Welcome to the Thyroid Ethanol and Radiofrequency Ablation Center of Santa Monica

Master’s class in thyroid ethanol ablation PEI and Radiofrequency ablation RFA is now available to endocrinologists. A new procedures you can learn at my side for 3 days. ( check out master’s class section for details).

Since 1998 we have been treating thyroid patients with ethanol. This is called PEI. Most don’t know it is the treatment of choice for mixed benign thyroid and parathyroid cystic nodules. It is the preferred method to ablate a nodule without to need for a thyroid surgery. Primary physicians, surgeons and a surprising number of endocrinologists say the procedure is painful and dangerous. It is a safe outpatient 10-20 minute procedure done in my center. No hospital, scar, no need for thyroid hormone replacement for life, and no serious complications.

Since 2o02 since Radiofrequency was first used in Korea to a ablate solid benign thyroid nodules. 5 years ago I travel to Italy to train in thyroid RFA. I had several RF systems in my office and trained several thyroidologists. The Korean system with short probe and thin needle was the best available for thyroid work. It is FDA approved in the USA for soft tissue. This means it can be used for thyroid nodules but there are no codes and insurance coverage. I have developed a candidate evaluation system.I am training other interventional thyroidologists in the method and will begin clinical trials and am now treating my patients in my center in Santa Monica. There is sections on this website and my top thyroid blog on both PEI and RFA. If you have a large benign nodule or cyst you need to read all about my alternative therapy options to a thyroid surgery. Also if you have had thyroid cancer after surgery, and neck dissection and have a recurrence consider PEI or RFA in place of another surgery.

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.

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 had 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.

Thyroid Ethanol Ablation

Cystic thyroid and parathyroid benign nodules.

Recurrent thyroid cancer neck lymph node metastatic disease.

Primary encapsulated micro-papillary cancers

Small <1.5 cm primary cancers as alternative if the patient does not want surgery or long periods with a cancer in the neck they can opt of ethanol ablation.

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

Thyroid Ethanol Ablation 101: Alternative to more thyroid cancer surgery or Radioiodine.

Posted 8 hours ago by Dr Guttler

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Thyroid Ethanol Ablation 101: Alternative to more thyroid cancer surgery or Radioiodine.

More Use of Alternative Treatment Without Complications and Expense of Surgery or Radioiodine is Needed for Recurrent Thyroid Cancer in the Lymph Nodes.

More Use of Alternative Treatment Without Complications and Expense of Surgery or Radioiodine is Needed for Recurrent Thyroid Cancer in the Lymph Nodes

Before Ethanol Ablation PEI After 10 months post PEI

Management of recurrent and persistent metastatic lymph nodes in well-differentiated thyroid cancer: a multifactorial decision-making guide.

Dr.Guttler’s Comments:

1.Well-differentiated thyroid cancer (WDTC) recurs in up to 30% of patients.

2. They fail to guide the clinician as to the multitude of factors that should be taken into account.

3. The Thyroid Cancer Care Collaborative (TCCC) is a web-based repository of a patient’s clinical information.

4. Ten clinical decision-making modules (CDMMs) process this information and display individualized treatment recommendations.

5. Surgery remains the most common treatment in recurrent/persistent WDTC.

6. However, careful observation may be the recommended course in select patients.

7. Reoperation yields biochemical remission rates between 21% and 66%.

8. There is a reported 1.2% incidence of permanent unexpected nerve paralysis and a 3.5% incidence of permanent hypoparathyroidism.

9. Percutaneous ethanol ablation has been reported as therapeutic alternatives.

10.Radioactive iodine is not primary therapy for metastatic lymph nodes.

Ethanol ablation PEI saves money and is effective in ablating recurrent thyroid cancer lymph nodes.

Go to Mayo clinic and see Dr. Ian Hay. His study saved 35 patents $1.5 million in surgery costs and did not have one single major complication of nerve or parathyroid damage.

or see me for the same PEI therapy.

Call 1-310-393-8860 or thyroid.manager@protonmail.com for details if you have been told to risk more complication potential with another neck surgery.

Richard Guttler MD,FACE,ECNU

Interventional thyroidologist

thyroid.com

Thyroid Radiofrequency Ablation RFA

Surgical alternative for benign solid or mixed nodules.

Surgical alternative for toxic and autonomous functioning thyroid nodules AFTN.

Surgical alternative for Recurrent lateral neck lymph node metastatic papillary thyroid cancer.

Surgical and Active surveillance alternative for primary micro-papillary <1.5 cm cancers.

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

My patient just returned from Korea where her 10 cm nodule was ablated 90% with two sessions. She was done under local so the operator could tell if she had symptoms. Many places doing RFA put the patient to sleep and can’t monitor the voice. This allows discovery of symptoms after the procedure. She returned and told me there were no complications. Many operators will not do massive nodules and refer them to surgery.

This patient went to have RFA evaluation in Europe and because of the size of the nodule was told to have surgery instead.

My patient had the exact size 10 cm nodule and traveled to Korea

and had two sessions of thyroid RFA with 90% reduction of the nodule.

She is planning to go back in 6 months to complete the ablation of the remaining 10%.

If you are a patient with a large nodule and have put off the surgery for years

now is the time to remove it without surgery.

Call me at 310-393-8860 or email to thyroid.manager@protonmail.com

After I determine if you are a candidate for RFA I will arrange the treatment.

in Europe or Korea.

The evaluation includes a examination ultrasound and repeat FNA, molecular markers for cancer from the nodule.

We need to be sure there is no cancer with a low risk <3%.

Richard Guttler MD,FACE,ECNU

Interventional Thyroidologist

Meet Dr. Guttler

The Thyroid Center of Santa Monica is a multi-service 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. He is an interventioal thyroidologist expert in ablation procedures with ethanol PEI and the new for the US radiofrequency ablation RFA.

Full Bio

Non-Surgical Thyroid Cancer Treatment

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

My special expertise from 40 years of experience treating patients with thyroid nodules and cancer will give the patient the best chance to get the correct treatment and avoid unnecessary thyroid surgery.

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 thyroid nodules,cancer, 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 (PEI) for cysts and thyroid cancer lymph nodes, radiofrequency ablation for solid 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 or email to thyroidmanager@protonmail.com

Thyroid No Surgery 101

ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are Recommended to get Training in Radiofrequency Ablation RFA

Posted 4 days ago

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ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are...

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Thyroid No Surgery: First Ethanol and Now Thyroid Radiofrequency Ablation.

Posted 8 days ago

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Thyroid No Surgery: First Ethanol and Now Thyroid Radiofrequency Ablation.

DR.Guttler’s Comments: In 2014 I published the first article on ethanol ablation for...

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Google Search for Interventional Thyroidologists treating patients in his office with ethanol PEI and radiofrequency ablation RFA

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Endocrinologists Can Learn to Do RFA in their office if they have been doing their own ultrasounds and biopsies.

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Ethanol Ablation of a thyroid cyst and a recurrent cancer in a neck lymph node.

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Why Thyroid Micropapillary thyroid cancer will be treated with radiofrequency RFA instead of Surgery or Active Surveillance.

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Why Thyroid Micropapillary thyroid cancer will be treated with radiofrequency RFA instead of Surgery or Active Surveillance.

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2020 The Year of Thyroid Ablation by Interventional Thyroidologists.

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2020 The Year of Thyroid Radiofrequency Ablation RFA by Interventional Thyroidologists. Typical...

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RFA 101:Radiofrequency Ablation of thyroid nodule done in Korea by by Dr.Sim

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RFA 101:Radiofrequency Ablation of thyroid nodule done in Korea by by Dr.Sim

RFA 101:Video of Radiofrequency Ablation of thyroid nodule done in Korea by by Dr.Sim and Cho in...

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FDA approved Thyroid RFA: Alternative to Surgery for solid nodules and cancer lymph nodes and small micro-papillary cancers in the thyroid gland as alternative to surgery or active surveillance.Certain parathyroid adenomas can be treated also without surgery.

Call me at 310-393-8860 or secure email at thyroid.manager@protonmail.com.

Ask for Alicia.

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 to active surveillance. We will evaluate you to see if you are a candidate for RFA. On my recommendation t you can be treated in Europe or Korea until RFA is approved in the USA.

Learn More

Breakthrough Radiofrequency Ablation Treatment

Thyroid RFA 101: How to add a thyroid radiofrequency ablation RFA procedure to your endocrine practice.

Posted 1 day ago

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Thyroid RFA 101: How to add a thyroid radiofrequency ablation RFA procedure to your endocrine...

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ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are Recommended to get Training in Radiofrequency Ablation RFA

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ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are...

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Thyroid No Surgery: First Ethanol and Now Thyroid Radiofrequency Ablation.

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See More About Thyroid RFA

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 had 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.

Thyroid Ethanol Ablation Cystic thyroid and parathyroid benign nodules. Recurrent thyroid cancer neck lymph node metastatic disease. Primary encapsulated micro-papillary cancers

Thyroid Ethanol Ablation 101: Alternative to more thyroid cancer surgery or Radioiodine.

Thyroid Ethanol Ablation 101: Alternative to more thyroid cancer surgery or Radioiodine.

More Use of Alternative Treatment Without Complications and Expense of Surgery or Radioiodine is Needed for Recurrent Thyroid Cancer in the Lymph Nodes.

5. Surgery remains the most common treatment in recurrent/persistent WDTC.

6. However, careful observation may be the recommended course in select patients.

7. Reoperation yields biochemical remission rates between 21% and 66%.

8. There is a reported 1.2% incidence of permanent unexpected nerve paralysis and a 3.5% incidence of permanent hypoparathyroidism.

9. Percutaneous ethanol ablation has been reported as therapeutic alternatives.

10.Radioactive iodine is not primary therapy for metastatic lymph nodes.

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

Meet Dr. Guttler

Non-Surgical Thyroid Cancer Treatment

Your one-stop-shop for the diagnosis and treatment of thyroid conditions. My special expertise from 40 years of experience treating patients with thyroid nodules and cancer will give the patient the best chance to get the correct treatment and avoid unnecessary thyroid surgery.

Thyroid No Surgery 101

ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are Recommended to get Training in Radiofrequency Ablation RFA

Thyroid No Surgery: First Ethanol and Now Thyroid Radiofrequency Ablation.

Google Search for Interventional Thyroidologists treating patients in his office with ethanol PEI and radiofrequency ablation RFA

Endocrinologists Can Learn to Do RFA in their office if they have been doing their own ultrasounds and biopsies.

Ethanol Ablation of a thyroid cyst and a recurrent cancer in a neck lymph node.

Why Thyroid Micropapillary thyroid cancer will be treated with radiofrequency RFA instead of Surgery or Active Surveillance.

2020 The Year of Thyroid Ablation by Interventional Thyroidologists.

RFA 101:Radiofrequency Ablation of thyroid nodule done in Korea by by Dr.Sim

Breakthrough Radiofrequency Ablation Treatment

Thyroid RFA 101: How to add a thyroid radiofrequency ablation RFA procedure to your endocrine practice.

ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are Recommended to get Training in Radiofrequency Ablation RFA

Thyroid No Surgery: First Ethanol and Now Thyroid Radiofrequency Ablation.

From The Blog

Thyroid RFA 101: How to add a thyroid radiofrequency ablation RFA procedure to your endocrine practice.

ECNU Certified Endocrinologists Doing Their own Biopsies and Ethanol Ablations PEI are Recommended to get Training in Radiofrequency Ablation RFA

Thyroid No Surgery: First Ethanol and Now Thyroid Radiofrequency Ablation.

Google Search for Interventional Thyroidologists treating patients in his office with ethanol PEI and radiofrequency ablation RFA

Endocrinologists Can Learn to Do RFA in their office if they have been doing their own ultrasounds and biopsies.

Ethanol Ablation of a thyroid cyst and a recurrent cancer in a neck lymph node.

Type of Neck Cysts You Don’t Need Surgery to Cure Them With Ethanol Ablation PEI

Neck Cysts No Surgery: Ethanol Ablation PEI for all cystic neck nodules.

Ethanol injection PEI for Branchial Cleft Cyst.

Parathyroid Radiofrequency Ablation for Secondary Hyperparathyroidism

Less Parathyroid Surgery in 2020: Parathyroid Radiofrequency Ablation RFA of Primary Parathyroid Adenoma: 10 cases

Why Thyroid Micropapillary thyroid cancer will be treated with radiofrequency RFA instead of Surgery or Active Surveillance.

2020 The Year of Thyroid Ablation by Interventional Thyroidologists.

Parathyroid Adenoma PTA Treated with Radiofrequency Ablation RFA.

Parathyroid Adenoma Treated without surgery by Radiofrequency ablation.

Parathyroid Adenoma No Surgery 101: 2 more cases treated with radiofrequency ablation.

Parathyroid Adenoma No Surgery 101: Radiofrequency Ablation for Parathyroid Adenoma

PTA No Surgery 101: Radiofrequency Ablation RFA for Parathyroid Adenoma PTA

RFA 101:Radiofrequency Ablation of thyroid nodule done in Korea by by Dr.Sim

Thyroid Cancer and Radiofrequency Ablation RF 101: Why Active Surveillance is Not an Attractive Alternative to Surgery.

No More Surgery/Parathyroid Adenoma 101: Alternative Therapy with Radiofrequency and Ethanol Ablation.

Thyroid No Surgery: Radiofrequency RFA and Ethanol Ablation: PEI for Thyroid Cancer Recurrent Lymph Nodes

Master’s Class in Radiofrequency Ablation: Practice moving shot technique with phantom.

Thyroid No Surgery 101: Ethanol ablation PEI for a Large Symptomatic Benign Thyroid Cyst

My Sonographer Matt talks about Ethanol Ablation of benign thyroid cysts.

Thyroid No Surgery 101: Why are Physicians Sending their Patients for Surgery When Ethanol Ablation is the treatment of choice and it is done in my office ultrasound room?

Thyroid No More Surgery for Recurrent Thyroid Cancer in the Neck Lymph Nodes and Benign Cystic Thyroid Nodules

Ethanol Ablation of Parathyroid Cysts

Outpatient Thyroid Radiofrequency Ablation RF for Nodules: No hospital needed! Walk in and out of the endocrinologists office 30 minutes after the treatment.

Thyroid Nodule RF video from RF Medical Korea.

Why Do Patients in the US Drop out of Active Surveillance For Their Micro-papillary Thyroid Cancer?

Compounding Pharmacy: Bad News for Hypothyroid Patients

Active Surveillance AS, Surgery or Radiofrequency Ablation RFA for Micro-Papillary Thyroid Cancer

Thyroid Ethanol Ablation

Cystic thyroid and parathyroid benign nodules.

Recurrent thyroid cancer neck lymph node metastatic disease.

Primary encapsulated micro-papillary cancers

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

My special expertise from 40 years of experience treating patients with thyroid nodules and cancer will give the patient the best chance to get the correct treatment and avoid unnecessary thyroid surgery.