What are Your options when your surgeon refuses to listen to your desire to avoid surgery with thyroid cancer?

What are Your options when your surgeon refuses to listen to your desire to avoid surgery with thyroid cancer?

What are Your options when your surgeon refuses to listen to your desire to avoid surgery with thyroid cancer?
  1. Check out alternative minimally invasion procedures by checking the internet.
  2. Consider getting an outside opinion.
  3. If your surgeon is refuses to listen to you, you can insist your case be presented to the hospital tumor board. The board has other physicians and even a lay person on them.
  4. The other members of the board may be more understanding to our desire to avoid surgery.
  5. A lay member may even scold the surgeon for not listening to your desires.

Case History.

  1. 38 Y/O female was diagnosed with hyperparathyroidism. There was FNA prior to the surgery. The surgeon removed the PTA but also removed the right lobe because of the palpable nodule. The right lobe had a 6 mm micro-papillary thyroid cancer.
  2. There was 1/3 central compartment lymph nodes was positive for PTC.
  3. 6 month F/U found a single level 4 abnormal lymph node that was positive at FNA.
  1. The expert thyroid surgeon told her she had only one option and that was to do a total removal of the left lobe and do a radical neck dissection on both sides.
  2. The patient a medical professional herself, refused the surgery.
  3. The surgeon was upset. “No one has ever refused my recommendation for surgery for this type of cancer.”
  4. To force her to agree to the extensive removal of a normal left lobe and the do extensive bilateral neck dissection to the ears on both sides, the surgeon presented her to the university tumor board.
  5. At the tumor board she continued to express the desire to have radiofrequency ablation RFA to just the one cancer lymph node instead of major neck surgery.
  6. The surgeon defended his position by saying “no one has refused my recommendation in 20 years.”
  7. The non-surgeon members defended the patient’s desire for limited treatment with RFA.
  8. They scolded the surgeon for not including the patient wishes in the for therapy by not even exploring her wish for RFA.
  9. The patient1.2×1.4x 1.8 cm (1.8 cm volume) level IV lymph node. The left lobe has no nodules.
  10. My endocrine neck ultrasound did not find any other lateral neck or central compartment abnormal lymph nodes.
  11. After signing a letter stating she refuses surgery she has been treated with RFA for the single lymph node. She will follow up in 6 months with a cutting needle biopsy CNB of the area to look for residual cancer cells.
  12. You can request a tumor board hearing if your surgeon is pushing you to do the surgery against your will.
  13. The bottom line is she should have had the option in 2021 to have RFA for the parathyroid adenoma instead of surgery she did not want.This first surgery set the whole sad story going with the removal of the right lobe at the time of the parathyroid surgery. That is when they found a very small micro-papillary and 1/3 lymph nodes.
  14. Remember thyroid surgery is elective and has complications and long term quality of life issues.The lobectomy she had against her will, caused her to become hypothyroid, requiring life time thyroid hormone therapy.
  15. RFA is safe and she would not have needed T4 treatment.
  16. RFA can be the answer to many thyroid and parathyroid problems in patients who worry about the effects of thyroid surgery.
  17. Call me at 310-393-8860 or email to secure [email protected]
  18. Never go to surgery without outside second opinions from expert thyroid physicians, or tumor board opinions.
  19. Ask for Alicia
  20. Dr.G.
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