This show is for thyroid patients determined to improve their quality of life, with the best information available.
You will gain insight from those who have discovered improved well-being regardless of setbacks, and hear from leading healthcare professionals, including endocrinologists, surgeons, functional medicine practitioners, and radiologists.
You Have a Thyroid Nodule? This is what happens next - with Dr. Regina Castro from The Mayo Clinic
This episode details the medical approach to thyroid nodules. Topics include:
• 60% of the U.S. population has thyroid nodules
• Discovered when evaluating other neck issues such as an unrelated pain
• What happens when you are told you have a thyroid nodule?
• How to know if your thyroid nodule is cancerous?
• When is surgery done despite the nodule being benign?
• Decreasing patient anxiety with quick biopsy results
• The American Thyroid Association as a resource for patients and physicians
• A word of caution about sourcing medical information from online resources
Dr. M Regina Castro is an endocrinologist in Rochester, Minnesota and is affiliated with Mayo Clinic. She received her medical degree from Central University of Venezuela and has been in practice for more than 20 years. Dr. Castro accepts several types of health insurance, listed below. She is one of 78 doctors at Mayo Clinic who specialize in Endocrinology, Diabetes & Metabolism. She also speaks multiple languages, including Spanish and French.
M. Regina Castro, M.D.
THYROID NODULES — Thyroid nodule size larger than 4 cm does not increase the risk of false negative biopsy results or the risk of cancer
American Thyroid Association
Thyroid Cancer Surgery? The Single Most Important Question to Ask Your Surgeon with Dr. Gary Clayman
This is a candid interview with Dr. Gary Clayman about thyroid cancer surgery and making sure a patient receives the best available care.
Dr. Clayman has performed more than four hundred thyroid cancer operations per year for over twenty years among patients ranging from 6 months to 100+ years of age. Nearly half of Dr. Clayman’s patients have undergone failed initial surgery for their thyroid cancer by another surgeon or have recurrent, persistent, or aggressive thyroid cancer. If it pertains to thyroid surgery or thyroid cancer, there is likely nothing that he hasn’t seen.
Dr. Clayman left the M. D. Anderson Cancer Center in the fall of 2016 to form the Clayman Thyroid Cancer Center in Tampa, Florida
If someone is considering surgery, Dr. Clayman discusses important topics, including:
Do not let a doctor operate on you unless the surgeon can prove to you that he/she has done a minimum of 150 annual thyroid surgeries, and for a minimum of ten years. This means, do not see a surgeon unless he/she has completed a minimum of 1500 thyroid surgeries. Damage to voice box nerves is preventable, when surgery is done right. 90% of thyroid surgeries done in the U.S. are by doctors doing fewer than fifteen thyroid surgeries per year There is a growing trend of patients being more informed compared to years past Do not rush into a surgery. Vet your doctor and hospital. Talk to people and make sure you have selected a skilled surgeon Surgery is not franchisable, use caution when If a case is too complex, important that a less experienced surgeon seek help from a more experienced surgeon Incomplete surgery is completely unacceptable (persistence of disease) Advice to surgeons, especially less-experienced ones Other Doctor Thyroid episodes referenced during this interview:
The Financial Burden of Thyroid Cancer with Dr. Jonas de Souza from The University of Chicago Medicine
The Parathyroid, and a Safer — Less-Scarring Thyroid Surgery with Dr. Babak Larian from Cedars-Sinai
A Must Listen Episode Before Getting Surgery – Do Not Do It Alone, with Douglas Van Nostrand from MedStar Washington Hospital
Dr. Gary Clayman
Thyroid Cancer Overview
Book: Atlas of Head and Neck Surgery
The American Thyroid Association
Thyroid Cancer and Children with Dr. Andrew Bauer from the Perelman School of Medicine, U of Pennsylvania
Andrew J. Bauer, MD is an Associate Professor of Pediatrics at the Perelman School of Medicine, University of Pennsylvania and serves as the Director of the Thyroid Center in the Division of Endocrinology and Diabetes at The Children’s Hospital of Philadelphia. Dr. Bauer maintains active membership as a fellow in the American Academy of Pediatrics (FAAP), the Endocrine Society, the Pediatric Endocrine Society, and the American Thyroid Association. He also volunteers as a consultant for the Thyroid Cancer Survivors Association and the Graves’ Disease and Thyroid Foundation. In the American Thyroid Association Dr. Bauer has recently served as a member of the pre-operative staging committee, the thyroid hormone replacement committee, and as a co-chair for the task force charged to author guidelines on the evaluation and treatment of pediatric thyroid nodules and differentiated thyroid cancer. His clinical and research areas of interest are focused on the study of pediatric thyroid disease, to include hyperthyroidism, thyroid nodular disease, thyroid cancer, and inherited syndromes associated with an increased risk of developing thyroid nodules and thyroid cancer.
In this episode Dr. Bauer shares the complexities of managing children with thyroid nodules, and differentiated thyroid cancer. This is a must listen interview for parents whose child has a thyroid nodule or thyroid cancer diagnosis.
There are a several important differences in how pediatric thyroid nodules and differentiated thyroid cancer (DTC) present and respond to therapy. Kids are less frequently diagnosed with a thyroid nodule; however, the risk for malignancy is four- to fivefold higher compared with an adult thyroid nodule. For DTC (specifically papillary thyroid cancer), more than 50% of pediatric-aged patients will have metastases to cervical lymph nodes at the time of diagnosis, but because the tumors typically retain the ability to absorb iodine (retain differentiation), disease-specific mortality is very low, with > 95% of pediatric patients surviving from the disease. This is true even for children with pulmonary metastases, which occur in approximately 15% of patients who present with lateral neck disease.
With the high risk for malignancy and the invasive potential of the cancer, there has been a stronger tendency to take kids with thyroid nodules to the operating room (OR) and to administer RAI to those found to have DTC. With a greater realization of the increased risk for surgical complications as well as the short- and long-term complications of RAI treatment, the guidelines emphasize the need for appropriate preoperative assessment of nodules, and the approach to surgical resection, and they provide a stratification system and guidance for surveillance to identify which patients may benefit from RAI. The stratification system, called the "ATA pediatric risk classification," is not designed to identify patients at risk of dying of disease; it is designed to identify patients at increased likelihood of having persistent disease.
We have known about these differences for years, but the approach to evaluation and care has never been summarized into a pediatric-specific guideline. The adult guidelines aren't organized to address the differences in presentation, and the adult staging systems are targeted to identify patients at increased risk for disease-specific mortality. So, the adult guidelines are not transferable to the pediatric population.
Dr. Andrew Bauer
American Thyroid Association
A Summary of Radioactive Iodine Treatment for Thyroid Cancer, with Dr. Alan Waxman from Cedars Sinai
Not all thyroid cancer patients who receive a thyroidectomy require radioactive iodine, but for those whose cancer maybe more aggressive and spread beyond the thyroid area, often radioactive iodine (RAI) is protocol.
RAI treatment may vary depending on the hospital. For example, in this interview you hear protocol for RAI at Cedars Sinai.
In this interviews, Dr. Alan Waxman explains what occurs leading up to, during, and after RAI. Topics discussed include:
If staying at the hospital after taking RAI, how long is the stay required? Should you go home after RAI? What is the benefit of staying overnight at the hospital when receiving RAI? Worldwide trends toward prescribing lower doses of RAI. Is there risk in RAI causing leukemia? The importance of ultrasound prior to administering RAI of done. The need to stimulate TSH prior to administering RAI. Withdrawal versus injections in raising TSH levels. Damage to salivary glands. Alan D. Waxman, MD is Director of Nuclear Medicine at the S. Mark Taper Foundation Imaging Center at Cedars Sinai. He is also a member of the Saul and Joyce Brandman Breast Center – A Project of Women’s Guild and the Thyroid Cancer Center at Cedars-Sinai Medical Center. He is a clinical professor of radiology at Los Angeles County + University of Southern California (USC) Medical Center. Dr. Waxman’s participation in research has led to the development of many new imaging techniques and equipment adaptations. A leading expert in nuclear medicine imaging, Dr. Waxman has directed efforts to develop innovations in whole-body tumor imaging using new and existing radiolable compounds. Dr. Waxman is an active member and officer of the Society of Nuclear Medicine. He has authored numerous publications and lectured extensively throughout the world. Dr. Waxman is a graduate of the USC Medical School, where he completed his postgraduate training. He also completed a clinical research fellowship at the National Institutes of Health.
Dr. Alan Waxman
Salivary gland toxicity after radioiodine therapy for thyroid cancer.
Blog by Philip James
American Thyroid Association
34: What Happens When Thyroid Cancer Travels to the Lungs? with Dr. Fabian Pitoia from the Hospital of University of Buenos Aires
30: Thyroid Cancer and Children with Dr. Andrew Bauer from the Perelman School of Medicine, U of Pennsylvania
My Doctor Has Thyroid Cancer — Dr. Aime Franco from University of Arkansas
Dr. Aime Franco is professor at the University of Arkansas. She leads a research group investigating the role of thyroid hormones in tumorigenesis. She is also actively involved, both locally and nationally, advocating for the importance of biomedical research and the importance of engaging patients and survivors in cancer research.
After, completing her Ph.D. in Cancer Biology, she became a thyroid cancer research fellow at Memorial Sloan-Kettering Cancer Center in the Human Oncology and Pathogenesis Program.
Dr. Franco is a survivor of thyroid cancer, and balances her research as a mom and competitive triathlete.
in this interview we explore the following:
Does thyroid cancer have a good prognosis compared to other cancers because its different or because we are aggressive with surgery and radiation therapy?
What were some personal insecurities when facing thyroid cancer surgery?
What are the questions in regard to TSH that the medical community is overlooking?
Which prescription medication works best?
How often and when should thyroid blood markers be tested?
You may find Dr. Franco here, http://physiology.uams.edu/faculty/aime-franco/
Father, husband, runner, musician, and the lifestyle changes that came after thyroid cancer surgery (Patient Story)
In this interview, some of the key points include:
Self-discovered thyroid nodule Diagnosed thyroid nodule FNA and biopsy 5 cm nodule Juice cleanse and no more red meat 3 hour surgery Regret about a Friday afternoon surgery Outpatient surgery Vocal cord paralysis Impact of vocal cord paralysis RAI six weeks post surgery - 176 mc RAI diet A positive and optimistic approach to the disease Surgeon did not present consequences of thyroid surgery Ran cross-country in high school