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

Dr. Juan Brito discusses the Mayo findings.

Key factors behind the rise

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

 

Unnecessary treatments

  1. 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.
  2. 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.
  3. 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.
  4. Yet radioactive iodine treatments are not recommended for people with low-risk thyroid lesions.
  5. 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.

  1. It can change the diagnosis.

  2. It can change the extent of surgery.

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

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

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

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

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

  8. 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.

  9. 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

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See More About Thyroid RFA
Thyroid Cancer Awareness Month
This is my doctor.
He is amazing.

I was wary because he has reviews that are not favorable. Upon reading the reviews it’s clear that people have him poor reviews for two reasons 1) he does not take insurance so it is a lot of out of pocket expense and 2) He doesn’t go in for “natural” treatments because not a single “natural” cure has even been shown to have any effect whatsoever on thyroid disease. Patients need medication.
He is ALL about using non-invasive treatments whenever possible. He will exhaust options before recommending surgery or life-altering treatments.
He, along with a handful of colleagues, innovated the specialty of neck/thyroid ultrasound. He is kind, gentle, and above all, honest and real with his patients.

Michelle King Cohen

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