What is Active Surveillance AS for Thyroid Cancer?
- Overdiagnosis of thyroid cancer is epidemic in the world.
- By age 50, half of the population has at least one thyroid nodule, and by age 90, almost everyone does — making the portion of the population with potential for thyroid cancer diagnosis (or overdiagnosis) very large.
- To prevent problems first do not have an thyroid ultrasound unless there are clear indications.
- If you did have an ultrasound and a 1 cm nodule was found do not have a biopsy unless the need is confirmed by an endocrinologist, not a surgeon or family doctor.
- Central location of this micro-papillary cancer makes it ideal for AS instead of immediate surgery.
- If you did not listen and went ahead with the biopsy and it was positive for a micro-thyroid cancer consider a consultation to see if you are a candidate for Active surveillance AS.
- The consultant is expert in deciding if the cancer is in a place inside your thyroid that is located away from close contact with the capsule or in the isthmus.
- If you and your family agree to be followed with yearly ultrasounds of the thyroid and neck, you can join the increasing number of patients that have deferred surgery forever in the AS registry.
- The criteria for a rescue surgery is a 3 mm increase in nodule size.
- The deferred surgery has no increased risks than the if you did the surgery when the cancer was first diagnosis.
- Participants reported that their decision not to intervene received little support or reassurance from health care providers and others, and many reported receiving skeptical, even derisive responses, such as being told they were “stupid,” “wrong,” or “crazy.”
- Don’t be fooled by these naysayers. This is an acceptable method being done at major centers in the world.
- Some AS patients kept their thyroid cancer findings secret in order to avoid negative feedback. Untreated cancer is a scarlet letter. Do not keep if from your nuclear family members.
- “Culturally we are conditioned to think that if you’re diagnosed with cancer, you have to do everything you can to rid your body of that cancer.
- A cancer that is going to sit in the thyroid gland for the rest of your life is not a serious cancer needing quick action. In a few AS patients small 3 mm growth over years will trigger the rescue surgery.
- Thyroid micro-cancer is not alone in being followed by AS,prostate cancer is another slow growing cancer using AS.
- 310-393-8860. Ask for Matt. Call for my evaluation to see if you are a candidate for my non-surgical intervention at first with a small harmless thyroid cancer. You may never need surgery, and if it grows 3 mm on ultrasound you still can have safe surgery later.
Surgery even by modern standards have serious complications in 2017, especially if you have a safe non surgical alternative. The 14 century method of thyroid surgery had very high death rate, and in the hands of a low volume surgeon doing <25 total thyroidectomies a year you may not die but can lose your voice of your calcium glands more often that if you were operated by a high volume surgeon.