Doctor Thyroid

In this episode, we visit with Carla. She had thyroid cancer surgery.  During the interview, we discuss: 50 biopsies of the first nodule 5 cm nodule Biopsies RAI Weight gain Support from family NOTES American Thyroid Association 23: You Have a Thyroid Nodule, What Happens Next? with Dr. Regina Castro from The Mayo Clinic 64: Managing Indeterminate Thyroid Nodules, with Dr. Kimberly Vanderveen from Denver Center for Endocrine Surgery  

Dr. Eduardo Faure Especialista en Endocrinología. UBA Médico egresado de la Facultad de Medicina de la Universidad Nacional de Rosario.  Especialista en Endocrinología egresado de la Facultad de Medicina de la Universidad de Buenos Aires.  Especialista recertificado por AMA (Asociación Médica Argentina) / SAEM (Sociedad Argentina de Endocrinología y Metabolismo) años 2003 y 2009. Realizó su formación como Endocrinólogo en el Servicio de Endocrinología del Complejo Médico PFA Churruca-Visca. Buenos Aires. Argentina.   Se sub-especializó en el área de Tiroides.  Actualmente se desempeña como Médico de Planta del Servicio de Endocrinología del Complejo Médico PFA Churruca-Visca.  Es Jefe de la Sección Tiroides de dicho Servicio.   Sus trabajos de investigación se basan fundamentalmente en Tiroides.  Fue docente de Fisiología de la Cátedra de Fisiología Humana de la Facultad de Medicina de la Universidad Nacional de Rosario.  Es docente de la Carrera de Médicos Especialistas en Endocrinología de la Universidad de

Professor Akira Miyauchi (Figure 1) is President and COO of Kuma Hospital, Center of Excellence in Thyroid Care, Kobe, Japan. He is a Japanese endocrine surgeon, and a pioneer in active surveillance, and visionary in regard to treatment of thyroid cancer.  World renowned researcher, and lecturer. As the associate professor of the Department of Surgery, Kagawa Medical University, he proposed and initiated a clinical trial of active surveillance for low-risk papillary micro cancer in collaboration with Kuma Hospital in 1993. In 2001, he was appointed the President of Kuma Hospital. Since then, he has been keen on the study of evaluating treatments for papillary micro cancer, observation versus surgery. During this episode, the following topics are discussed: Financial burden of surgery versus total cost of active surveillance over ten years.  Setting patient expectations prior to FNA to manage anxiety When the laryngeal nerve is severed during thyroid surgery, it can and should be repaired, with proper surgeon

Ezra Cohen, MD, is a board-certified oncologist and cancer researcher. He cares for patients with all types of head and neck cancers, including esophageal, thyroid and salivary gland cancers. Dr. Cohen is also an internationally recognized expert on novel cancer therapies and heads the Solid Tumor Therapeutics program at Moores Cancer Center. Much of his work has focused on squamous cell carcinomas and cancers of the thyroid, salivary gland, and HPV-related oropharyngeal cancers. As a physician-scientist, he is especially interested in developing novel therapies and understanding mechanisms of sensitivity or resistance; cancer screening; and using medication and other agents to delay or prevent cancer (chemoprevention). He was recently appointed chair of the National Cancer Institute Head and Neck Cancer Steering Committee, which oversees NCI-funded clinical research in this disease. Dr. Cohen is editor-in-chief of Oral Oncology, the most respected specialty journal in head and neck cancer. A frequent speaker

Kimberly Vanderveen, MD is a Colorado native and graduate of Bear Creek High School in Lakewood, CO. She received her bachelor’s degree with honors from Muhlenberg College in Allentown, PA. She then earned her medical degree from Northwestern University in Chicago, IL in 2001. Dr. Vanderveen completed her surgical residency at UC-Davis in Sacramento, CA. During her residency, she also obtained a master's degree in Clinical Research and was actively involved in cancer research and education. After her surgical training, Dr. Vanderveen completed a fellowship in Endocrine Surgery at the Mayo Clinic in Rochester, MN. She is knowledgeable in both medical and surgical aspects of endocrine diseases. She specializes in surgery for diseases of the thyroid, parathyroid, adrenal glands and is a high volume neck and adrenal surgeon. In this episode, the following topics are discussed: Two roads of tests: rule out and malignant markers Rule-out tests picks up innocent behavior pattern.  Most common is Afirma Malignant ma

A native of Saskatchewan, Canada, Dr. Kaptein began teaching at the Keck School of Medicine in the Endocrinology Division in 1977. She became a tenured Professor of Medicine in 1990, a position she currently holds. Dr. Kaptein is a distinguished member of the Western Society for Clinical Investigation, American Society of Nephrology, the Endocrine Society and the American Thyroid Association. An accomplished researcher and lecturer, Dr. Kaptein has been invited to speak on the topics of Endocrinology and Nephrology in such cities as Montreal, Milan, Tel Aviv, Jerusalem, Vienna and Rotterdam, to name a few. In this interview, Dr. Kaptein discusses the need to consider each patient before making treatment decisions.  In some cases, this may mean foregoing the removal of cancerous lymph nodes.  NOTES American Thyroid Association Dr. Elaine Kaptein    

Carmelo Nucera, M.D., Ph.D., is currently an Assistant Professor at Harvard Medical School, Boston, in the Division of Cancer Biology and Angiogenesis (Department of Pathology), Beth Israel Deaconess Medical Center. Dr. Nucera received his M.D. and Ph.D. in Experimental Endocrinology and Metabolism from Italy. Dr. Nucera is highly driven by an intense desire to make important contributions that will directly benefit patients. Dr. Nucera is strongly committed to make discovery aimed to immediately cure patients that are suffering with aggressive tumors and rare/orphan cancer disease. Dr. Nucera has a clinical background and intensely served patients with fatal human diseases. In this episode, Dr. Nucera discusses a combination drug therapy using vemurafenib and palbociclib represents a novel therapeutic strategy to treat papillary thyroid carcinoma (PTC).  NOTES Carmelo Nucera Researchers identify novel therapeutic strategy for drug-resistant thyroid cancers Publication: Thyroid Cancer and resistance to BR

Dr. Paul Y. Casanova-Romero, M.D., M.P.H., F.A.C.P., F.A.C.E, E.C.N.U, que se unió a Palm Beach Diabetes y Endocrine Specialists en 2012, recibió su grado médico con honores (Summa Cum Laude) y Doctor en Ciencias Médicas (DMSc), de la Universidad de Zulia, la Escuela de Medicina en Venezuela. Posteriormente se unió a la facultad de su Alma Mater y en 1998, el Grupo de Investigación del Programa de Prevención de la Diabetes (D.P.P.) en el Instituto de Investigación de la Diabetes-Universidad de Miami. Completó su posgrado en Medicina Interna y Endocrinología (Jackson Memorial Hospital) y estudios de postgrado en Salud Pública (M.P.H.) con el Premio de Mérito Académico en la Universidad de Miami. Un consultor privado endocrinólogo y orador nacional desde 2006, el Dr. Paul Y. Casanova-Romero de investigación extensa sobre la prevención de la diabetes, trastornos de la tiroides, síndrome metabólico y otros trastornos endocrinos han sido ampliamente publicadas. Sigue colaborando en estudios de investigación en Est

Dr. Lisa Sardinia is an associate professor in the Pacific University Biology Department. She received a B.S. in Biology from Whitworth College, a Ph.D. in Microbiology from Montana State University and a J.D. from the University of California, Hastings College of the Law.   Following graduate school, she was awarded a National Cancer Institute research fellowship at the University of California, San Francisco studying molecular genetics. At Pacific University, she teaches Molecular Biology, Microbiology, Basic Science for Optometry and Human Genetics for Physician Assistants. She has been the recipient of the Thomas J. and Joyce Holce Endowed Professorship in Science and the S.S. Johnson Foundation Award for Excellence in Teaching at Pacific University. In the episode, we discuss: Microbiome Microbes inside the gut Gut microbe biota 95% of serotonin manufactured in gut Dark chocolate and bacteria in your gut Probiotics Prebiotics are food that we eat that has food for good bacteria Soluble fiber Eat food th

Dr. José A. Hakim realiza más de 400 cirugías al año. Es cirujano general. Especialista en cirugía de cabeza y cuello en relación con el cáncer. En este entrevista, hablamos sobre: No todos los cánceres de tiroides deben ser operados. No todos los nódulos tiroideos deben ser biopsiados. La mitad de la población tiene nódulos tiroideos. El 10% de esos nódulos tienen cáncer. En Colombia, 2,5 millones de personas tienen cáncer de tiroides. 15 millones de personas tienen cáncer de tiroides en los Estados Unidos, y lo más probable es que no lo sepan. Los estudios muestran que el 30% de los cadáveres tienen nódulos tiroideos con cáncer. Comprender las repercusiones de hacer una biopsia. Si se trata de un nódulo que no requiere cirugía, incluso si es cáncer, decirle a un paciente esto a veces hace más daño en la forma de estrés emocional que lo que es necesario. No sacrificar una tiroides debido a la fobia. La carga es en el médico para no desencadenar paranoia y estrés en el paciente diciéndoles que "podría" tener

Dr. Hernán Tala es endocrinólogo de la Clinica Alemana en Santiago, Chile. Su area especialidad incluye cáncer de tiroides avanzado, endocrinologia general, y enfermedades tiroides. Los temas presentados incluyen: Una mejor comprensión de la biología del cáncer de tiroides, y que no todo el cáncer de tiroides es igual. La enfermedad es única en cada paciente. La importancia de entender el perfil del cáncer en cada paciente. Diagnóstico del nódulo. Perfil molecular del nódulo tiroideo. Una pausa en la exploración universal del cáncer de tiroides. Vigilancia activa Menos radiación, o ningún tratamiento de radiación en los casos que anteriormente recibirían radiación La importancia para los médicos de compartir una comprensión universal de la vigilancia activa, por lo que los pacientes obtener una recomendación coherente. Hipotiroidismo en pacientes con tiroidectomía total. El cáncer de tiroides es lento en comparación con otros tipos de cáncer. Qué se requiere para la adopción adicional de la innovación del tr

This episode is recorded from Boston and the World Congress on Thyroid Cancer, where leading doctors and researchers have gathered to share the latest medical research and trends related to thyroid disease.  At the Congress, Dr. Okamoto presented on Thyroid Cancer Guidelines Around the World He helped write the Japanese guidelines on thyroid cancer.  He is Professor & Chair of the Department of Surgery at Tokyo Women’s Medical University.  Key points from this episode include: Most Western countries carry out total thyroidectomies, whereas in Japan, the approach is more conservative with a fundamental practice of hemithyroidectomy whenever possible. By not doing a total thyroidectomy, this allows the patient to not avoid taking thyroid replacement medication. Complete thyroidectomy is conducted when 80-90% of lymph nodes have metastasis. I-131 treatment is decreasing despite cases of cancer increasing For I-131 treatment, patients wait more than 6 months post surgery. When receving I-131 treatment, patie

This episode is recorded from Boston at the World Congress on Thyroid Cancer, where thyroid doctors and researchers gathered to share the latest medical research and medical improvements related to thyroid disease.  Dr. Özer Makay is an expert in nerve monitoring during thyroid surgery, and has been a guest faculty member in South Korea, Italy, France, the Netherlands, Germany, Belgium and Bulgaria.  He has received 17 awards and honors for his scientific studies.  He has authored a 300-page book on nerve monitoring during thyroid surgery.  This episode covers the following topics: Protecting the recurrent laryngeal nerve (RLN) and superior laryngeal nerve during thyroid surgery. Outcomes of damaging these nerves during surgery include no voice, hoarseness, shortness of breath, problem with drinking water or aspiration, impaired physical exertion with something as simple as climbing a flight of stairs. Why some centers have a higher occurrence of damage during thyroid surgery and include an error rate as hig

La glándula tiroides es un órgano importante del sistema endocrino. Está ubicada en la parte anterior del cuello, justo por encima de donde se encuentran las clavículas. La tiroides produce hormonas que controlan la forma como cada célula en el cuerpo usa la energía. Este proceso se denomina metabolismo. Hipotiroidismo es una afección en la cual la glándula tiroides no produce suficiente hormona tiroidea. Esta afección a menudo se llama tiroides hipoactiva. Este episodio Dra. Gabriela Brenta discute sobre hipotiroidismo, las causas, los síntomas, pruebas y exámenes, el tratamiento, pronóstico, posibles complicaciones, y cuándo contactar a un médico. Dra. Gabriela Brenta, M.D., Ph.D. Docente de post grado de la Universidad Favaloro y de las carreras de Especialista en Endocrinología así como de Bioquímica Clínica dependientes de Universidad de Buenos Aires.  Médica adscripta en el Servicio de Endocrinología y Metabolismo de la Unidad Asistencial Dr. César Milstein de Buenos Aires, Sector Tiroides.  Presidente

Doctor Califano es Endocrinóloga del Instituto de Oncología AH Roffo, Universidad de Buenos Aires. Es miembro del Departamento de Tiroides de la Sociedad Argentina de Endocrinología y Metabolismo y de la Sociedad Latinoamericana de Tiroides. Es coautora del Consenso Multisocietario Argenino para el Manejo del Cáncer de Tiroides Diferenciado. En esta entrevista, discutimos lo siguiente: ¿Qué es un nódulo?  ¿Qué sucede durante ecografia? ¿Qué sucede durante la oja fina? Si es cáncer, ¿siempre hace la cirugía? Si no es cáncer, ¿algunas veces hace cirugía? ¿Qué sucede durante la cirugía? ¿Cuánto tiempo se tarda en recuperarse? ¿Es necesario radioactivo?   ¿Qué sucede durante la RAI? ¿Hay efectos secundarios? Dieta especial. Si se elimina mi tiroides, ¿cómo será mi vida después? T4 ¿Cómo elijo al mejor cirujano? ¿Cuáles son los errores médicos que usted ve con más frecuencia y cómo pueden evitarse? ¿A qué hora del día debo tomar mi medicamento para la tiroides?

This is an in depth discussion about the connection between flame retardants and plastics, and thyroid cancer.  These chemicals, also known as endocrine disruptors, have a clear connection to thyroid cancer occurrence. The research is presented by Julie Ann Sosa, MD MA FACS is Chief of Endocrine Surgery at Duke University and leader of the endocrine neoplasia diseases group in the Duke Cancer Institute and the Duke Clinical Research Institute. She is Professor of Surgery and Medicine. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. She is widely published in outcomes analysis, as well as cost-effectiveness analysis, meta-analysis, and survey-based research, and she is director of health services research.  NOTES: Study Associates Flame Retardants with Papillary Thyroid Cancer Flame retardants used in furniture may increase thyroid cancer risk Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013 How to Buy a Sofa without Toxic Flame Retardants Juli

I sometimes get asked, why am I doing this podcast?  What started out as a pet project is now being listened to in over 30 countries and with as many as 20000 downloads per episode.  So far, thyroid patients are embracing the opportunity to hear from the world’s leading thyroid doctors, and gaining the information needed to make better decisions related to health. So why did I start Doctor Thyroid? My motivation for doing this podcast is to help patients avoid bad experiences related to thyroid cancer and thyroid disease, including bad surgery.   And, provide resources to help make better health decisions and improve quality of life. My thyroid surgery resulted in errors, which have downgraded my quality of life significantly.  Knowing what I know now, I would have picked a different surgeon, or chosen no surgery at all.  Because, as this interview will discuss, although perceived as safe, thyroid surgery is not without risks.  To be published next month, new research reveals thyroid surgery errors are five t

Dr. Rashika Bansal is a PGY-2 resident in Internal Medicine at St. Joseph's Regional Medical Center in Paterson, NJ.  Her major research has been with diabetes prevalence and awareness in rural India, with special interest in thyroid disease.  In this episode Dr. Bansal shares the research she presented at AACE 2017 and ENDO 2017, regarding the poor readability scores for thyroid cancer web sites. The challenge for these web sites and health institutions is to translate thyroid education from complex to simple and easy to understand.  Currently, many patients are not following with treatment, citing confusion after being exposed to the various thyroid cancer education resources.   NOTES Thyroid Education Scores Low for Readability Thyroid patient education materials not adequately targeted to patient reading level  

Weighing treatment options for thyroid cancer, with deep consideration for the patient’s lifestyle, could become the new norm in assessing whether surgery is the best path.  Dr. Allen Ho states, “if a patient is a ballerina or an opera singer, or any other profession that could be jeopardized due to undesired consequences of thyroid cancer surgery, then the best treatment path maybe active surveillance.”  Undesired consequences of thyroid cancer surgery could be vocal cord paralysis, damage to the parathyroid glands resulting in calcium deficiencies, excessive bleeding or formation of a major blood clot in the neck, shoulder nerve damage, numbness, wound infection, and mental impairment due to hypothyroid-like symptoms.  Or in the case of a ballerina, undesired scarring could jeopardize a career.    The above risks occur in approximately 10% of thyroid cancer surgeries.  Although, some thyroid cancer treatment centers have a much more reduced incidence of undesired consequences, while others much higher.  In

What Happens When Thyroid Cancer Travels to the Lungs? Fabian Pitoia, M.D., serves as the Head of the Thyroid Section of the Division of Endocrinology and Investigation Area Coordinator at the Hospital de Clinicas of the University of Buenos Aires (UBA). He works also as an Proffessor of internal medicine at the Faculty of Medicine (UBA). Dr Pitoia serves as a Full Member of the Argentine Society of Endocrinology and Metabolism, of the Latin American Thyroid Society, the Endocrine Society and he is a Correspondent Member of the American Thyroid Association. In this episode Dr. Pitoia addresses the following topics: 10% of thyroid cancer patients will have distant metastatic disease The disease will travel to lungs, bones, or both Treatment with RAI is most effective for those under 40 years old Evaluation of metastatic thyroid cancer in the lungs is a CT scan In 2006, there was a change in the treatment of the disease Adverse events of medication The coordination between the endocrinologist and the oncologis