ThyroidNoSurgery.Com: The Place on the Web to Find All You Need to Know About Alternatives To Surgery for Thyroid Nodules,Cysts and Even Some Cancers.

ThyroidNoSurgery.Com: The Place on the Web to Find All You Need to Know About Alternatives To Surgery for Thyroid Nodules,Cysts and Even Some Cancers.

ThyroidNoSurgery.Com: The Place on the Web to Find All You Need to Know About Alternatives To Surgery for Thyroid Nodules,Cysts and Even Some Cancers.

ThyroidNoSurgery.Com: The Place on the Web to Find All You Need to Know About Alternatives To Surgery for Thyroid Nodules,Cysts and Even Some Cancers.

  1. Small classic papillary thyroid cancer <1.5 cm treated without surgery by Active Surveillance. Yes,You heard me.These may never go are usually not aggressive, and sit quietly in your neck for >23 years in some studies. A 50 year registry can make sure your original size and negative neck lymph node ultrasound can be accessed by all your future endocrinologists.
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  3. The new former low grade cancer is now called non-invasive follicular tumor with papillary cancer like cells. NIFT-P. The reduced need for a total will markedly decrease complications as the majority of surgery on the thyroid is done by low volume surgeons. Surgery is stilled needed but a lobectomy will allow pathologists to determine if it is non-invasive. The beauty of this is there will be no diagnosis of cancer and no cancer follow up protocol or radioiodine. Your insurance will not have a cancer diagnosis to increase your costs.003OLYMPUS DIGITAL CAMERA3. The thyroid ultrasound is a great tool for diagnosis of thyroid nodules and cancer.However,it can be a cause of too many nodules being evaluated for cancer.Therefore the first rule for deciding to have a thyroid ultrasound is find out if you have a clinical indication such as family history,or a exam finding of a goiter or nodule.Refuse any “routine” screening ultrasound, or a free one at a health fair. JUST SAY NO!img_0477
  4. 4. If you allowed the ultrasound and a nodule was found, you can defer the biopsy until you have expert opinion that a biopsy is indicated. Many small nodules are found in the normal population with increasing age. These can be watch instead of biopsy, and only if they grow should a biopsy be done. This will save you from a surgery that was not necessary if you have not had the small nodule biopsied at first.

5. You had the biopsy and it was suspicious. Before any surgery get another opinion. There are cancer marker tests that can be done on your slides from the initial biopsy, or collected from a repeat biopsy to help determine if the surgery is needed.

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6. Some cancer markers (RAS) are associated with a single follicular cell carcinoma and usually can be treated with less dangerous surgery of lobectomy. BRAF and RET-PTC with papillary thyroid cancers which may need a total.

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Image result for Microwave ablation of thyroid nodules

7. Even recurrent papillary thyroid cancer locally in neck lymph nodes after first neck dissection can be treated by non-invasive PEI ( ethanol ablation). This saves the patient another hospital admission for another neck dissection with all the risks and pain a suffering.

Image result for ethanol ablation of neck lymph nodes in thyroid cancer

Image result for ethanol ablation of neck lymph nodes in thyroid cancer

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8. PEI is also the treatment of choice for thyroid and parathyroid cysts. There is no need for a thyroid surgery with this type thyroid cystic nodule with >50-60% cyst fluid. Refuse surgery until you have an evaluation to see if this is right for you. 15 minute treatment as outpatient or hospitalization, surgery and recovery.

Image result for ethanol ablation of neck lymph nodes in thyroid cancer

Image result for ethanol ablation of neck lymph nodes in thyroid cancer

2 cyst fluids from a thyroid cysts.

Bottom clear fluid was from a parathyroid cyst.

 

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Benign thyroid nodules big enough to cause symptoms were usually referred for surgery.However, in the last 10 years Radiofrequency ablation RFA and recently high intensity focused ultrasound HIFU have been used instead of surgery. Before getting that surgery bed in the hospital get an evaluation for one of these non-invasive treatments. At present after my evaluation you need to spend 2 days in Europe or Korea to have RFA or HIFU. This is still less expensive and less morbidity that a hospitalization for thyroid surgery.

Ideal nodule RFA and HIFU is a micro-cyst spongiform nodule.

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Image result for RFA ablation of thyroid nodules

 

Image result for RFA ablation of thyroid nodules

HIFU for thyroid nodules. There is no probe to stick in the nodule like RFA and ethanol.The probe just sits on the skin. Truly non-invasive.

Image result for HIFU ablation of thyroid nodules

 

Image result for HIFU ablation of thyroid nodules

 

Image result for HIFU ablation of thyroid nodules

HIFU ablated nodule

Image result for HIFU ablation of thyroid nodules
HIFU centers in France,Germany,Italy and Asia. A referral from me gets you a 2 day in and out 20-45 minute HIFU tratment and back  to the USA for my followup. Call Matt 310-393-8860 for details.
New method is microwave ablation of thyroid nodules MWA.
TWo US beams cross at focal point and the heat from movement of billions of water molecules destroys the nodules cells.
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Similar to RFA it kills a cigar shaped  1 cm area at a time so overlapping fields need to treated area.
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Early study with MWA showing area of nodule destruction.
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Before HIFU
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Locating vagus and recurrent nerves
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Injecting numbing medicine on the capsule.
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Microwaves use an antenna inserted into the nodule
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Post MWA nodule
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Microbubbles are seen in the areas of destruction of the nodule cells.
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Santa Monica Thyroid Center is the one stop shop of all things thyroid ablation interventional. In house Ethanol ablation cysts and thyroid cancer lymoh nodes and a referral evaluation service for RFA, HIFU and soon for MWA. Matt is the one to talk to.He is my thyroid sonographer. Call Matt 310-393-8860 .We do 1-2 day total evaluations needed before being a candidate for Ablation centers in Europe and Korea.
Ancient Turkish painting of barbaric  goiter surgery. Modern surgery is better but complications are still too high when a low volume surgeon does the surgery < 25 total thyroidectomies per year.
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