96 episodes

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.

Doctor Thyroi‪d‬ Philip James interviews top thyroid experts about surgery, nutrition, endoc

    • Medicine
    • 4.0 • 47 Ratings

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.

    51: What Do You Do For a Living?⎥Why It Matters, with Dr. Ashok R. Shaha from MSKCC

    51: 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. This can help thyroid cancer patients avoid unnecessary and potentially damaging over-treatment, while still providing the best option for control of their cancer and better quality of life after treatment. Dr. Shaha works very closely with Memorial Sloan Ketterings’ endocrinologists to monitor the careful post-treatment hormone balancing necessary for thyroid cancer patients. Many academic hospitals and medical societies worldwide have invited Dr. Shaha to speak on the principles of targeted thyroid surgery and to share his expertise in the treatment of head and neck cancers.
     
    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. Anxiety when diagnosed with cancer. Medical legalities — spend a lot of time with patient — and empower patient. Let the treatment not be worse than the disease. Large tumors, more than 4 cm,  bulky nodes,  voice hoarseness,  vocal cord is paralyzed.  All circumstances where surgery maybe advocated. If a tumor is benign but there is presence of compressive goiters, or deviation of trachea or swallowing difficulty. Considering the condition of the patient, age, cardiac issues. When voice is critical to the patients livelihood, such as teachers, politicians, and singers. Main three complications of surgery include bleeding, change of voice, calcium problems. Non-academic surgeons. Cancer treatment requires a team: surgeons, anesthesiologist, pre-op, radiologist, pathologist, endocrinologists, oncologists. When wind pipe is involved with tumor. When in surgical business a long time, you become humble no matter how good you are. Family present during consultation. God gave you an organ — you took it away — now you are on a pill — since the surgery its ’just’ not the same. When treatment is out of the box — many will not agree with you. How to develop a scale to measure quality of life. To avoid scarring, surgery maybe conducted through the armpit in Korea and Japan. Fibrosis Progress in understanding biology of thyroid cancer only cancer, that there is 98% survival. NOTES:
    Dr. Ashok R. Shaha
     
    RELATED EPISODES:
    50: Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist? with Dr. Michael Tuttle from Sloan Kettering
    40: New Research Reveals Thyroid Surgery Errors 5x More Frequent Than Reported with Dr. Maria Papaleontiou from Michigan Medicine
    42: Flame Retardants Connected to Thyroid Cancer, with Dr. Julie Ann Sosa from Duke University
    35: Rethinking Thyroid Cancer – When Saying No to Surgery Maybe Best for You with Dr. Allen Ho from Cedars-Sinai in Los Angeles
     
    21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
    09: Thyroid Cancer Patients Experience Quality of Life Downgrade with Dr. Raymon Grogan and Dr. Briseis Aschebrook from the University of Chicago Medicine
    36: 1 in 3 People Die With Thyroid Cancer — Not From with Dr. Seth Landefeld from UAB
     
    American Thyroid Association

    • 50 min
    89: Your Patient ‘Type’ May Determine Your Thyroid Cancer Treatment → Dr. Michael Tuttle from Sloan Kettering

    89: Your Patient ‘Type’ May Determine Your Thyroid Cancer Treatment → Dr. Michael Tuttle from Sloan Kettering

    During this interview, Dr. Tuttle discusses the following points:
    Challenges of managing thyroid cancer as outlined by the guidelines Scaling back care for insurance-challenged patients, and adopting a plan that gets the same result without needing the expensive tests Desired outcome is survival and no recurrence, a third is for no harm that would be caused by an unnecessary surgery Unwanted side affects of thyroid cancer include nerve damage, parathyroid damage, and infections RAI sometimes has unwanted side affects With technology, ultrasounds and biopsies, we know some cancers do not need to be treated, as they are now being found very early Change in ATA guidelines, low risk cancers can be considered for observation Two different kinds of patient profiles: Minimalist and Maximalist 1cm or 1.5cm? Patient characteristic, ultra sound characteristics, and the medical team characteristics weighs who is the most appropriate for observation 400 active surveillance patients currently at MSKCC Certain parts of the world are harder to offer observation as a treatment due to practicality, examples include Latina America where multi-nodular goiters are common, and Germany still is iodine deficient About Dr. Tuttle, in his words:
    I am a board-certified endocrinologist who specializes in caring for patients with advanced thyroid cancer. I work as part of a multidisciplinary team including surgeons, pathologists, radiologists, nuclear medicine specialists, and radiation oncologists that provides individualized care to patients treated at Memorial Sloan Kettering for thyroid cancer.
    In addition to treating patients I am also actively researching new treatments for advanced thyroid cancer. I am a professor of medicine at the Joan and Sanford I. Weill Medical College of Cornell University and travel extensively both in the US and abroad, lecturing on the difficult issues that sometimes arise in the management of patients with thyroid cancer. My research projects in radiation-induced thyroid cancer have taken me from Kwajalein Atoll in the Marshall Islands to the Hanford Nuclear power-plant in Washington State to regions in Russia that were exposed to fallout from the Chernobyl accident.
    I am an active member of the American Thyroid Association (ATA) and the Endocrine Society. In addition to serving on the ATA committee that produced the current guidelines for the management of benign and malignant nodules, I am also a Chairman of the National Comprehensive Cancer Network Thyroid Cancer Panel, a consultant to the Endocrinologic and Metabolic Drugs Advisory Committee of the FDA, and a consultant to the Chernobyl Tissue Bank.
    NOTES
    Listen to Doctor Thyroid

    American Thyroid Association

    Dr. Michael Tuttle

    RELATED EPISODES
    35: Rethinking Thyroid Cancer – When Saying No to Surgery Maybe Best for You with Dr. Allen Ho from Cedars-Sinai in Los Angeles
    22: Avoiding Thyroid Cancer Surgery, Depending on the Size with Dr. Miyauchi from Kuma Hospital in Kobe, Japan
    21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies

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

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

    The USPSTF upholds its 1996 recommendation against screening for thyroid cancer among asymptomatic adults.
    The USPSTF commissioned the systematic review due to the rising incidence of thyroid cancers against a background of stable mortality, which is suggestive of over-treatment. And in view of the results, the task force concluded with “moderate certainty” that the harms outweigh the benefits of screening.
    The USPSTF emphasizes, however, that this recommendation pertains only to the general asymptomatic adult population, and not to individuals who present with throat symptoms, lumps or swelling, or those at high risk for thyroid cancer.
    A global problem
    The over-diagnosis of thyroid cancer is worldwide.  
    South Korean doctors treated these newly diagnosed thyroid cancers by completely removing the thyroid—a thyroidectomy. People who undergo these surgeries require thyroid replacement hormones for the rest of their lives. And adjusting the dose can be difficult. Patients suffer from too much thyroid replacement hormone (sweating, heart palpitations, and weight loss) or too little (sleepiness, depression, constipation, and weight gain). Worse, because of nerves that travel close to the thyroid, some patients suffer vocal-cord paralysis, which affects speech.
    Over-diagnosis and over-treatment of thyroid cancer hasn’t been limited to South Korea. In France, Italy, Croatia, Israel, China, Australia, Canada, and the Czech Republic, the rates of thyroid cancer have more than doubled. In the United States, they’ve tripled. In all of these countries, as had been the case in South Korea, the incidence of death from thyroid cancer has remained the same.
    1 in 3 people die with thyroid cancer, not of.
    NOTES
    As heard on NPR
    Dr. Seth Landefeld
    American Thyroid Association
    RELATED DOCTOR THYROID INTERVIEWS
    35: Rethinking Thyroid Cancer – When Saying No to Surgery Maybe Best for You with Dr. Allen Ho from Cedars-Sinai in Los Angeles
    22: Avoiding Thyroid Cancer Surgery, Depending on the Size with Dr. Miyauchi from Kuma Hospital in Kobe, Japan
    21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
    www.docthyroid.com

    • 23 min
    37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University

    37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University

    Antonio Bianco, MD, PhD, is head of the division of Endocrinology and Metabolism at Rush University Medical Center.   Dr. Bianco also co-chaired an American Thyroid Association task force that updated the guidelines for treating hypothyroidism.
    Dr. Bianco’s research has revealed the connection between thyroidectomy, hypothyroidism symptoms, and T4-only therapy.  Although T4-only therapy works for the majority, others report serious symptoms.  Listen to this segment to hear greater detail in regard to the following topics:
    Combination therapy of adding T3 to T4 85% of patients on Synthroid feel fine. Nearly 5% of the U.S. population takes T4 or Levothyroxine, as revealed by the NHANE survey.  This means 10 - 15 million Americans.  Residual symptoms of thyroidectomy include depression, difficulty losing weight, poor motivation, sluggishness, and lack of motivation.  For some, there is no remedy to these symptoms.  For others, adding T3 to T4 shows immediate improvement.  The importance of physical activity and its benefit in treating depression If we normalize T3 does it get rid of hypothyroid symptoms? Overlap between menopause and hypothyroid symptoms Notes:
    American Thyroid Association
    Bianco Lab
    Bianco Lab on Facebook
    NHANES Survey
    The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations.

    • 43 min
    50: Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist? with Dr. Michael Tuttle from Sloan Kettering

    50: Regarding Thyroid Cancer, Are You a Minimalist or a Maximalist? with Dr. Michael Tuttle from Sloan Kettering

    Many centers from around the world want to know how Memorial Memorial Sloan Kettering Cancer Center treats thyroid cancer.  A key member of the MSKCC is Dr. Michael Tuttle. 
    During this interview, Dr. Tuttle discusses the following points:
    Challenges of managing thyroid cancer as outlined by the guidelines Scaling back care for insurance-challenged patients, and adopting a plan that gets the same result without needing the expensive tests Desired outcome is survival and no recurrence, a third is for no harm that would be caused by an unnecessary surgery Unwanted side affects of thyroid cancer include nerve damage, parathyroid damage, and infections RAI sometimes has unwanted side affects With technology, ultrasounds and biopsies, we know some cancers do not need to be treated, as they are now being found very early Change in ATA guidelines, low risk cancers can be considered for observation Two different kinds of patient profiles: Minimalist and Maximalist 1cm or 1.5cm? Patient characteristic, ultra sound characteristics, and the medical team characteristics weighs who is the most appropriate for observation 400 active surveillance patients currently at MSKCC Certain parts of the world are harder to offer observation as a treatment due to practicality, examples include Latina America where multi-nodular goiters are common, and Germany still is iodine deficient About Dr. Tuttle, in his words:
    I am a board-certified endocrinologist who specializes in caring for patients with advanced thyroid cancer. I work as part of a multidisciplinary team including surgeons, pathologists, radiologists, nuclear medicine specialists, and radiation oncologists that provides individualized care to patients treated at Memorial Sloan Kettering for thyroid cancer.
    In addition to treating patients I am also actively researching new treatments for advanced thyroid cancer. I am a professor of medicine at the Joan and Sanford I. Weill Medical College of Cornell University and travel extensively both in the US and abroad, lecturing on the difficult issues that sometimes arise in the management of patients with thyroid cancer. My research projects in radiation-induced thyroid cancer have taken me from Kwajalein Atoll in the Marshall Islands to the Hanford Nuclear power-plant in Washington State to regions in Russia that were exposed to fallout from the Chernobyl accident.
    I am an active member of the American Thyroid Association (ATA) and the Endocrine Society. In addition to serving on the ATA committee that produced the current guidelines for the management of benign and malignant nodules, I am also a Chairman of the National Comprehensive Cancer Network Thyroid Cancer Panel, a consultant to the Endocrinologic and Metabolic Drugs Advisory Committee of the FDA, and a consultant to the Chernobyl Tissue Bank.
    Clinical Expertise: Thyroid Cancer Languages Spoken: English Education: MD, University of Louisville School of Medicine Residencies: Dwight David Eisenhower Army Medical Center Fellowships: Madigan Army Medical Center Board Certifications: Endocrinology and Metabolism NOTES
    22: Avoiding Thyroid Cancer Surgery, Depending on the Size with Dr. Miyauchi from Kuma Hospital in Kobe, Japan
    21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
    35: Rethinking Thyroid Cancer – When Saying No to Surgery Maybe Best for You with Dr. Allen Ho from Cedars-Sinai in Los Angeles
    The American Thyroid Association

    • 39 min
    55: Thyroid Cancer Treatment and Surgery Explained⎥Dr. Gerard Doherty from Harvard Medical School

    55: Thyroid Cancer Treatment and Surgery Explained⎥Dr. Gerard Doherty from Harvard Medical School

    Dr. Gerard Doherty, an acclaimed endocrine surgeon, is a graduate of Holy Cross and the Yale School of Medicine. He completed residency training at UCSF, including Medical Staff Fellowship at the National Cancer Institute.  Dr. Doherty joined Washington University School of Medicine in 1993, and became Professor of Surgery in 2001. In 2002 he became Head of General Surgery and the Norman W. Thompson Professor of Surgery at the University of Michigan, where he also served as the General Surgery Program Director and Vice Chair of the Department of Surgery. From 2012 to 2016, Dr. Doherty was the Utley Professor and Chair of Surgery at Boston University and Surgeon-in-Chief at Boston Medical Center before becoming Moseley Professor of Surgery at Harvard Medical School, and Surgeon-in-Chief at Brigham and Women’s Hospital and Dana-Farber Cancer Institute. 
    Dr. Doherty was trained in Surgical Oncology, and has practiced the breadth of that specialty, including as founder and co-director of the Breast Health Center at Barnes-Jewish Hospital.  His clinical and administrative work was integral in the establishment of the Siteman Cancer Center at Washington University.  Since joining the University of Michigan in 2002, he has focused mainly on surgical diseases of the thyroid, parathyroid, endocrine pancreas and adrenal glands as well as the surgical management of Multiple Endocrine Neoplasia syndromes. He has devoted substantial effort to medical student and resident education policy.  His bibliography includes over 300 peer-reviewed articles, reviews and book chapters, and several edited books.  
    He currently serves as President of the International Association of Endocrine Surgeons, Past-President of the American Association of Endocrine Surgeons, Editor-in-Chief of VideoEndocrinology and Reviews Editor of JAMA Surgery.  He is a director of the Surgical Oncology Board of the American Board of Surgery.
    In this episode, the following topics are discussed:
    Imaging has increased thyroid nodule discovery. Following patients with small thyroid cancer — analogous to prostate cancer.  Better followed than treated. Tiny thyroid cancers can be defined by those nodules less than 1/4 inch in size.  Less RAI is being used as a part of thyroid cancer treatment. This means, less need to do total thyroidectomy or thyroid lobectomy.    Dry mouth and dry eyes are risks to doing RAI.  Also, there is risk to developing a second malignancy.   Most of the secondary cancers are leukemia. Risks to operation include changes to voice and calcium levels.  Thyroid surgery is a safe operation but not risk free. Best question for a patient to ask is, who is my treatment team? The quarterback of treatment team is often the endocrinologist . Cluster of issues can happen after RAI, such as the need to carry water and eye drops for life. For some patients taking thyroid hormone replacement, their blood levels are correct, but still does not feel well on standard treatment protocol. By the end of two weeks, most people go back to what they were doing before surgery with a relatively normal state. Scarring reduction; massage, aloe, Vitamin E. NOTES:
    American Association of Endocrine Surgeons
    American Thyroid Association

    • 27 min

Customer Reviews

4.0 out of 5
47 Ratings

47 Ratings

Marge De ,

Episode 93 Dr. Wartofsky

This was a very well done episode. A lot of good information. The only unfortunate thing is that the doctor follows the school of thought that there is a one size fits all method of thyroid medication management.

ASPantaleone ,

Great Resource!

I was recently diagnosed with PTC and upon diagnosis I started to search for resources to inform me and help me navigate my journey. One resource was Philip James, Doctor Thyroid. I have listened to many of his episodes to hear about his perspective along with the perspective of authorities and patients. The insights have helped me broaden my thinking on this subject along with giving me HOPE! I can’t thank Philip enough for his time and efforts in providing a very specific set of resources to a very specific topic that has a huge importance to anyone affected by this diagnosis. Best wishes to Philip and everyone participating!

111171 ,

Episode 5 is not what is described.

I was very interested in hearing this episode about best way to take thyroid meds but instead the episode is about cancer. Is there some way to get the episode described?

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