What you need to know about when to get help from outside consultants before surgery

What you need to know about when to get help from outside consultants before surgery

What you need to know about when to get help from outside consultants before surgery

What you need to know about when to get help from outside consultants before surgery.

Dr.Guttler’s opinion:

  1. When there is a question about if you need a thyroid ultrasound. Doing one when it was not indicated can cause you to get a biopsy and even a surgery you did not need.
  2. When there is a question about the need for a biopsy after an ultrasound. Many nodules are too small or have findings not requiring a biopsy.
  3. When the biopsy has a questionable result and they want to do a diagnostic thyroid surgery. Modern DNA/RNA molecular marker testing can save you from an unnecessary surgery.
  4. When the biopsy shows you have papillary thyroid cancer PTC and they want to operate ASAP. PTC is not a cancer you need to rush to surgery. The DNA/RNA marker tests can help define the type of surgery needed.
  5. When they recommend a total thyroid removal and the PTC is a follicular variant. These are best treated with a lobectomy not a total as they have RAS mutations and act like a follicular tumor not papillary.
  6. When you have a 1.5 cm classic papillary cancer and they want to do surgery. This low risk PTC’s can be treated by either active surveillance  AS or ablation by ethanol PEI or radiofrequency RFA. Just following these can save the surgery.In a few if there is slight growth a rescue surgery can be done without hnegative effects.
  7. When you are told to have your whole thyroid removed for follicular variant papillary thyroid cancer. A new condition called noninvasive follicular tumor with papillary looking cells or NIFT-P is not a cancer and is best diagnosed by lobectomy only. 32 slices of the tumor can separate NIFT-P for a folicular variant PTC by capsule invasion.
  8. When you are told the only treatment for your symptomatic large benign nodule is surgery. Treatment of choice for these is not surgery in 2019. Minimally invasive methods with ethanol PEI or radiofrequency RFA are the best choice to save yoou from thyroid surgery.
  9. When you are told to have more surgery and radioiodine because you have a recurrence in your neck lymph nodes after you have had neck dissection and prior RAI/131 therapy. Treatment of up to 3-5 abnormal nodes can be safely done with ethanol PEI or radiofrequency ablation RFA.
  10. All these are grounds to seek an outside the network expert opinion before you have surgery.
  11. call me at 310-393-8860 or thyroid.manager@protonmail.com for my evaluation.
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