Why Do Patients in the US Drop out of Active Surveillance For Their Micro-papillary Thyroid Cancer?

Why Do Patients in the US Drop out of Active Surveillance For Their Micro-papillary Thyroid Cancer?

Why Do Patients in the US Drop out of Active Surveillance For Their Micro-papillary Thyroid Cancer?

Why do Patients in the US Drop out of Active Surveillance For Their Micro-papillary Thyroid Cancer?

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Dr.Guttler’s comments:

  1. Patients in the US are not happy to keep a thyroid cancer in their neck and many drop out of AS programs and have the surgery even though there has been no growth or lymph node involvement.
  2. In the United States, adoption of active surveillance for small intrathyroidal thyroid cancers remains in its early stages. A very limited number of centers offer this so-called watchful waiting as an alternative to immediate surgery, as observed in an article published earlier this year (JAMA. 2019;321:2020-2021).

    And this is despite the American Thyroid Association recommending active surveillance for the same tumor type in 2015.

  3. Americans are not like the Japanese patients and are worried about the tumor sitting in their neck for years.
  4.  The available alternative to surgery for all those who drop out of AS or those who reject both surgery and AS at the beginning can now have thyroid radiofrequency ablation RFA.
  5. This is a safe outpatient treatment that can ablate the small cancer inside the thyroid gland.
  6. Follow up cutting needle biopsy of the area where the tumor was can determine if is destroyed by RFA.

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Dr.Guttler doing thyroid RF on a patient.

call 310-393-8860 for details of Thyroid RF treatment for your small thyroid cancer.

email to thyroid.manager@protonmail.com

Dr.G.

Japanese Patients Accept Watchful Waiting for Low-Risk Thyroid Cancer.

Pam Harrison

Medscape News

October 29, 2019

 More than half of patients with low-risk papillary thyroid microcarcinomas (PTMCs) in Japan are assigned to active surveillance — as recommended by Japanese guidelines — rather than immediate surgery, according to the first survey of its kind there on the current management of low-risk PTMCs.

“This survey shows a high rate of active surveillance for PTMCs in Japan,” Iwao Sugitani, MD, PhD, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan, and colleagues write in their article published in Thyroid.

“However, marked differences in the indication and recommendation for active surveillance among institutions were also observed,” they stress.

“To increase the use of active surveillance for PTMC, physicians, primary care doctors, patients, and their families should be educated,” and the socio-medical environment should also be improved, they recommend.

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