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 No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

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Thyroid Nodule 101: Patient Yelp Review of Massive Benign Thyroid Nodule Treated with Ethanol PEI and Radiofrequency RFA Ablation.

Posted 3 days ago

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Thyroid Nodule 101: Patient Yelp Review of Massive Benign Thyroid Nodule Treated with Ethanol PEI and Radiofrequency RFA Ablation.

Dr.Guttler’s comments on this review of my treatment of an unusual patient with a massive...

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Thyroid Cancer 101: The Scarlet Letter Big C Tattoo to the Blue Letter b tattoo. Looks like Papillary Thyroid Cancer but it is Not Cancer.

Posted 14 days ago

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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 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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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 No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

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Thyroid Nodule 101: Patient Yelp Review of Massive Benign Thyroid Nodule Treated with Ethanol PEI and Radiofrequency RFA Ablation.

Posted 3 days ago

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Thyroid MicroCancer 101: TCCC Member Richard Guttler’s Non-Surgical Options.

Posted 12 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 No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid Nodule 101: Patient Yelp Review of Massive Benign Thyroid Nodule Treated with Ethanol PEI and Radiofrequency RFA Ablation.

Thyroid Cancer 101: The Scarlet Letter Big C Tattoo to the Blue Letter b tattoo. Looks like Papillary Thyroid Cancer but it is Not Cancer.

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.

Rfa 101

Breakthrough Radiofrequency Ablation Treatment

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid Nodule 101: Patient Yelp Review of Massive Benign Thyroid Nodule Treated with Ethanol PEI and Radiofrequency RFA Ablation.

Thyroid MicroCancer 101: TCCC Member Richard Guttler’s Non-Surgical Options.

From The Blog

Thyroid Cancer 101: Thyroid Cancer Going to the Dogs

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery

Thyroid Nodule 101: Patient Yelp Review of Massive Benign Thyroid Nodule Treated with Ethanol PEI and Radiofrequency RFA Ablation.

Subclinical Hypothyroidism 101: Causes Brain to Shrink?

Thyroid Cyst Treatment 101: How Simple Can it Be to Save You From Surgery?

Thyroid Cysts 101: Ethanol Treatment is Not Dangerous

Primary Micro-Papillary Thyroid Cancers 101: There are Three Options

Recurrent Thyroid Cancer 101: How Ethanol Ablation PEI Can Save You from Another Hospital Stay for a Repeat Neck Dissection Thyroid Surgery.

Thyroid and Parathyroid Cysts 101: Ethanol Ablation PEI, Treatment of Choice is Still Not Done Enough In the USA

Thyroid Cancer That is Now a Benign Tumor 101: How do You Find Out The Needle Biopsy Result of Papillary Thyroid Cancer Could Be A Benign Tumor Instead ?

Thyroid MicroCancer 101: TCCC Member Richard Guttler’s Non-Surgical Options.

Thyroid Cancer 101: TCCC Member Richard Guttler MD.FACE,ECNU

Thyroid Cancer 101: The Scarlet Letter Big C Tattoo to the Blue Letter b tattoo. Looks like Papillary Thyroid Cancer but it is Not Cancer.

Hyperthyroidism 101: What Causes The Thyroid Cells to Go Wild Forming a Toxic Thyroid Nodule?

Thyroid Cancer 101: Men Have Lower Survival Rate

Thyroid Cancer 101: Does Your Cell Phone Cause Thyroid Cancer?

Hashimoto’s Thyroiditis CHT 101: Rheumatoid Arthritis Increases Your risk of CHT.

Hypothyroidism 101: Does Ayurvedic Treatment Do Anything to Treat Hypothyroidism

Thyroid Cancer 101:Tall People are at a greater risk of thyroid cancer,

Thyroid Pseudo-Nodules 101: Rare Killian-Jamieson KJ Diverticulum Looks like a Thyroid Nodule.

Hashimoto’s Thyroiditis 101: This is a very poor article to read if you want to know about this disease.

Smoking and Overweight Mothers Put Unborn Child At Risk

Thyroid Cancer Surgery 101: Half or a Whole Loaf ? Depends how you slice it

Thyroid Surgery 101: Not Everything is in This Article!

Thyroid Cancer101: A Bout with ‘The Big C

Thyroid Nodules 101: “Bumps on Your Neck”

Hypothyroid 101: Is soy good or bad for your thyroid?

Hypothyroid101: Women are from Venus and Men are from Mars: Differences in Symptoms for Women vs Men .

Hypothyroid 101: When to Treat Subclinical Hypothyroidism

Thyroid Cancer Alert: Cancer Causing Fire Retardant Found in Michigan Deer.

Thyroid Cancer Diagnosis 101: Bad Ultrasound Reports= Too Many Thyroid Biopsies

Thyroid Cancer 101: Thyroid Over-diagnosis and Treatment of Harming Patients.

Thyroid Cancer 101: Megan’s Story

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

Hypothyroid101: Women are from Venus and Men are from Mars: Differences in Symptoms for Women vs Men  .