Choosing Surveillance Over Surgery đ„ Thyroid Cancer Treatment Without Surgery
Release Date: 09/22/2023
Doctor Thyroid
I share my personal journey with thyroid surgery performed by Dr. Michael Yeh at UCLA. I break down what happened before, during, and after my surgery for a small thyroid nodule that was diagnosed as papillary thyroid cancer. Learn about the devastating complications I experienced, including vocal cord damage requiring an implant and nerve damage affecting my shoulder. I discuss important research showing that many thyroid cancers don't require immediate surgery, including a Finnish cadaver study and Dr. Miyauchi's 30-year watch-and-wait approach in Kobe, Japan. ...
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Join us as Dr. Emad Kandil, a leading expert in thyroid ablation, sits down with Philip James in the heart of New Orleans. In this candid and insightful conversation, Dr. Kandil shares his journey from aspiring engineer to becoming a renowned thyroid surgeon, influenced by a life-changing event involving his younger brother. Against the backdrop of the city's iconic Café du Monde and a rigorous CrossFit session, the two explore the complexities of thyroid surgery, discussing why Dr. Kandil often advocates for ablation over traditional thyroidectomies to preserve patients' quality of life. As...
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In this interview with Dr. Emad Kandil, a leading expert in thyroid ablation, patient Elizabeth shares her journey of receiving conflicting medical advice regarding her thyroid nodule. After consultations with multiple doctors in New York who recommended surgery, Elizabeth sought an alternative in New Orleans with Dr. Kandil, who offered a less invasive optionâthyroid ablation. This video explores the benefits of microwave ablation (MWA) as an effective treatment for thyroid nodules, avoiding the complications of surgery and long-term medication dependency. Dr. Kandil provides in-depth...
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In this in-depth interview, Dr. Emad Kandil, a leading expert in thyroid ablation at Tulane University, discusses the advanced technique of Microwave Ablation (MWA) for treating thyroid nodules. Dr. Kandil explains the science behind MWA, how it compares to Radiofrequency Ablation (RFA), and addresses common misconceptions such as concerns over excessive heat. He also explores the benefits of MWA over traditional thyroid surgery, including the preservation of thyroid function and the minimization of complications. This discussion is precious for medical professionals, researchers, and...
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In this expert-level analysis, we compare the clinical effectiveness of Microwave Ablation (MWA) and Radiofrequency Ablation (RFA) for the treatment of thyroid nodules, with a focus on key decision-making criteria for selecting the optimal minimally invasive treatment. This detailed case study, featuring Dr. Emad Kandil and patient testimony, offers a comprehensive exploration of advanced thyroid nodule management techniques. We begin with the patientâs journey, documenting her initial treatments with RFA, which resulted in limited success and the eventual regrowth of the thyroid nodule. Dr....
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Dr. Emad Kandil, one of the leading thyroid surgeons in the U.S. and a pioneer in non-surgical thyroid cancer treatment, is featured in this video discussing the benefits of thyroid ablation as an alternative to surgery. Based at Tulane University, Dr. Kandil has successfully treated numerous patients using this minimally invasive procedure, which allows for the targeted destruction of cancerous thyroid nodules without removing the thyroid gland. - The patient story told by Vanessa: "you have thyroid cancer" - 12:38 Dr. Kandil discusses treating thyroid cancer without surgery In...
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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...
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In a world where misinformation can spread as rapidly as legitimate data, discerning the truth becomes a critical skillâespecially 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. âBetter information leads to better health,â he says,...
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Durante una entrevista detallada en el podcast RFAMD, el anfitriĂłn Philip James conversĂł con la Dra. Ana Voogd, una distinguida cirujana de cabeza y cuello con mĂĄs de 30 años de experiencia, sobre la integraciĂłn gradual de la terapia de ablaciĂłn tiroidea en el panorama mĂ©dico de Argentina. La Dra. Voogd, que dirige el departamento de cirugĂa de cabeza y cuello en uno de los hospitales mĂĄs grandes de Argentina, proporcionĂł perspectivas valiosas sobre el enfoque evolutivo del paĂs hacia el cuidado del tiroides. Un Paso Hacia Procedimientos Menos Invasivos La Dra. Voogd explicĂł la...
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As the medical community swiftly embraces thyroid ablation, a groundbreaking non-surgical treatment for thyroid nodules, concerns arise about the potential risks associated with its rapid adoption. Key among these concerns is the lack of ultrasound expertise among practitioners and the contentious decision to treat nodules that may be too small to warrant intervention. This article delves into the insights of Dr. Jagdish Dhingra, a seasoned thyroid surgeon, who highlights the crucial balance between leveraging medical innovations and ensuring patient safety through skilled application and...
info_outlineSeptember is Thyroid Cancer Awareness Important, surgery isnât always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it.
In recent years, innovative methods in thyroid cancer management have drastically changed the field, and potentially the future of cancer treatments overall. A thought-provoking revelation comes from a discussion held at the World Congress on Thyroid Cancer in London, where a paradigm-shifting concept was discussed by two highly respected figures in the field.
Dr. Akira Miyauchi of Kuma Hospital in Kobe, Japan, and Dr. Michael Tuttle from Sloan Kettering Cancer Center, New York, unveiled a practice that goes against traditional medical protocol: favoring active surveillance over immediate surgery in managing papillary thyroid cancer. The method has been utilized at Kuma Hospital for 30 years, and in this time, not one patient has died from this type of cancer. This groundbreaking revelation was discussed in a live interview hosted by Philip James of the Doctor Thyroid podcast.
According to Dr. Miyauchi, the original proposal for this trial of active surveillance was approved and initiated in 1993. It is based on the principle that early intervention is not always critical. Instead, the method favors regular monitoring of the patientâs condition to identify any changes in the cancerâs progression.
âThe 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 â these instances are significantly smaller in active surveillanceâ 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. Tuttleâs 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.
âHaving seen a few now that are on the other side of that, I can tell you for most people they werenât upset they werenât sad that we had to do something but they felt like theyâd given it their bestâ Dr. Tuttle explained.
This approach might, however, require a change in doctorsâ attitudes as well. Itâs not only about informing patients about their cancer but also managing their anxiety and uncertainty about the âwait and seeâ strategy. The physiciansâ warm-heartedness, their reassuring demeanor, and the trust they establish with their patients are crucial factors that may significantly affect patientsâ psychological well-being.
The shift from immediate surgical intervention to active surveillance represents a revolutionary approach to managing thyroid cancer. The results from the Kuma Hospital trial are prompting the medical community to rethink its strategies and consider adopting this new method more broadly. Although active surveillance might not be the right choice for all patients, it presents an alternative and safe option for those with papillary thyroid cancer, potentially improving both their physical and psychological quality of life.
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About Philip James
In 2013, his laryngeal nerve was severed, shoulder nerve damaged, parathyroids ruined, and residual cancer left behind â all for a 1 cm thyroid nodule.
Later, a vocal cord implant was inserted to help him speak.
The word he uses to describe his work as patient advocate is, âtonglenâ. Or, using his pain and hardship to help others.
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