Welcome to the Thyroid Center of Santa Monica. We can help you get outside second opinions for these thyroid conditions.Don’t let managed care providers prevent you from making sure they are doing the right thing. 1. Do you really need a screening thyroid ultrasound with no history or findings? 2. Do you really need a needle biopsy for your small nodule? 3.Do you really need surgery for your indeterminate suspicious thyroid nodule? 4.Do you really need to go to surgery without the a consultation with an expert thyroid cancer physician? The answer is no to all four. Without second opinions 25% go to surgery for a benign nodule.

Out of Network Second Opinion Before Surgery for Thyroid Nodules and Cancer

How Does it work?

Ask for your records to be sent to a thyroid expert for review before you consider surgery as the correct treatment. Some patients turn out to not have cancer. Some have a tumor that was called cancer in the past but now is a benign tumor.Some have a small thyroid cancer that active surveillance like prostate cancer can be used instead of surgery. Also ethanol ablation or radiofrequency can ablate it while it is small as a third alternative. Come to see me for an evaluation before you you consider surgery.

Second Opinion results:

What if the recommendation is no surgery?

What are the non-surgical options possible?

Active surveillance of <1.5 cm primary papillary thyroid cancers Follow these with ultrasound yearly instead of surgery. Only operate if the nodule grows >3 mm. Most never have surgery, and the rest do just as well as if the had surgery at first.Alternative if the patient does not want surgery of long periods with a cancer in the neck they can opt of ethanol ablation or RFA.

~ Ultrasound-Guided PEI thyroid mixed cysts,
Parathyroid cysts, thyroid cancer lymph nodes and small <1.5 cm primary cancers

~ RFA radiofrequency ablation for solid nodules, recurrent thyroid cancers and small primary cancers

Thyroid cancer is overdiagnosed and overtreated, say Mayo doctors

By Susan Perry | 08/28/13

Dr. Juan Brito discusses the Mayo findings.

Key factors behind the rise

Imaging
Insurance pays for these imaging tests.
The routine use of neck ultrasonography has increased at least 80 percent since 1980.

Unnecessary treatments

Overdiagnosis often leads to overtreatment, the number of thyroidectomies (surgeries that remove all or part of the thyroid gland) rose 60 percent in the United States between 1996 and 2006.
The thyroidectomy procedure is costly and associated with several serious and permanent complications, including nerve injury to the larynx. People who’ve had a total thyroidectomy — or even, in some cases, a partial one — must also take thyroid replacement therapy for the remainder of their lives, a treatment that poses its own health risks.
Radioactive iodine treatment is also being increasingly prescribed in the United States for low-risk papillary lesions. In 1973, one in 300 patients with thyroid cancer received these treatments. In 2006, that number had grown to two in five patients.
Yet radioactive iodine treatments are not recommended for people with low-risk thyroid lesions.
The treatments are associated with a reduced quality of life and a risk of developing other types of cancer, including leukemia and cancer of the salivary gland.

Out of Network Second Opinion Before Surgery.

Thyroid Surgery is rarely an emergency.It is an elective procedure.

Don’t rush without knowing all your options.

Why a second opinion? It can confirm that you are doing the right thing.

2/10 did not agree with the original DX of cancer.

4/10 indeterminate FNA biopsies were confirmed on second opinion.

2/10 Indeterminate FNA biopsies were non-diagnostic on second opinion..

4/10 indeterminate FNAs were benign on second opinion.

13/100 Indeterminate FNA biopsies on initial cytology hd cancer at surgery.

30/100 indeterminate FNA biopsies from second opinion had cancer.

14/100 did not have cancer on second opinion.

5/10 indeterminate cases had a different diagnosis on second opinion.

43/100 indeterminate biopsies had a definite benign result on second opinion.

It can change the diagnosis.
It can change the extent of surgery.
It can find the type of cancer has been downgraded to benign.
It can find that you had a nodule that was incompletely evaluated before recommending surgery.
It can help you find non-surgical treatment for benign nodules and some thyroid cancers.
It can find that your small cancer is harmless and can be best treated by just yearly ultrasounds or ethanol ablation instead of surgery.
It can help you find alternative treatment specialists for small cancers in the thyroid and local recurrent cancers.
It can determine if a nodule or cancer can be treated with minimally invasive ethanol or radio frequency ablation instead of surgery.

9.Finally it can direct you to high volume thyroid surgeons with low complication rate.
Second opinion is not a wasted time.It is giving you peace of mind that you are doing the right thing.

Meet Dr. Guttler

The Thyroid Center of Santa Monica is a multiservice center established for the diagnosis and treatment of thyroid disorders in Santa Monica, California. Since 1974, Dr. Richard Guttler, clinical thyroidologist and board-certified endocrinologist, has been the director for the Thyroid Center of Santa Monica. Dr. Guttler is also the sole owner of the Endocrine Neck Ultrasound Lab of Southern California, an extension of the thyroid center.

Full Bio

Non-Surgical Thyroid Cancer Treatment

Your one-stop-shop for the diagnosis
and treatment of thyroid conditions

Our practice is highly specialized and is one of only a few centers across the United States focused entirely on thyroid problems.

We commonly serve patients who have been diagnosed with hypothyroidism, hyperthyroidism, Hashimoto’s thyroiditis, and other conditions involving the thyroid. For patients diagnosed with thyroid cancer and thyroid nodules, we offer innovative, advanced techniques that are smart, cost-effective alternatives to surgery. Interventional thyroid procedures include ultrasound-guided percutaneous ethanol injections (PEIs) for cysts and thyroid cancer lymph nodes,radiofrequency ablation for solid nodules, and HIFU for solid thyroid nodules

Because of our specialty services, patients come from all over the world to see Dr. Guttler. In addition, endocrinologists travel to Dr. Guttler’s office for his workshops and Masters classes offering advanced training and knowledge in thyroidology.

Thyroid Center of Santa Monica welcomes your call and looks forward to serving patients and their physicians. To request a consultation, please call our office at (310) 393-8860

Thyroid No Surgery 101

Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate?

Posted August 23, 2018

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Thyroid No Surgery for Thyroid cysts 101: 10 year post PEI No Recurrence.

Posted August 10, 2018

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Thyroid No Surgery for Thyroid cysts 101: 10 year post PEI No Recurrence.

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Thyroid Cancer 101: Why You Need An Expert Second Opinion Before Surgery

Posted July 27, 2018

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Thyroid Surgery 101: 1869 Almost half 8/20 of the goiter patients having surgery died.

Posted July 2, 2018

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Thyroid Nodules and Cancer 101: Radiofrequency Ablation (RFA) Instead of Surgery.Is It Safe? The Answer is Yes.

Posted June 29, 2018

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What are the Benefits and Risks of Thyroid Nodule Evaluation in Patients ≥70 Years Old

Posted April 26, 2018

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What are the Benefits and Risks of Thyroid Nodule Evaluation in Patients ≥70 Years Old. Comments...

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Published in American Thyroid Association new video journal VideoEndocrinology: My Simple Office Ethanol Ablation Procedure for thyroid/parathyroid cysts and recurrent thyroid cancer lymph nodes.

Posted March 7, 2018

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Thyroid No Surgery 101: Thyroid Radiofrequency Ablation RFA in 2018

Posted December 18, 2017

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Thyroid No Surgery 101: Thyroid Cancer Radiofrequency Ablation RFA in 2018 Dr.Guttler Comments...

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Rfa 101

Thyroid Radiofrequency RFA 101: RFA for benign thyroid nodules, and Thyroid Cancer nodal metastatic lymph nodes, and micro-papillary thyroid cancer

The patient with a cosmetic or symptomatic benign thyroid nodules can be treated with RFA.Also thyroid cancer lymph nodes and micro-papillary cancer can be an alternative active surveillance. We need to send you to Europe or Korea until RFA is approved in the USA.

Learn More

Breakthrough Radiofrequency Ablation Treatment

Thyroid Cancer 101: Why with thyroid cancer awareness week you should not get thyroid cancer screening.

Posted 1 day ago

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Massive Benign Goiter Nodule: Endocrinologists Fail to Offer Alternative Therapy to Serious Thyroid Surgery.

Posted 5 days ago

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Thyroid No Surgery: Very Large Benign Thyroid Nodules 101: Radiofrequency Ablation RFA can treat these massive nodules without surgery !

Posted 6 days ago

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See More About Thyroid RFA

Second Opinion results: What if the recommendation is no surgery? What are the non-surgical options possible?

Thyroid cancer is overdiagnosed and overtreated, say Mayo doctors

Unnecessary treatments

Out of Network Second Opinion Before Surgery. Thyroid Surgery is rarely an emergency.It is an elective procedure. Don’t rush without knowing all your options.

2/10 did not agree with the original DX of cancer.

4/10 indeterminate FNA biopsies were confirmed on second opinion.

2/10 Indeterminate FNA biopsies were non-diagnostic on second opinion..

4/10 indeterminate FNAs were benign on second opinion.

13/100 Indeterminate FNA biopsies on initial cytology hd cancer at surgery.

30/100 indeterminate FNA biopsies from second opinion had cancer.

14/100 did not have cancer on second opinion.

5/10 indeterminate cases had a different diagnosis on second opinion.

43/100 indeterminate biopsies had a definite benign result on second opinion.

It can change the diagnosis.

It can change the extent of surgery.

It can find the type of cancer has been downgraded to benign.

It can find that you had a nodule that was incompletely evaluated before recommending surgery.

It can help you find non-surgical treatment for benign nodules and some thyroid cancers.

It can find that your small cancer is harmless and can be best treated by just yearly ultrasounds or ethanol ablation instead of surgery.

It can help you find alternative treatment specialists for small cancers in the thyroid and local recurrent cancers.

It can determine if a nodule or cancer can be treated with minimally invasive ethanol or radio frequency ablation instead of surgery.

9.Finally it can direct you to high volume thyroid surgeons with low complication rate.

Second opinion is not a wasted time.It is giving you peace of mind that you are doing the right thing.

Meet Dr. Guttler

Non-Surgical Thyroid Cancer Treatment

Your one-stop-shop for the diagnosis and treatment of thyroid conditions

Thyroid No Surgery 101

Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate?

Thyroid No Surgery for Thyroid cysts 101: 10 year post PEI No Recurrence.

Thyroid Cancer 101: Why You Need An Expert Second Opinion Before Surgery

Thyroid Surgery 101: 1869 Almost half 8/20 of the goiter patients having surgery died.

Thyroid Nodules and Cancer 101: Radiofrequency Ablation (RFA) Instead of Surgery.Is It Safe? The Answer is Yes.

What are the Benefits and Risks of Thyroid Nodule Evaluation in Patients ≥70 Years Old

Published in American Thyroid Association new video journal VideoEndocrinology: My Simple Office Ethanol Ablation Procedure for thyroid/parathyroid cysts and recurrent thyroid cancer lymph nodes.

Thyroid No Surgery 101: Thyroid Radiofrequency Ablation RFA in 2018

Rfa 101

Breakthrough Radiofrequency Ablation Treatment

Thyroid Cancer 101: Why with thyroid cancer awareness week you should not get thyroid cancer screening.

Massive Benign Goiter Nodule: Endocrinologists Fail to Offer Alternative Therapy to Serious Thyroid Surgery.

Thyroid No Surgery: Very Large Benign Thyroid Nodules 101: Radiofrequency Ablation RFA can treat these massive nodules without surgery !

From The Blog

Thyroid Cancer 101: Does your sister or mother have thyroid cancer? If they do you are at risk.

Thyroid Cancer 101: Linked with Inflammatory bowel disease (IBD), especially those with Ulcerative colitis ?

Thyroid Cancer 101: Why with thyroid cancer awareness week you should not get thyroid cancer screening.

Thyroid Nodules 101: Why you should not go to surgery without molecular marker studies if you have a Indeterminate biopsy result.

Hypothyroidism 101: Untreated Hypothyroidism and Your Chances of Dying.

Patient Diagnosed with Acromegaly During an Evaluation for Interventional Treatment for Her Goiter.

Thyroid Cancer 101: Branchial Cleft Cyst is Really Thyroid Cancer.

Massive Benign Goiter Nodule: Endocrinologists Fail to Offer Alternative Therapy to Serious Thyroid Surgery.

Autoimmune Hashimoto’s and Graves’ disease and Alopecia Areata Linked.

Autoimmune Hashimoto’s and Graves’ disease and Alopecia Areata Linked.

Thyroid No Surgery: Very Large Benign Thyroid Nodules 101: Radiofrequency Ablation RFA can treat these massive nodules without surgery !

Canine Thyroid Cancer: Meet K-9 officer Gimi

Thyroid Cancer 101: After 9/11

Thyroid Cancer and Nodules: Online Second Opinions

Hypothyroid 101: Avoid Desiccated Animal Thyroid

Treat Ugly or Symptomatic Enlarging Benign Thyroid Nodules Without Surgery

Thyroid No Surgery 101: Ethanol Ablation PEI is First Line Treatment for Cystic Thyroid and Parathyroid Nodules.

Thyroid No Surgery 101: Do not have a thyroid ultrasound without an Indication.

Thyroid Self Exam: Where is the thyroid Gland?

Is Mono Lisa Hypothyroid?

Large Benign Thyroid Nodules 101: Ablation vs Surgery

Thyroid Cancer 101: When is watching the small thyroid cancer better than immediate surgery?

Massive Benign Nodule Treated in Three Sessions in Korea with Radiofrequency RFA.

Thyroid No Surgery 101: Avoid surgery for thyroid and parathyroid cysts

Benign Thyroid Nodules 101: Ugly Symptomatic Nodules Removed with Radiofrequency Ablation not Surgery.

Thyroid Cancer 101: A Variant of Papillary Cancer Which is Now not a Cancer.

Medullary Thyroid Cancer 101: Hard To Diagnose Without Screening Calcitonin

Thyroid Nodule/Cancer 101: Routine Second Opinion Saves Unnecessary Surgery..

Thyroid Nodule Cancer 101: Second Opinion Should Routine.

Thyroid Nodule and Cancer 101: Second Opinions are Essential for Your Safety.

Thyroid Micro-papillary Cancer 101: When are there central compartment lymph node metastatic disease CLNM?

Hashimoto’s Thyroiditis CHT 101: Thyroid Lymphoma in Pre-exisiting CHT

Thyroid Nodules 101: Outside Second Opinions of Thyroid Needle Biopsy Slides. Saves unnecessary surgery.

Thyroid Cancer 101: Why Outside Second Opinions Matter.It can result in major therapeutic and prognostic modifications.

The Future Bright for Thyroid Tumor Ablation with Ethanol PEI and Radiofrequency RFA According to Two Experts in Molecular Marker Research and One Research Endocrinologist

Thyroid Cancer Alternative Therapy 101: Ethanol PEI and radiofrequency ablation RFA

Thyroid Cancer 101: Are you being treated for the correct thyroid cancer? Read these 4 cases and then get a second opinion before the surgery.

Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate?

Are You Diagnosed with Thyroid Cancer? Take a Second Opinion

Second Opinion results:

What if the recommendation is no surgery?

What are the non-surgical options possible?

Out of Network Second Opinion Before Surgery.

Thyroid Surgery is rarely an emergency.It is an elective procedure.

Don’t rush without knowing all your options.

Your one-stop-shop for the diagnosis
and treatment of thyroid conditions