Thyroid No Surgery 101: Dr.Guttler’s Rules to Avoid Unnecessary Thyroid Surgery for a diagnosis of thyroid cancer by biopsy.
Active Surveillance and NIFT-P
- Never have thyroid surgery when told you have thyroid cancer without outside second opinion first. Why? One if it is small and located entirely inside your thyroid gland it may be a candidate for Active surveillance. This is used for small cancers with low risk of spreading in your lifetime. Yearly ultrasound to monitor size to ensure there is no growth. If there is the unlikely possibility of even the slight growth of 3 mm a delayed surgery can be done without harm from the delay.
- A kind of papillary thyroid cancer called follicular variant that shows no evidence of invasion outside the capsule of the nodule is now downgraded to a benign tumor called Non-invasive follicular tumor with papillary looking cells. or NIFT-P.
- If you have a potential NIFT-P you may need only a lobe removed to confirm there is no invasion.
- If the diagnosis is NIFT-P after the surgery you are done.
- You did not have thyroid cancer after all!
- There will not be any long term cancer follow up with imaging or radiation.
- If your other lobe is normal you will not need thyroid hormone.
- Your insurance will not carry a cancer diagnosis for life.
- This is very important you get a second opinion before you have surgery.
- Large NIFT-P nodules could prompt the surgeon to do a total thyroidectomy
- It would be to late to avoid thyroid hormone for life even if you don’t have cancer.
- See me for an evaluation or do an on line second opinion at 310-393-8860 or firstname.lastname@example.org.