Thyroid Cancer 101: Why Thyroid Cancer Patients Need to Determine if Thyroid Surgery is Needed, and if Needed How Much Needs to Be Removed
Complications from thyroid cancer surgery increase with the use of low volume surgeons doing less than 25 total thyroidectomies a year.
A high volume thyroid surgeon have lower complication rates than the low volume surgeons doing 1-24 cases a year. A recent study from Michigan found the 7% complication rates post op and 12% by one year.
A study from Duke university found high volume surgeons had lower rates than the ones doing 1-24 cases a year.
The over all 7% and 12% rates are due to low volume surgeons doing too many thyroidectomies. We expect our thyroid surgeons doing > 25 a year to have very low complication rates. 1-2%.
Post-operative complications include fever, infection, blood clots or swelling,hypoparathyroidism, hypocalcemia, and vocal cord or fold paralysis. These conditions can have lifelong impact on patients.
The Patient Needs to get involved in Their Treatment Plan for their cancer.
- What is your diagnosis? In 2017 some thyroid cancers are now downgraded to benign. Non-invasive Follicular Tumors with papillary cell features or NIFT-P. These will cut your complication risk as only lobectomy is needed to confirm there is no invasion.
- Are you a candidate for no surgery up front and only later if their is 3 mm growth of your 10-15 mm classic papillary thyroid cancer? This is Active Surveillance, and can save you surgical complication by not having any surgery at first. If you do have minimal growth over years you still can have safe surgery.
- If outside consultation with thyroid cancer experts confirm you need a total get on a plane to the closest center with known high volume surgeons.
- If you have total thyroidectomy and neck dissections already, and their is recurrence or persistent in the neck, consider seeking interventional thyroid ablation physicians to do ethanol ablation PEI of the lymph nodes without another surgery.
- What is your Age >65 ? Be extra careful on your pick to do your surgery, and find out if you can have alternative treatment. 10% and 20% complications older than 65. 3%/6% for those <65.
- What about Bad Thyroid Cancer? Get on a plane to MD Anderson,Sloan Kettering,Mayo, Clayman Cancer center, and other centers with expert “cancer endocrinologists” to “team” treat you.
- Beware of your friendly local surgeon your family doctor referred you to for your surgery. These surgeons do too many thyroid surgeries. These surgeons in small towns or community hospitals as well as major cities do as little as one a year with nasty complication rate 70% higher than high volume surgeons.
- Read this before you get a surgery date with a surgeon doing you as their only thyroid surgery that year. 50% of the surgeons do only one case a year!
- 85% of the surgeons do 1-5 cases a year. surgeons with 2-5 cases/year still have nasty complication rates of 35%.
- High Volume Surgeons are the answer to your complication risk problem.
- If you have a low risk cancer after conferring with expert outside opinions consider either active surveillance or lobectomy. If you have NIFT-P, you will not have the cancer follow up studies and radiation of a cancer patient, and will have the least likely to go bankrupt. Thyroid cancer is one of the leading causes of bankruptcy in the USA.
- Call Matt at 310-393-8860 for a pre-surgery evaluation. It can save your parathyroids,voice and other complications that occur from low volume surgeons.
- Matt is my Office Manager