacy.
Challenges in Training and StandardizationAs thyroid ablation gains popularity, Dr. Noel emphasized the need for standardized training and guidelines. She expressed concern over the “Wild Wild West” atmosphere as more doctors seek to learn these techniques, underscoring the need for cautious and well-guided adoption of the technology.
The Cost FactorAddressing the practical aspects of thyroid ablation, Dr. Noel spoke about the variability in insurance coverage and costs in the United States. She noted that while some patients on the West Coast enjoy substantial coverage, others face significant out-of-pocket expenses, highlighting the need for broader insurance acceptance.
Looking to the FutureDr. Noel’s vision for the future of thyroid treatment is one of optimism, contingent on the acceptance of new medical codes and continued technological innovation. She sees a world where thyroid nodules and cancer are treated more efficiently and less invasively, a testament to the dynamic nature of medical progress.
Dr. Julia Noel’s interview on the RFAMD podcast provides a compelling look into the future of thyroid care. Her dedication to advancing treatment options, patient education, and the safe adoption of new technologies sets a benchmark in the field of thyroid health. As these technologies evolve, Dr. Noel’s insights offer a valuable perspective on the potential for improved patient care and the importance of informed medical choices.
Are you an ablation doctor or searching for one?Get listed on the directory at www.rfamd.com ✅
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
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Thyroid Ablation: A Game-Changer in Preserving Quality of Life
www.rfamd.com
Thyroid disorders, particularly those requiring surgery, have long been a concern for patients due to the potential lifelong dependence on medication and associated quality of life changes. However, a significant shift is occurring in thyroid treatment with the advent of thyroid ablation, a technique that is rapidly gaining preference among patients and physicians alike.
The Rise of Thyroid AblationIn a recent podcast interview on RFAMD, Dr. Erivelto Volpi, a renowned head and neck surgeon from São Paulo, Brazil, shared his extensive experience in thyroid ablation. Dr. Volpi, who has performed around 8,000 thyroid surgeries and 400 thyroid ablations in over 35 years, notes the growing trend towards thyroid ablation. He attributes this shift primarily to the preservation of the patient’s quality of life, a crucial factor often overshadowed in traditional surgical approaches.
Why Patients Prefer Thyroid AblationDr. Volpi explains that most patients seeking thyroid ablation do so not just to avoid surgery but to maintain their quality of life. They fear the changes that lifelong medication post-surgery might bring, having seen friends or family struggle with hormone replacements. Thyroid ablation, which involves radiofrequency or microwave treatment, offers an effective alternative. It shrinks benign thyroid nodules and even treats initial cancers, preserving thyroid function and thus the patient’s pre-existing quality of life.
The Global Perspective and AcceptanceThyroid ablation is not just a localized phenomenon. Dr. Volpi highlights its rapid adoption worldwide, with countries like South Korea, Brazil, Italy, France, Spain, Turkey, and Egypt leading in this practice. This global acceptance is partly due to patient advocacy and the internet, which have empowered patients to seek the best treatment options, often traveling across borders to access this care.
The Procedure and Its BenefitsCompared to conventional surgery, thyroid ablation is minimally invasive, with fewer complications like voice changes. Recovery is swift, often within 24 to 48 hours, significantly quicker than traditional surgery. This aspect further reinforces its preference among patients.
Are you an ablation doctor or searching for one?Get listed on the directory at www.rfamd.com ✅
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
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FIND A THYROID ABLATION DOCTOR at www.rfamd.com FOLLOW @DoctorThyroid #thyroid #thyroidcancer #ultrasound
Introduction
⦿ Host: Welcome by the host of the RFAMD podcast.
⦿ Guest: Introduction of Dr. Giovanni Mauri, a medical professional from Milan, Italy.
Dr. Mauri's Journey into Medicine
⦿ Childhood Influence: Inspired by his father, a radiologist.
⦿ Career Choice: Fascination with radiology and interventional radiology.
⦿ Family Background: His father worked in diagnostic radiology in an oncological hospital.
History of Ablation in Italy
⦿ Early Adoption: Discussion of pioneers in ablation treatments in Italy, starting in the 1980s.
⦿ Development: The evolution of ablation techniques, from ethanol ablation for liver cancers to radiofrequency ablation.
Dr. Mauri's Specialization
⦿ Scope of Ablation: Treating various cancers (liver, kidney, lung, bone, soft tissues) with thermal ablation.
⦿ Focus on Thyroid Ablation: Special emphasis on treating both benign and malignant thyroid diseases.
Patient Success Stories
⦿ Personal Case: A female patient treated multiple times for lymph node metastasis, avoiding further surgery.
⦿ Impact on Patients: Emphasizing the success and life-changing effects of successful thyroid ablation treatments.
Thyroid Surgery vs. Ablation
⦿ Patient Perspective: Benefits in terms of invasiveness and future hormonal treatment.
⦿ Medical Community: Surgeons appreciating the option of ablation to manage resources and time effectively.
Global Trends in Thyroid Ablation
⦿ FDA Approval: The significant impact of FDA approval in the U.S. in 2018.
⦿ Rapid Growth: Thyroid ablation as the fastest-growing field in ablation treatments worldwide.
Dangers of Rapid Growth
⦿ Training and Expertise: Emphasizing the necessity of proper training and the risks posed by inexperienced practitioners.
⦿ Comparison of Techniques: Differences between traditional surgery and ultrasound-guided ablation procedures.
Pioneers in Thyroid Ablation
⦿ Innovations: Introduction of specifically designed needles and techniques in Korea and Italy. ⦿ Global Adoption: The spread of thyroid ablation practices to countries like South America, North America, and Europe.
Risks of Thyroid Ablation
⦿ Medical Risks: Potential damages during the procedure, such as bleeding or nerve damage.
⦿ Technical Challenges: Importance of ultrasound skills and adjunctive techniques to minimize risks.
Risks of Thyroid Ablation
⦿ Medical Risks: Potential damages during the procedure, such as bleeding or nerve damage.
⦿ Technical Challenges: Importance of ultrasound skills and adjunctive techniques to minimize risks.
Unsuccessful Cases
⦿ Benign Nodules: Rare unsuccessful cases, often due to initial under-treatment.
⦿ Malignant Tumors: Possibility of incomplete ablation, with options for re-treatment.
Selecting the Right Provider
⦿ Criteria for Choosing: Experience of the physician, ideally in a hospital setting for beginners.
⦿ Importance of Supervision: Emphasis on proper environment and supervision for new practitioners.
Addressing Skepticism
⦿ Literature and Communication: Using scientific evidence and open discussions to address concerns.
⦿ Surgical Alternatives: Emphasizing ablation as a reversible option compared to definitive surgery.
Types of Ablation
⦿ Radiofrequency vs. Microwave: Discussion on the advantages and risks of each type in thyroid treatments.
Guidelines and Clinical Experience
⦿ Lag in Guidelines: The delay in incorporating new treatments like ablation into official guidelines.
⦿ Individualized Treatment: Tailoring treatment options based on clinical experience, despite guidelines.
Guidelines and Clinical Experience
⦿ Lag in Guidelines: The delay in incorporating new treatments like ablation into official guidelines.
⦿ Individualized Treatment: Tailoring treatment options based on clinical experience, despite guidelines.
Patient Perception and Decision Making
⦿ Overdiagnosis and Overtreatment: Addressing the issue of overdiagnosis in thyroid cancer and the role of minimally invasive treatments.
⦿ Patient Preferences: Understanding patient choices in treatment options, including active surveillance.
Second Opinions and Treatment Choices
⦿ Changing Treatment Plans: Cases where patients change their mind after seeking a second opinion.
⦿ Informed Decision Making: The importance of providing comprehensive information to patients.
Innovations in Thyroid Treatment
⦿ New Technologies: Exploring new treatments like embolization, expanding the scope of minimally invasive procedures.
Conclusion and Rapid Fire Questions
⦿ Future of Thyroid Treatment: Predictions about the shift towards ablation in the next decade.
⦿ Importance of Communication: The crucial role of clear communication in discussing cancer treatments with patients.
For podcast inquiries or if you would like to be a guest. Contact: [email protected]
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. In the world of medicine, it’s not uncommon for patients to feel overwhelmed and uncertain when faced with a diagnosis that requires surgery. For Peter Miller, a 64-year-old man from the UK, this was certainly the case when he was diagnosed with thyroid goiter. Three specialists recommended thyroidectomy as the only viable treatment option, but Peter was hesitant to undergo such a procedure due to the potential risks and complications associated with it.
Fortunately, Peter took matters into his own hands and conducted his own research, which led him to an alternative treatment option – Radiofrequency Ablation (RFA). Through an article written by Philip James and the Philip James YouTube channel, Peter discovered Dr. Roberto Valcavi, an Appalachian doctor in Italy, who had experience performing the RFA procedure.
After discussing his options with Dr. Valcavi via email and video consultation, Peter underwent the RFA procedure in Italy. The results were remarkable – Peter experienced significant improvement in his symptoms, and he was happy to have avoided surgery.
Peter’s story highlights the importance of being an advocate for your own health and well-being. Conducting research, seeking second opinions, and exploring all treatment options are crucial steps in making informed medical decisions. Peter’s success with RFA also underscores the importance of raising awareness about this non-surgical treatment option.
Despite its efficacy, RFA is not widely available in many countries, and healthcare professionals may not be aware of it as a treatment option for thyroid goiter. It is crucial to raise awareness about RFA so that patients have access to all viable treatment options.
Peter’s experience with RFA serves as an inspiration for patients who may be hesitant to undergo surgery for thyroid goiter. Being your own advocate, doing research, and exploring all treatment options can lead to better health outcomes. And with the help of knowledgeable medical professionals like Dr. Valcavi, patients can find the right treatment option that works best for them.
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About Dr. Roberto ValcaviRoberto Valcavi MD, FACE, ECNU is specialist in Endocrinology and specialist in Internal Medicine. 20 years and 1800+ RFA procedures done; laser since 2000 and radiofrequency ablation starting in 2010.
At present, Dr. Roberto Valcavi is Director of the E.T.C. (Endocrine & Thyroid Clinic) in Reggio Emilia, Italy, dedicated to the diagnosis and therapy of endocrine neck (thyroid, parathyroid, lymph nodes) benign and malignant lesions.
He is specialized in ultrasound- guided ablative therapy of thyroid nodules by radio frequency (RFA), minimally invasive surgery that is able to effectively treat more than 90 % of benign thyroid nodules and over 80 % of malignant thyroid nodules, saving the thyroid gland.
View Full Profile: Dr. Roberto Valcavi
About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
LinkedInContent on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. In this interview, Dr. Giovanni Mauri, an interventional radiologist specializing in ablation for the treatment of various conditions including thyroid cancer, shares his insights with Philip James on the Doctor Thyroid and RFAMD podcasts.
Dr. Mauri highlights one of the recent advancements in the field of ablation – the possibility of treating small thyroid cancers (up to one or two centimeters) without surgery. This innovative approach allows for the complete treatment of the cancer while preserving the thyroid gland.
He advises every patient diagnosed with thyroid cancer to be aware that ablation is a valid treatment option. He emphasizes the importance for both physicians and patients to know that this option exists, and encourages patients to seek advice about the possibility of being treated by ablation instead of surgery.
The interview concludes with Dr. Mauri extending an invitation for anyone with doubts about this procedure to reach out to him. His contact information is available in the episode description for those interested in learning more about treating thyroid cancer with ablation.
The discussion provides a fresh perspective on thyroid cancer treatment, focusing on non-surgical options and the potential benefits of ablation. The interview wraps up with a farewell from Italy.
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
LinkedInContent on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. In a comprehensive interview conducted by Philip James from the RFAMD and Doctor Thyroid podcasts, Dr. Greg Randolph from Harvard Medical School shares his insights on patient-centered approaches for treating thyroid nodules. The interview focuses on thyroid ablation, a procedure that treats thyroid nodules without surgery.
Dr. Randolph emphasizes the importance of not only measuring the volumetric reduction of the nodule after ablation but also considering patient-reported outcomes. These outcomes include the patient’s perception of the nodule, such as whether they still have a lump sensation in their neck or a visible lump. Despite the successful reduction of the nodule size on ultrasound, the patient may still perceive a visual or physical presence, thus it’s critical to include what’s meaningful for the patient in the outcomes.
He also discusses the importance of understanding a patient’s concerns and expectations. Whether it’s a benign nodule or a low-stage malignancy, each patient will have their own concerns and priorities. Some may fear the potential of a hidden cancer while others may be apprehensive about surgical procedures. Hence, the treatment decision should be apparent after a thorough discussion of the patient’s preferences and the medical realities.
Lastly, he stresses the importance of physicians offering a variety of treatment options. For benign nodules or small cancers, patients should have the option to select from different rational treatments. Dr. Randolph also advocates for spending adequate time with the patient, allowing them to ask questions and make informed decisions.
This patient-centered approach fosters a less paternalistic, more collaborative physician-patient relationship, ensuring that the patient’s desires and concerns are addressed during the treatment process.
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About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
LinkedInContent on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. We recently had the unique opportunity to converse with esteemed Dr. Erivelto Volpi from Brazil at the Thyroid Ablation Conference held in Italy.
As an authority on thyroid treatments, he took the time to share his insights and valuable experience with us. Just a week before, we had caught up with him at the World Congress on Thyroid Cancer in London, and we were delighted to sit down with him again.
The conference presented a golden opportunity for specialists from around the globe to converge, exchange thoughts, and learn from the experts in the field. One area that stood out more than ever at this conference was the exploration of thyroid cancer treatment with ablation. Dr. Volpi explained, “it is a new field, and in selected patients, we can offer the opportunity to avoid surgery using thermal ablations technologies.”
Dr. Volpi emphasized that it is crucial to understand that ablation is indeed a viable option for treating thyroid cancer. However, patient selection plays an integral role in determining its effectiveness. “Usually, nodules up to one centimeter located inside the thyroid parenchyma are considered suitable cases. The results in terms of the treatment outcomes are exactly the same as those from a conventional surgery,” he noted.
Brazil has been at the forefront of using ablation as a treatment option for thyroid nodules for over a decade. As this methodology is now gaining momentum globally, including in the U.S. and countries like Indonesia, Dr. Volpi offers lessons from Brazil’s experience.
His key piece of advice for doctors new to this treatment method is to begin with benign and small-sized nodules. “When you start to do RFA (Radiofrequency Ablation), always start with benign nodules and not so huge nodules. For patients with cosmetic or symptomatic nodules, RFA is a very good option when starting your learning curve,” he advises. This strategy, he believes, will be beneficial not just for patients, but also for doctors who are beginning to learn this procedure.
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About Dr. Erivelto VolpiDr. Erivelto Volpi é um Cirurgião de Cabeça e Pescoço, especialista em doenças da tireoide e da paratireoide.
Dr. Erivelto Volpi teve toda seu treinamento no Hospital das Clínicas da Universidade de São Paulo, onde permanceu por 30 anos, 4 anos como médico residente em Cirurgia Geral e Cirurgia de Cabeça e Pescoçoe 26 anos como médico do Serviço de Cirurgia de Cabeça e Pescoço, onde atuou no atendimento e cirurgias de pacientes e no treinamento de médicos residentes e estagiários, além da formação de alunos de graduação e pós-graduação.
Sua tese de Doutorado em 2011 foi sobre segurança em cirurgia de tireoide, especificamente na monitorização neuro-fisiológica intra-operatória dos nervos laríngeos (responsáveis pela movimentação das cordas vocais).
Dr. Volpi sempre esteve interessado em tratamentos minimamente invasivos, sendo um dos pioneiros no Brasil na realização de Tireoidectomias Minimamente Invasivas (MIVAT), tendo feito seu treinamento na Universidade de Pisa com o Dr. Paolo Miccoli.
Sempre preocupado em oferecer o melhor aos seus pacientes, Dr. Volpi em 2018 realizou seu treinamento em Ablação por Radiofrequência em Seoul, na Coréia do Sul com o Prof. Baek, o desenvolvedor da técnica de Ablação por Radiofrequência (RFA).
Retornando ao país, foi um dos primeiros médicos a realizar o procedimento, deste então tem tratado pacientes de todo o Brasil e da América do Sul, além de ter uma das maiores experiências da América Latina neste tratamento, hoje Dr. Volpi é responsável por um curso de treinamento em RFA, tendo já treinado médicos do Brasil, América Latina e EUA.View Full Profile: Dr. Erivelto Volpi
About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.
LinkedInContent on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. A recent interview from the TNT conference on thyroid ablation in Italy, Philip James of the Doctor Thyroid and RFAMD podcasts had a one-on-one discussion with Dr. Catherine Sinclair, a seasoned head and neck surgeon from Melbourne, Australia. Having served at Mount Sinai in New York for 11 years before relocating back to Melbourne in 2021, Dr. Sinclair offers a unique perspective and extensive expertise in thyroid surgery and laryngology.
The Importance of Nerve Protection
As a specialist who’s invested in both head and neck surgery and the voice box, Dr. Sinclair developed a keen interest in thyroid surgery due to the significant risks it presents to the vocal nerves during thyroid procedures, including during ablation. The laryngeal nerves, in particular, tend to be the patients’ greatest concern during thyroid procedures due to the potential damage they might sustain.
Many patients seeking Dr. Sinclair’s services are often singers or professional voice users who want to avoid surgery out of fear for their vocal nerves. As such, they prefer ablation. However, as she explains, it is crucial that they understand the risks to the laryngeal nerves and other vital structures in the area and the strategies used to mitigate these risks during ablation.
Limitations in Nerve Monitoring
In surgery, nerve monitoring is employed to keep track of and protect the nerves. But with ablation, patients are usually awake, which means the conventional nerve monitoring technology can’t be used. This presents a significant area of research on how to protect the nerves when the patient is conscious.
Dr. Sinclair emphasizes that though the risk is slightly lessened with surgery, it still exists. To counter this, specific strategies are used to minimize potential damage, but it’s never a guarantee that no injuries will occur.
Patients’ Preparedness and Awareness
Patients must ask about the surgeon’s experience, the number of ablations performed, and any potential complications that they should worry about. The more experienced the surgeon, the less likely there are to be complications of any kind, nerve injury included.
Contrary to some patients’ assumptions, nerve monitoring isn’t used in ablation since it requires general anesthesia. Early in her ablation experience, Dr. Sinclair used nerve monitoring on patients under general anesthesia. This procedure showed that nerve potentials remain stable as long as lower energy is used at the back of the thyroid gland where the nerves run. Furthermore, by minimizing time spent in the critical zones, nerve injury can be mostly prevented.
Real-time Vocal Assessment
During ablation, Dr. Sinclair often asks her patients to count in a monotone. This simple technique allows her to detect any changes in the voice, a potential indicator of nerve damage due to heat during the procedure. According to her, this method has helped prevent nerve issues.
State of Thyroid Ablation in Australia
Until recently, Dr. Sinclair was the only one performing thyroid ablations in Australia. Now, a colleague has started doing them in Western Australia. However, given the demand and the country’s size, she anticipates more physicians will adopt this procedure. Her main concern is ensuring that it’s done safely, with physicians possessing good ultrasound skills, interventional biopsy skills, and comprehensive knowledge of neck anatomy.
Final Thoughts
Dr. Sinclair’s parting advice to those considering thyroid ablation or thyroidectomy is to have realistic expectations. They should understand that injuries can happen despite the best precautions. However, the experience of the proceduralist can help lessen complications, and there are strategies to reduce the likelihood of nerve damage. Patients should also be well-informed and know what questions to ask their proceduralist before opting for ablation.
Interested parties can reach Dr. Sinclair by email at [email protected]. She encourages inquiries from both domestic and international individuals.
About Philip JamesAs the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.
Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society. LinkedIn
Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. In a recent episode of the Doctor Thyroid and RFAMD podcasts, Dr. Vaninder Dhillon, an esteemed laryngologist and ENT surgeon from Johns Hopkins, highlighted the critical issue of voice and swallow risks associated with thyroidectomy and thyroid ablation.
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@JohnsHopkinsMedicineThe interview sheds light on the importance of preserving the voice and offered insights into innovative approaches to avoid surgery.
Dr. Dhillon, who has extensive experience in both laryngology and endocrine head and neck surgery, underscored the significance of the voice and swallow outcomes in patients undergoing these procedures. Her research and clinical practice focus on improving outcomes and quality of life for patients who may face post-operative issues with their voice and swallow, as well as those with general voice and swallow complaints.
One of the most common complications after thyroid surgery is vocal cord paralysis, which can have a significant impact on a patient's voice. While the overall percentage of patients experiencing voice issues after thyroidectomy varies, it can be as high as 30 to 50 percent, with temporary paralysis affecting up to 15 percent. Although permanent paralysis is rarer (1-2 percent), it remains a concern for patients.
During the interview, Dr. Dhillon emphasized the importance of differentiating between voice and swallowing outcomes, as the latter is often overlooked. Swallowing complaints are higher than voice complaints, with some studies showing up to 60 percent of patients experiencing temporary swallowing issues post-operatively.
Voice and swallow assessments are crucial before and after surgery. Dr. Dhillon stressed the need for a comprehensive evaluation, including endoscopy and video stroboscopy, to examine the larynx more closely during speech. These assessments help in identifying potential issues with the recurrent laryngeal nerve and the superior laryngeal nerve.
Dr. Dhillon's team has implemented voice and swallow tests before surgery, and they continue to monitor patients post-operatively to ensure any issues are addressed promptly. This proactive approach helps patients feel more confident and informed about the potential risks to their voice and swallow function.
The conversation also discussed the rise of radiofrequency ablation (RFA) as an alternative to surgery. RFA is a minimally invasive technology for treating thyroid nodules and thyroid cancers. While RFA has a lower risk of voice and swallow complications than surgery, Dr. Dhillon stressed the importance of a thorough pre-RFA laryngeal exam to ensure optimal outcomes.
However, Dr. Dhillon acknowledged that more research is needed to fully understand the potential voice and swallow risks associated with RFA. Standardized protocols and patient-reported outcomes can be vital in evaluating these risks and ensuring patient safety during the procedure.
Dr. Vaninder Dhillon highlighted the importance of safeguarding the voice and swallow function in thyroid surgery and ablation. By proactively evaluating and addressing potential complications, patients can make informed decisions and seek appropriate interventions to protect their vocal and swallowing abilities. The ongoing research and innovative approaches in this field offer hope for improved outcomes and a better quality of life for those affected by thyroid conditions.
About Dr. Vaninder DhillonAssistant Professor of Otolaryngology – Head and Neck Surgery
Vaninder “Vinny” K. Dhillon, M.D., is an assistant professor of otolaryngology – head and neck surgery at Johns Hopkins University School of Medicine, specializing in both children and adults. She practices out of Johns Hopkins Otolaryngology – Head and Neck Surgery in Bethesda, Maryland. Dr. Dhillon is also affiliated with Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center in Baltimore, Maryland, as well as Sibley Memorial Hospital in Washington, D.C.
Dr. Dhillon has an expertise in endocrine surgery, laryngology, otolaryngology, parathyroid diseases and surgery, swallowing disorders, thyroid diseases and surgery, and voice problems.
Dr. Dhillon earned her medical degree from Keck School of Medicine of University of Southern California. She completed a residency in otolaryngology at Los Angeles County and University of Southern California Medical Center.
View Full Profile: https://www.rfamd.com/vaninder-dhillon/
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About Philip JamesIn 2013, his laryngeal nerve was severed, shoulder nerve damaged, parathyroids ruined, and residual cancer left behind — all for a 1 cm thyroid nodule.
Later, a vocal cord implant was inserted to help him speak.The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others.
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September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it.
In recent years, innovative methods in thyroid cancer management have drastically changed the field, and potentially the future of cancer treatments overall. A thought-provoking revelation comes from a discussion held at the World Congress on Thyroid Cancer in London, where a paradigm-shifting concept was discussed by two highly respected figures in the field.Dr. Akira Miyauchi of Kuma Hospital in Kobe, Japan, and Dr. Michael Tuttle from Sloan Kettering Cancer Center, New York, unveiled a practice that goes against traditional medical protocol: favoring active surveillance over immediate surgery in managing papillary thyroid cancer. The method has been utilized at Kuma Hospital for 30 years, and in this time, not one patient has died from this type of cancer. This groundbreaking revelation was discussed in a live interview hosted by Philip James of the Doctor Thyroid podcast.
According to Dr. Miyauchi, the original proposal for this trial of active surveillance was approved and initiated in 1993. It is based on the principle that early intervention is not always critical. Instead, the method favors regular monitoring of the patient’s condition to identify any changes in the cancer’s progression.
“The most important thing might be the unclosing safety of the active surveillance. Compared to immediate surgery, the instances of unfavorable events such as vocal cord paralysis, hypoparathyroidisms, or patients with surgical scars, patients taking Levothyroxine – these instances are significantly smaller in active surveillance” explained Dr. Miyauchi.
The focus of active surveillance is not to disregard treatment but to delay intervention until necessary, allowing for better management of the disease. This, in turn, reduces the risk of complications often associated with early and possibly unnecessary surgery.
However, surveillance does not mean the absence of treatment. Many patients are proactive in their health management, adopting healthier lifestyles, engaging in physical activities, and sometimes utilizing alternative treatments. The goal remains the same: to halt or slow the progression of the cancer.
Dr. Tuttle reiterated that the outcomes and survival rates between early and delayed intervention are largely the same. Importantly, patients who do show a small increase in the size of the cancer or the appearance of small lymph nodes in the neck can still be efficiently treated with delayed surgery. This does not compromise their chance of a full recovery or increase their risk of recurrence or distant metastasis.
In the U.S., where active surveillance has been practiced for around 12 years, Dr. Tuttle’s experience with patients who have needed to switch to surgery has been largely positive. Most were grateful for having been able to keep their thyroid for as long as they did, and many even reported feeling healthier due to the lifestyle changes they had implemented.
“Having seen a few now that are on the other side of that, I can tell you for most people they weren’t upset they weren’t sad that we had to do something but they felt like they’d given it their best” Dr. Tuttle explained.
This approach might, however, require a change in doctors’ attitudes as well. It’s not only about informing patients about their cancer but also managing their anxiety and uncertainty about the ‘wait and see’ strategy. The physicians’ warm-heartedness, their reassuring demeanor, and the trust they establish with their patients are crucial factors that may significantly affect patients’ psychological well-being.
The shift from immediate surgical intervention to active surveillance represents a revolutionary approach to managing thyroid cancer. The results from the Kuma Hospital trial are prompting the medical community to rethink its strategies and consider adopting this new method more broadly. Although active surveillance might not be the right choice for all patients, it presents an alternative and safe option for those with papillary thyroid cancer, potentially improving both their physical and psychological quality of life.
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About Philip JamesIn 2013, his laryngeal nerve was severed, shoulder nerve damaged, parathyroids ruined, and residual cancer left behind — all for a 1 cm thyroid nodule.
Later, a vocal cord implant was inserted to help him speak.The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others.
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You have been diagnosed with thyroid cancer, and contrary to your doctor's advice, you choose to not proceed with surgery. Is this a patient trend, and how often are patients making this decision?
In a qualitative analysis, Dr. Louise Davies reports on the experience of US patients who self-identify as having an over-diagnosed thyroid cancer.
How likely is death as result of thyroid cancer? In a study by H. Harach, he sites that when reviewing random autopsies, thyroid cancer was prevalent in 34% of the cadavers.
Dr. Davies states, if diagnosed with thyroid cancer, important questions to ask, include:
How big is the tumor? How was the tumor discovered? Are there any symptoms?Dr. Davies says those who choose to opt for no surgery are sometimes called stupid by those who know them, and end up feeling isolated and anxious, with little or no support.
Louise Davies, MD, MS, FACS is an Associate Professor at Geisel School of Medicine
and Dartmouth Institute for Health Policy & Clinical Practice (TDI).She is Chief, Otolaryngology at Veterans Administration, White River Jct., VT
Dr. Davies is an otolaryngologist - head & neck surgeon whose thyroid related research is aimed at defining and documenting the problem of rising thyroid cancer incidence and developing management approaches to the problem in ways that are safe and effective. Clinically, Dr. Davies cares for patients with both head and neck and thyroid cancer and general otolaryngology problems primarily at the VA hospital, with a limited practice at Dartmouth Hitchcock Medical Center. Her career is defined by her goal of helping patients and physicians make good decisions for their cancer care by providing clear, helpful data in useful formats at the needed time and place.NOTES:
JAMA Abstract: Dr. Davies
Thyroid Stories Project
Dr. Michael Tuttle, from Sloan Kettering
Yasuhiro Itoa and Akira Miyauchi
Nonoperative management of low-risk differentiated thyroid carcinoma
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Jonas de Souza participates in both clinical and outcomes research studies on malignancies of the upper aerodigestive tract, especially head and neck cancers. His research focuses on the use of novel therapeutic agents along with measurements of financial burden, patients’ preferences, and the trade-offs between the risks and benefits of cancer therapies. His research has sought to integrate outcomes research, patient preferences, health policy, and economics into clinical practice. His ultimate goal is to increase access to essential cancer therapies by providing policy makers and scientific communities with the required information on patient preferences and on barriers that lie between cancer patients and access to care. De Souza has authored and presented papers and given lectures on head and neck malignancies, reimbursement methods in oncology, and evidence-based care. He is the principal investigator for a trial examining the role of SPECT-CT in the follow-up of patients with locally advanced head and neck cancers. De Souza earned his MD from the University of Rio de Janeiro State. He completed his residency specializing in internal medicine at the University of Texas Health Science Center in 2008 and a fellowship focusing on hematology/oncology at the University of Chicago in 2011. During this episode the following topics are discussed: “Financial toxicity,” or the financial burdens that some patients suffer as a result of the cost of their treatments can cause damage to their physical and emotional well-being.
Financial impact of thyroid cancer Lost income or high out-of-pocket costs for treatment, medication or related care.
Like any other side effect, financial toxicity should be disclosed and discussed with the patients.
Patients with thyroid cancer had a 41% increased risk for unemployment at 2 years
Jonas de Souza MD, MBA The High Cost of Cancer Care May Take Physical and Emotional Toll on Patients Thyroid Cancer Diagnosis Affects Employment, Income -
Dr. Jeremy Freeman was born in Hamilton, Ontario and grew up in Toronto. He attended medical school at the University of Toronto, graduating with highest honours. He completed his otolaryngology residency at the University of Toronto.
After receiving his Fellowship from the Royal College of Surgeons of Canada in 1978, he spent two further years of advanced training, one as a Gordon Richards Fellow at the Princess Margaret Hospital in Toronto in Radiation and Medical Oncology and a second year as a McLaughlin Fellow, training in Head and Neck Oncology at the Royal Marsden Hospital in London, UK. He was the first fellow of the Advanced Training Council sponsored by the two head and neck societies.
A Full Professor, he occupies the Temmy Latner/Dynacare Chair in Head and Neck Oncology at the University of Toronto, Faculty of Medicine. He is former Otolaryngologist-in-Chief at the Mount Sinai Hospital stepping down after fulfilling his 10 year appointment. He has an active practice focusing on head and neck oncology with a primary interest in endocrine surgery of the head and neck.
He has given over 500 scholarly presentations, has been invited as a visiting professor and surgeon internationally, and has published over 280 articles in the scientific literature. He has been involved in a number of administrative roles in the American Head and Neck Society and is also on the editorial board of a number of high impact journals focusing on head and neck oncology. He has recently been appointed to the National Institute of Health (in Washington DC) task force on the management of thyroid cancer.
He is the Director of the University of Toronto Head and Neck Oncology Fellowship, considered to be one of the top three such fellowships in North America.
He was the program chair and congress chair of the First and Second World Congresses on Thyroid Cancer held in 2009 and 2013 in Toronto. He was the Keynote speaker at the Congress held in Boston in 2017. He has been invited worldwide to deliver keynotes in the management of thyroid malignancies.
In this episode the following topics are discussed:
Cost of thyroid surgery in varies depending on jurisdiction Surgery and active surveillance is a fixed cost Costs after surgery TG tests, ultrasound, thyroid hormone costs Contrary to some proponents, surgery is not more cost effective than active surveillance Hypo parathyroidism leads to daily doses of calcium and vitamin D If there is RLN damage, then there could be more surgery and voice therapy There are more costs than solely the surgical fee Levothyroxine costs Ramifications of degree of thyroid cancer Thyroid cancer is a low risk of death Many people die with thyroid cancer but don’t die from it Possibility versus probability Emotional expense of malignancy and being labeled survivor Lead a normal life or the survivor label Lifetime cost of thryoidectomy Medical costs and cost of travel, time of work, baby-sitters, and all expenses that go into managing thryoidectomy for ancillary items How long can someone live without thyroid replacement hormone post thyroidectomy? Quality of life post thyroidectomy Psychological wellbeing Do not do a FNA for nodule under 1 cmNOTES
Dr. Jeremy Freeman
Jeremy Freeman's scientific contributions
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Thyroid radiofrequency ablation (RFA) is a treatment option for thyroid nodules that aims to remove the nodule while preserving the thyroid gland. This procedure has gained popularity in South Korea and other countries as an alternative to thyroidectomy, a surgery that involves removing the entire thyroid gland. However, the adoption of RFA has been slow in the United States due to insurance companies not covering the procedure, making it too costly for many patients.
Dr. Baek, a specialist in thyroid RFA, believes that the procedure is important for preserving thyroid function and improving the quality of life for patients. In contrast to thyroidectomy, which requires patients to take lifelong hormone replacement medication, RFA allows patients to maintain natural thyroid hormone production.
The cost of thyroid RFA is a significant barrier to its adoption in the United States. While the procedure is cheaper in South Korea and other countries, insurance coverage is a major factor in the affordability of treatment for patients. Insurance companies need to recognize the value of RFA and begin covering the procedure in order for it to become more widely available to patients.
Overall, thyroid RFA is a promising treatment option that has the potential to improve the lives of many thyroid nodule patients. It is important for insurance companies to acknowledge the benefits of this procedure and work towards making it more widely accessible to patients.
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Dr. Leonardo Rangel and Radiofrequency Ablation (RFA) for Malignant Thyroid Nodules.During this episode the following topics are discussed:
✅we are treating malignant nodules with radiofrequency ablation therapy
✅We are using radiofrequency ablation therapy since 2006
✅it is something that we are really experiencing is the treatment of those malignant thyroid nodules with radiofrequency ablation
✅avoid the risk of thyroidectomy
✅surgeons must give patients all treatment options; including no surgery
✅there are some nodules malignant nodules, they are not amenable for radiofrequency due to position, size, or something like this
✅patient consultations take longer because there are more treatment options to consider
✅ the problem of taking the levothyroxine
✅About Dr. Leonardo Rangel
Staff da Universidade do Estado do Rio de Janeiro
Membro da Sociedade Brasileira de Cirurgia de Cabeça e Pescoço
Membro da Sociedade Americana de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço
Membro da Sociedade Latinoamericana de Tireoidologia✅Facebook
Rangel MD - Cirurgia de Cabeça e Pescoço
@cabecaepescoco✅Website
https://www.rfamd.com/leonardo-rangel/✅ABOUT RFA MD
A guide for locating doctors of radiofrequency ablation. Find radiofrequency ablation doctors from across the world.
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www.rfamd.com✅ ABOUT Philip James
He is the host of the popular podcast: Doctor Thyroid
www.docthyroid.com
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In 2013, his laryngeal nerve was severed, shoulder nerve damaged, parathyroids ruined, and residual cancer left behind — all for a 1 cm thyroid nodule.
Later, a vocal cord implant was inserted to help him speak.
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All the above, the result of a bad thyroid surgery that dampened his quality of life — and left him wondering, what exactly happened — during what should be a low-risk surgery?
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His attempts to follow up with UCLA and the UCLA surgeon were ignored.
He then turned to other doctors for answers — this was the beginning of the podcast:
"Doctor Thyroid with Philip James"
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100+ episodes later, the Doctor Thyroid podcast is popular amongst patients; allowing them to access information from top doctors, without being limited by geography or economics.
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The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others.
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When not producing podcast episodes or co-hosting live Q&As for patients with top doctors, he leads the creative team at Doctor Marketing and Philip James Media — a marketing agency dedicated to digital communications serving the sectors of healthcare, payments, and Greentech.
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The Doctor Thyroid podcast is available in Spanish and English - and listened to in over 30 countries:www.doctiroides.com (Spanish)🔹
www.docthyroid.com (English)🔹✅Please email your requests to [email protected]
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