RFAMD

Innovations and Issues: from the RFAMD podcast hosted by 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. , 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. FIND MORE INFO ABOUT THYROID ABLATION,

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 Information Dr. 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 Fiction The 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 Health Dr. 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 Curse The 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 Information Looking 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 Resources In 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....

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 Invasivos La 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 Internacionales La 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 Asequibilidad La 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 Paciente La 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 Futuras Al 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, 🔷🔷🔷🔷 About Philip James As the host of the...

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 Africa Dr. 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 Colombia The 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 ultrasound However, 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 guidelines As 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...

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 Medicine The 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 Alternative With 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 Techniques The 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 Recovery Dr. 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 System A 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 Future In 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 ✅ 🔷🔷🔷🔷 About Philip James As 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...

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 Medicine Dr. 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 Shift Central 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 Forefront During 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 Risks With 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 Education An 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 Standardization As 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 Factor Addressing 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 Future Dr. 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 ✅ 🔷🔷🔷🔷 About Philip James As the host of the popular RFAMD and Doctor Thyroid...

Thyroid Ablation: A Game-Changer in Preserving Quality of Life www.docthyroid.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 Ablation In 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 Ablation Dr. 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 Acceptance Thyroid 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 Benefits Compared 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 ✅ 🔷🔷🔷🔷 About Philip James As 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

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. Post-Treatment Recovery ⦿ Patient Experience: Comparing recovery to dental work, with minimal pain and quick return to normal life. ⦿ Potential Complications: Rare cases of hematoma, mainly aesthetic concerns. 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. Patient Counseling ⦿ Approach to Counseling: The importance of discussing all treatment options with patients. ⦿ Team Collaboration: Multidisciplinary approach in decision-making and patient communication. Patient Perception and Decision Making ⦿ Overdiagnosis and Overtreatment: Addressing the issue of overdiagnosis in thyroid cancer and the role of...

In a podcast episode featuring Dr. Vaninder Dhillon from Johns Hopkins and hosted by Philip James, the discussion centers on the prevalence, detection, and treatment of thyroid nodules, focusing on ablation therapy as an alternative to surgery. Dr. Dhillon, an assistant professor in the Department of Otolaryngology at Johns Hopkins, specializes in the surgical management of thyroid and parathyroid diseases. She explains that thyroid nodules are quite common in the American population, with an estimated 30 to 50% of people having at least one thyroid nodule, the majority of which are benign. These nodules are often discovered incidentally through advanced imaging technologies or during physical examinations when patients experience symptoms like lumps or pressure in the neck. The conversation shifts to the treatment of multiple thyroid nodules. Dr. Dhillon points out that while it's not uncommon to have multiple nodules, the treatment approach has evolved. Previously, surgery was the standard treatment, but now, ablation is considered a viable, less invasive option that can preserve the rest of the functioning thyroid gland. Ablation is particularly effective for patients with multiple benign nodules, especially when the thyroid gland itself is not enlarged. It provides targeted volume reduction of the nodules, aiming to alleviate symptoms such as difficulty swallowing, voice changes, or neck discomfort. However, for patients with an enlarged thyroid gland, surgery might still be necessary if the gland size rather than the nodules is causing symptoms. Dr. Dhillon also touches on treating malignant nodules, stating that while surgery remains the primary treatment for thyroid cancers in the U.S., ablation can be considered for patients who are not candidates for surgery or have recurrent disease. The podcast emphasizes a new paradigm in thyroid nodule treatment: surgery is not always necessary, and in many cases, ablation can be an effective treatment. This is particularly significant for patients who wish to avoid surgery and its potential complications, such as the need for lifelong thyroid medication. Dr. Dhillon encourages those with multiple thyroid nodules to seek expert consultation about ablation, as it could be a suitable treatment option. The episode concludes with a reminder that treatment approaches are changing, and patients have options beyond surgery, reinforcing the importance of discussing these with a healthcare provider specialized in this field. Dr. Dhillon's contact information is provided for those interested in further discussion or treatment.

Treating Thyroid Nodules Without Surgery: An Insightful Discussion with Dr. Vaninder Dhillon Find more info about thyroid ablation at: www.rfamd.com The thyroid gland, a butterfly-shaped organ in the neck, is known to develop nodules or growths. While these nodules are often benign, they can sometimes cause cosmetic concerns or other symptoms for patients. Traditionally, surgical removal was the primary solution. But a revolutionary alternative, thyroid ablation, offers a less invasive approach, preserving both the thyroid gland and its functions. In a recent episode of the Doctor Thyroid podcast, Philip James interviewed Dr. Vaninder Dhillon, a reputed professional from Johns Hopkins, to delve deep into thyroid ablation and what patients can expect post-treatment. A Non-Surgical Solution: Thyroid Ablation Thyroid ablation is a minimally invasive treatment targeting the thyroid nodule directly. The most common type of ablation used is radiofrequency ablation, which employs a specific type of energy to address the nodule without affecting the rest of the thyroid gland. Unlike surgeries where parts of the gland might need to be removed, causing hormonal disruptions, ablation offers the benefit of not depriving patients of their thyroid or its hormones. The Journey of Nodule Reduction Dr. Dhillon explained that while the treatment does not make the nodule vanish instantly, the goal is to reduce its size and volume significantly. Using radiofrequency ablation, patients can expect a volume reduction of 60 to 80 percent within six months of the treatment, especially for nodules less than 20 milliliters cubed in size. However, it’s crucial to note that the timeline and effectiveness may vary based on the nodule’s initial size and location. Anatomical considerations also play a vital role in the treatment process. Addressing Both Benign and Malignant Nodules While the guidelines discussed focus primarily on benign nodules, the treatment is also a consideration for malignant nodules, especially if the patient has recurrent disease or is at high risk for another surgery. The Follow-up Post-ablation, patients typically return to Dr. Dhillon’s office at intervals of one month, three months, six months, and a year. These follow-ups ensure that the volume of the nodule is reducing and that the thyroid hormone levels remain stable. Rapid-Fire Takeaways Dr. Dhillon stressed the importance of patients understanding that the primary goal of ablation is to reduce the size of the nodule over the long term. The treatment provides an excellent alternative for patients, offering them the opportunity to direct treatment to specific nodules without the risks or uncertainties linked with surgical procedures. Concluding Remarks The discussion with Dr. Dhillon offers a beacon of hope to countless patients grappling with thyroid nodules, giving them insight into a less invasive solution that puts their well-being first. As medical innovations like thyroid ablation become more mainstream, patients have more choices, ensuring they receive the best care tailored to their unique needs. For more details about Dr. Dhillon and her contributions to the thyroid community, including her presentations at the American Thyroid Association conference, readers can refer to the links provided in the podcast episode description. 🔷🔷🔷🔷 About Dr. Vaninder Dhillon Assistant 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,...

En la reciente conferencia TNT en Reggio Emilia 2023: 2da Reunión Internacional sobre Terapias Mínimamente Invasivas Guiadas por Ultrasonido, el anfitrión del podcast Doctor Thyroid y RFAMD, Philip James, tuvo la oportunidad de entrevistar a la Dra. Lorena Savluk, una destacada radióloga intervencionista de Buenos Aires, Argentina. La Dra. Savluk fue bienvenida por James, agradeciendo su presencia y su disposición para hablar sobre el impacto de las terapias mínimamente invasivas en el tratamiento de los nódulos tiroideos y el cáncer de tiroides. "En esta conferencia, estamos discutiendo tratamientos de nódulos tiroideos a través de la ablación por radiofrecuencia y por microondas, aunque el enfoque principal es la radiofrecuencia", explicó la Dra. Savluk. La terapia de ablación por radiofrecuencia surge como una alternativa a la cirugía, para el tratamiento tanto de nódulos benignos como de microcarcinomas o cáncer de tiroides recurrente en el cuello. Esta terapia minimiza la necesidad de intervenciones quirúrgicas permitiendo a los pacientes mantener la glándula y su función. En este sentido, la Dra. Savluk destacó que "esta terapia es particularmente útil para los pacientes con microcarcinoma papilar de tiroides que no desean someterse a una operación, o que prefieren no estar en un régimen de seguimiento activo". Además, es especialmente efectiva para el cáncer de tiroides recurrente en los ganglios del cuello. James preguntó sobre la disponibilidad de esta terapia en Argentina, a lo que la Dra. Savluk confirmó su presencia en el país. "Nuestro equipo ha estado realizando estas terapias desde 2021. Hemos tratado a un número considerable de pacientes con resultados muy prometedores. Los pacientes están satisfechos, principalmente porque no tienen que pasar por el quirófano", afirmó. La costumbre de este procedimiento en Argentina ronda los 2,000 dólares, y para los pacientes interesados en obtener más información, la Dra. Savluk recomendó visitar la página de rfa. Allí se puede encontrar un directorio de todos los médicos que ofrecen este tratamiento, facilitando la búsqueda de un profesional en su región o área de interés. La entrevista concluyó con saludos desde Italia y promesas de futuras discusiones sobre el tema. Con terapias mínimamente invasivas como la ablación por radiofrecuencia en aumento, las opciones de tratamiento para los nódulos y el cáncer de tiroides están evolucionando rápidamente, brindando a los pacientes alternativas más amigables y menos invasivas.

Molecular Profiling of Thyroid Nodules: A Conversation with Dr. Steven Hodak In a recent podcast episode of Doctor Thyroid and RFAMD, host Philip James was joined by Dr. Steven Hodak, a Professor of Medicine and Endocrinology at NYU Langone Health, New York. Dr. Hodak, who is also the President of the North American Society for Interventional Fibrinology, was present at the TNT conference in Italy when the podcast was recorded. The pair dived into the intriguing topic of molecular profiling of thyroid nodules and how it could relate to either ablation or thyroidectomy. The Significance of Molecular Diagnostic Testing Dr. Hodak began by explaining the relevance of molecular diagnostic testing to thyroid nodule ablation. He recounted that, ten to fifteen years ago, before molecular diagnostic testing was widely available, patients with an indeterminate nodule biopsy would almost always undergo surgery for a definitive diagnosis. This was due to the nodule not appearing normal, yet not definitively looking like cancer either. As a result, the only solution at the time was to remove the nodule, examine it under the microscope, and then provide a definite diagnosis. The shocking part of this approach was that in 80% of cases, patients did not have cancer, and would never have developed it. That meant these patients underwent a surgery that could have been avoided had the molecular diagnostic testing been available. Today, however, this testing has been revolutionary, enabling preoperative risk stratification of nodules, potentially avoiding unnecessary surgical interventions. Concerns Over Previous Practice Host Philip James highlighted the alarming nature of the previous practice where 80% of patients with an indeterminate thyroid nodule would undergo surgery as a diagnostic step. The patients would have their thyroid removed, only to discover that they did not have cancer. Dr. Hodak acknowledged the concern, explaining that while it may sound like an uncaring and unnecessary approach, the limitations of diagnostic methods available at the time left no other choice. Leaving the nodule there to 'see what happens' could have led to worse consequences if it was indeed cancerous. The Present Scenario and Global Adoption Currently, Dr. Hodak confirmed that molecular diagnostics is widely used by most doctors in the United States, thanks to the availability of good commercially available tests. However, he admitted that outside the U.S., it is still a struggle, primarily due to the lack of willingness among socialized medical programs to cover the cost. Dr. Hodak emphasized that the adoption of molecular diagnostics testing worldwide is crucial. He acknowledged that the U.S. had its struggles too before it was widely accepted, often due to inertia and resistance to change. However, the cost-saving potential of molecular diagnostics, along with the ability to reassure patients of a low risk in 60 to 70% of cases, underlines its potential. Molecular Testing and Ablation Dr. Hodak also discussed the connection between molecular testing and ablation. He noted that some of the questions regarding molecular testing and ablation remain open. For tumors with a negative genetic profile, which essentially equates to having a benign microscopic diagnosis, ablation can be used as a treatment method. For those with a positive genetic finding, however, the decision to offer ablation instead of surgery is still under active study. Dr. Hodak affirmed the growing personalization of care, thanks to technology advancements such as molecular testing, AI imaging, and ablation. Concluding Remarks In conclusion, Dr. Hodak stressed the importance of incorporating molecular profiling in decision-making regarding thyroid nodule treatment. For countries where this technology is readily available, it should be part of the treatment planning. For those where it is not, it remains an unfortunate reality and a sore point 🔷🔷🔷🔷 The Doctor Thyroid...

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. #thyroid #thyroidcancer #thyroidsurgery SUBSCRIBE @DoctorThyroid AVOID SURGERY www.rfamd.com @JohnsHopkinsMedicine The 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 Philip James As 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. About Dr....

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. 🔷🔷🔷🔷 The Doctor Thyroid and RFAMD podcast with Philip James is listened to in 100+ countries. It is a preferred patient resource for information related to thyroid cancer, RFA, hypothyroidism, pathology, and radiation therapy. Contact Philip at philipjames@docthyroid.com www.rfamd.com www.docthyroid.com About Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 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. 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. The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 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 philip@philipjames.co Instagram: @PhilipJames360 LinkedIn: www.linkedin.com/in/philip-james/ Facebook: @philipb07 YouTube: @Doctor Thyroid Twitter : @docthyroid

En una entrevista realizada por Philip James de los podcasts Doctor Thyroid y RFAMD, el Dr. Camilo González de Monterrey, México, habla sobre las terapias de tratamiento mínimamente invasivas para los nódulos tiroideos. El Dr. González enfatiza que cada paciente tiene una historia única y diferentes necesidades de tratamiento. La misión de la Asociación de Tratamiento de Nódulos Tiroideos (TNT) es enseñar y exponer a los médicos a diferentes terapias de tratamiento mínimamente invasivas, proporcionando así opciones menos agresivas para los pacientes que puedan preservar su función tiroidea y reducir riesgos como la pérdida de la capacidad de hablar y cantar. El Dr. González también señala la importancia de entender el impacto emocional de las cirugías en los pacientes, incluyendo la cicatriz postoperatoria y la necesidad de terapia de reemplazo hormonal. Estos factores a menudo no se discuten lo suficiente con los pacientes antes de la cirugía. Sin embargo, con estas nuevas terapias, los médicos pueden minimizar las complicaciones y mejorar la calidad de vida de los pacientes. Finalmente, el Dr. González destaca la importancia de que los médicos piensen en sus pacientes y les ofrezcan las mejores opciones de tratamiento para que puedan tomar decisiones informadas. Él enfatiza que el resultado más importante es el bienestar del paciente. Para más información sobre el Dr. González y su trabajo, puedes encontrarlo en el Hospital Universitario de la Universidad Autónoma de Nuevo León en Monterrey, México, donde está a cargo de la dirección de la clínica de tiroides. View Dr. González's Full Profile: https://www.rfamd.com/camilo-gonzalez/ 🔷🔷🔷🔷 The Doctor Thyroid and RFAMD podcast with Philip James is listened to in 100+ countries. It is a preferred patient resource for information related to thyroid cancer, RFA, hypothyroidism, pathology, and radiation therapy. Contact Philip at philipjames@docthyroid.com www.rfamd.com www.docthyroid.com About Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 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. 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. The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 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 philip@philipjames.co Instagram: @PhilipJames360 LinkedIn: www.linkedin.com/in/philip-james/ Facebook: @philipb07 YouTube: @Doctor Thyroid Twitter : @docthyroid

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. 🔷🔷🔷🔷 The Doctor Thyroid and RFAMD podcast with Philip James is listened to in 100+ countries. It is a preferred patient resource for information related to thyroid cancer, RFA, hypothyroidism, pathology, and radiation therapy. Contact Philip at philipjames@docthyroid.com www.rfamd.com www.docthyroid.com About Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 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. 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. The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 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 philip@philipjames.co Instagram: @PhilipJames360 LinkedIn: www.linkedin.com/in/philip-james/ Facebook: @philipb07 YouTube: @Doctor Thyroid Twitter : @docthyroid

In a recent interview with Philip James, host of the Doctor Thyroid and RFAMD podcasts, Dr. Alireza Falahati, a renowned endocrinologist from Utah, provided exciting insights from the TNT conference held in Reggio Emilia, Italy. The primary focus of the conversation was a groundbreaking development in the treatment of Graves' disease: the possibility of treating the entire thyroid gland with radiofrequency ablation (RFA), a potential game-changer in the management of this condition. Graves' disease is an immune system disorder that results in the overproduction of thyroid hormones, also known as hyperthyroidism. The conventional treatment strategies for Graves' disease include antithyroid medications, radioactive iodine therapy, and thyroid surgery. While effective, these treatments often come with potential side effects and risks, which highlights the need for novel, less invasive treatment options. Radiofrequency ablation involves using heat generated from high-frequency alternating currents to ablate or destroy abnormal tissue. This technique has found applications in the treatment of various medical conditions, including certain types of cancers. Dr. Falahati's revelation about the potential use of RFA to treat the entire thyroid gland could significantly transform the therapeutic landscape for Graves' disease, offering a non-invasive and low-risk treatment alternative. During the interview, Dr. Falahati expressed his enthusiasm about this novel approach, stating, "this is a new revelation. It is amazing. It's going to be really a game-changer and change our whole approach to patients with Graves' disease." The possibility of using RFA for the treatment of Graves' disease carries the promise of enhancing the quality of life for patients and instilling new hope for better disease management. Dr. Falahati also stressed the value of scientific conferences like TNT, where experts worldwide convene to share knowledge and foster innovative discussions. He lauded the conference for facilitating learning experiences and supporting the growth of transformative treatment approaches. As this method's adoption is still in the early stages, it's yet to be seen how quickly it will become a mainstream treatment option for Graves' disease. However, the optimism and anticipation echoed by Dr. Falahati signify a promising future in the field of endocrinology. In conclusion, Dr. Falahati expressed his gratitude towards the organizers and participants of the TNT conference, highlighting his eagerness to attend next year's event. The insights gained from such platforms continually contribute to the advancement of medical science, paving the way for more effective, less invasive treatments for complex diseases like Graves'. Radiofrequency ablation promises to be a groundbreaking addition to the therapeutic options, potentially revolutionizing patient care and improving their quality of life. View Dr. Alireza Falahati's Full Profile: https://www.rfamd.com/Alireza-Falahati/ 🔷🔷🔷🔷 The Doctor Thyroid and RFAMD podcast with Philip James is listened to in 100+ countries. It is a preferred patient resource for information related to thyroid cancer, RFA, hypothyroidism, pathology, and radiation therapy. Contact Philip at philipjames@docthyroid.com www.rfamd.com www.docthyroid.com About Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 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. 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. The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. The Doctor Thyroid podcast is available in Spanish and...

www.rfamd.com Gianluca Selvaggi's Remarkable Story: Discovering and Defeating Thyroid Cancer Through Ablation In an intriguing episode of the Doctor Thyroid and RFAMD podcasts, hosted by Philip James, we get to hear an inspiring story from a man named Gianluca Selvaggi. His experience with thyroid cancer and the subsequent successful treatment with ablation serves as a beacon of hope for those facing similar diagnoses. The Unusual Discovery Selvaggi's story is unique because he discovered his cancer in an unconventional manner – it was by sheer accident while "playing around" with ultrasound. During a visit to Dr. Roberto Valcavi's office to share some technology related to thyroid cancer, Dr. Valcavi performed a casual ultrasound check on Selvaggi's neck. To their surprise, they discovered a small carcinoma, confirming the presence of papillary thyroid cancer. Selvaggi described his initial reaction to the diagnosis as one of worry, which is not uncommon when confronted with the word 'cancer'. However, Dr. Valcavi's comforting approach and clear treatment pathway eased his anxieties. Treatment with Ablation Fast forward 20 days, Selvaggi underwent a radiofrequency ablation procedure – a non-surgical treatment that uses heat to destroy the cancer cells. The entire treatment took around 40-45 minutes, a significantly shorter period compared to conventional surgical methods. This was in May, and by the time Selvaggi joined the podcast in June, he reported feeling perfectly fine. Selvaggi shared that he was able to resume his normal life within just a few days of treatment. He was back to playing football and mountain biking, emphasizing the non-invasive nature and swift recovery associated with ablation treatment. Cancer-Free and Grateful A month after treatment, Selvaggi joyfully reported being cancer-free. His experience speaks volumes about the effectiveness of ablation treatment for thyroid cancer, especially considering that he did not have to undergo surgery. He praised Dr. Valcavi for his skill and reassurance throughout the process, stating, "My neck is perfect." When asked what he would tell other patients diagnosed with thyroid cancer, Selvaggi urged trust in the treating clinicians and the technology at hand. His story demonstrates the immense potential of minimally invasive treatments like ablation, showing they can successfully cure cancer without causing significant disruption to the patient's life. Gianluca Selvaggi's story is a powerful testament to modern medical advancements. Thanks to his chance ultrasound and the skilled work of Dr. Roberto Valcavi, Selvaggi was able to effectively treat his thyroid cancer, resuming his normal life just days after treatment. His tale underscores the importance of having reliable clinicians and trusting in new technologies that have the potential to revolutionize patient outcomes. 🔷🔷🔷🔷 The Doctor Thyroid and RFAMD podcast with Philip James is listened to in 100+ countries. It is a preferred patient resource for information related to thyroid cancer, RFA, hypothyroidism, pathology, and radiation therapy. Contact Philip at philipjames@docthyroid.com www.rfamd.com www.docthyroid.com About Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 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. 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. The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 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...

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 Catherine@melbournethyroidsurgery.com. She encourages inquiries...

@mskcc @DoctorThyroid @kumahospital 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...