Thyroid No Surgery 101: Ethanol Ablation PEI all but Ignored by Endocrinologists and Surgeons?Why is a First Line Treatment for Benign Thyroid Cystic Nodules Underutilized in the USA?

Thyroid No Surgery 101: Ethanol Ablation PEI all but Ignored by Endocrinologists and Surgeons?Why is a First Line Treatment for Benign Thyroid Cystic Nodules Underutilized in the USA?

Thyroid No Surgery 101: Ethanol Ablation PEI all but Ignored by Endocrinologists and Surgeons?Why is a First Line Treatment for Benign Thyroid Cystic Nodules Underutilized in the USA?

Thyroid No Surgery 101: Ethanol Ablation PEI all but Ignored by Endocrinologists and Surgeons? Why is a First Line Treatment for Benign Thyroid Cystic Nodules Underutilized in the USA? Why is this inhibiting the expanded use for recurrent nodal metastatic thyroid cancer and small primary micro-papillary thyroid cancers?

  1. Tell their patients it dangerous, and it hurts. Surgery is more dangerous, and has more side effects for weeks after the operation.

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  1. Easier to send them to their local hospital for surgery than to a center like Mayo clinic for PEI.
  2. Difficult to find endocrinologists  or interventional radiologists doing PEI.
  3. The present state of low payments for PEI is a farce. The fee must be more than a few dollars so more endocrinologists will be willing to learn the procedure.
  4. The myth that it has to be done in the hospital or surgery center, with nurses and anesthesia is dead wrong. PEI can be done safely without any of the expensive set up of outpatient surgery centers.
  5. The ECNU certified endocrinologist with one assistant can do PEI in the office in 10-20 minutes after evaluation by FNA and molecular markers that it is benign.
  6. Until now there has been no formal training in PEI. AACE, ATA and Endocrine society ultrasound workshops spend little time to teach hands on PEI. It is not part of ECNU certification examinations.
  7. To learn how to do PEI don’t ask for help from radiologists.They refuse to train anyone but their own IR people. Mayo IR’s are the worst as they will not train or even release any written in formation on PEI to any other specialty.
  8. How do we overcome these roadblocks to better patient care for our thyroid patients with nodules,cysts and recurrent and primary thyroid cancer?
  9. AACE has formed a thyroid tumor ablation task force to study ablation procedure including PEI and radiofrequency ablation RFA.
  10. It is hoped that with a second major non-surgical procedure along with PEI that endocrinologists will see the value to their patients when simple safe treatments that do not require surgery, hospital stays, post op complications, loss of work, and large co-pays can be done in their office.
  11. What can you do now to learn Thyroid PEI and Thyroid RFA?
  12. A one week master’s class at either Dr.JH Baek’s Asan Medical center in Seoul Korea, Roberto Valcavi’s at Centro-Palmer Institute in Italy, or mine in Santa Monica California USA.
  13. For details on the courses call Matt at 310-393-8860 or thyroid.manager@protonmail.com.
  14. Until endocrinologists in the US are trained in thyroid tumor ablation patients still need to have the option of a non-surgical therapy.
  15. Treatment Endocrinologist’s patients with PEI can be obtained at my center and others and the Mayo clinic.
  16. RFA is still not FDA approved in the USA but has been used for years in Europe, and Asia.
  17. Santa Monica Thyroid Center’s Richard Guttler has a referral center for evaluation for patient’s to see if they are candidates for  Thyroid RFA. An approved candidate can have a 2 day visit to Italy or Korea to have just the treatment as my evaluation is accepted and saves the need for a long stay for a new work up.
  18. Call Matt at 310-393-8860 or thyroid.manager@protonmail.com for details of PEI therapy in the USA for benign thyroid/parathyroid cysts, partially solid nodules, recurrent lymph node neck metastatic disease, and for micro-papillary thyroid cancers instead of surgery or active surveillance.
  19. Richard Guttler MD,FACE,ECNU
  20. Interventional Thyroidologist
  21. www.thyroid.com
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