Thyroid RF 101: What are your Choices with Small papillary thyroid Cancer?

Thyroid RF 101: What are your Choices with Small papillary thyroid Cancer?

Thyroid RF 101: What are your Choices with Small papillary thyroid Cancer?

Micro-papillary cancer:  ultrasound image

Thyroid RF 101: What are your Choices with Small papillary thyroid Cancer? Is PEI or RFA options beside surgery or watching it for 50 years?

  1. Have Surgery when it is first diagnosed, even if it is probably slow growing and may never grow. The “John Wayne” get it out of there approach.
  2. Active Surveillance with <1.5 cm cancers. Rescue surgery only if it grows 3 mm. It may never need surgery, but you always know you have a cancer in your neck.
  3. Ethanol PEI or radiofrequency ablation RFA of the micro-papillary cancer.For those who don’t want surgery but also don’t want a cancer in the neck for 50 year. Some patients say they still want their doctors to treat their thyroids more aggressively. Studies in Korea and the Mayo clinic have found that PEI/RFA ablation of the cancer is a third track for those who still don’t want surgery but also don’t want a cancer in the neck for 50 years. PEI is available now at Mayo clinic in a study or at my center.Call 310393-8860 or email at thyroid.manager@protonmail.com  for details. Also call about RFA.It is not available in the USA now but after evaluation I can refer you to Korea for RFA for primary micro-papillary ablation instead of surgery or surveillance.
  4. Richard Guttler MD,FACE,ECNU
  5. thyroidnosurgery.com.
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  8. Korean study on micro-papillary cancer RFA ablation.
  9. Dr.Ian Hay from Mayo clinic study with PEI presented at WTCC in Boston 2017.
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Most people diagnosed with cancer want to start treatment as soon as possible, for fear that delaying care will allow their tumor to grow out of control.
However 33% may be candidates for Active surveillance or PEI/RFA.
Only a 1/8 had 3 mm growth by 5 years. and none had spread outside the thyroid. 88% had no growth and did not need surgery.
Even some tumors (8%) have decreased in size over 5 years.
Only a few of the patients opted for surgery (3%).
Age is a factor.Younger patients (20-30) have a higher risk of growth than age >60.

Reference;

Natural History and Tumor Volume Kinetics of Papillary Thyroid Cancers During Active Surveillance

JAMA Otolaryngol Head Neck Surg. Published online August 31, 2017. doi:10.1001/jamaoto.2017.1442
Micro-papillary cancer:  ultrasound image

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