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Doctor Thyroid

Welcome to Doctor Thyroid with your host, Philip James. This is a meeting place for you to hear from top thyroid doctors and healthcare professionals. Information here is intended to help those wanting to 'thrive' regardless of setbacks related to thyroid cancer. Seeking good health information can be a challenge, hopefully this resource provides you with better treatment alternatives as related to endocrinology, surgery, hypothyroidism, thyroid cancer, functional medicine, pathology, and radiation treatment. Not seeing an episode that addresses your particular concern? Please send me an email with your interest, and I will request an interview with a leading expert to help address your questions. Philip James philipjames@docthyroid.com
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Now displaying: November, 2017
Nov 9, 2017

Kimberly Vanderveen, MD is a Colorado native and graduate of Bear Creek High School in Lakewood, CO. She received her bachelor’s degree with honors from Muhlenberg College in Allentown, PA. She then earned her medical degree from Northwestern University in Chicago, IL in 2001. Dr. Vanderveen completed her surgical residency at UC-Davis in Sacramento, CA. During her residency, she also obtained a master's degree in Clinical Research and was actively involved in cancer research and education. After her surgical training, Dr. Vanderveen completed a fellowship in Endocrine Surgery at the Mayo Clinic in Rochester, MN. She is knowledgeable in both medical and surgical aspects of endocrine diseases. She specializes in surgery for diseases of the thyroid, parathyroid, adrenal glands and is a high volume neck and adrenal surgeon.

In this episode, the following topics are discussed:

  • Two roads of tests: rule out and malignant markers
  • Rule-out tests picks up innocent behavior pattern.  Most common is Afirma
  • Malignant markers, or rule-in tests, are useful at determining extent of surgery, and help avoid a second or third surgery.  ThyroSeq, ThyraMIR, Rosetta
  • Do patients get both tests?  Rule out and behavior?
  • Approximately 15% of FNA’s come back indeterminate.  Some  centers as high as 30%
  • Managing indeterminate nodules when a patient chooses no surgery.
  • Taking into account emotional, financial, and lifestyle goals of the patient.
  • Addressing priorities and goals of the patients should come first.
  • Additional molecular testing, surgery, or active surveillance.
  • Profiling a patient who choose to remove thyroid even if indeterminate — is usually due to fear and the C word.
  • Price of molecular test is $3000 - $6000

NOTES

Kimberly Vanderveen, MD

American Thyroid Association

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22: Avoiding Thyroid Cancer Surgery, Depending on the Size with Dr. Miyauchi from Kuma Hospital in Kobe, Japan

09: Thyroid Cancer Patients Experience Quality of Life Downgrade with Dr. Raymon Grogan and Dr. Briseis Aschebrook from the University of Chicago Medicine

08: The Financial Burden of Thyroid Cancer with Dr. Jonas de Souza from The University of Chicago Medicine

 

Nov 6, 2017

Bryan McIver, MD, PhD

Dr. McIver contributes to Moffitt Cancer Center almost 20 years of clinical experience in the care of patients with endocrine diseases, specializing in the evaluation of patients with thyroid nodules and thyroid cancer. He has a particular interest in the management of patients with advanced and aggressive forms of cancer and the role of genetic and molecular techniques to improve the accuracy of diagnosis; to tailor appropriate treatment to a patientdisease. Dr. McIver has a long-standing basic research interest in the genetic regulation of growth, invasion and spread of thyroid tumors of all types. His primary research focus is the use of molecular and genetic information to more accurately diagnose thyroid cancer and to predict outcomes in the disease. Dr. McIver received his MB ChB degree from the University of Edinburgh Medical School in Scotland. He completed an Internal Medicine residency at the Royal Infirmary of Edinburgh, followed by a clinical fellowship and clinical investigator fellowship in Endocrinology at the School of Graduate Medical Education at Mayo Clinic in Rochester, MN. Prior to joining Moffitt, he was employed as Professor and Consultant at the Mayo Clinic and Foundation in the Division of Endocrinology & Metabolism. Amongst his most proud accomplishments, Dr. McIver counts his two commitment to education of medical students, residents and fellows; his involvement as a founding member of the World Congress on Thyroid Cancer, an international conference held every four years; and his appointment as a member of the Endowed and Master Clinician Program at the Mayo Clinic, recognizing excellence in patient care.  

In this episode, the follwoiung 

  • By sixty years old, more common to have nodule than not
  • Most nodules are benign
  • When to do a biopsy
  • How to interpret the results of biopsy
  • Advances in thyroid cancer
  • Ultrasound technology advancements
  • Molecular markers
  • Cytopathology categorizations
  • Molecular marker technologies
  • Gene expression classifier
  • Afirma
  • Identifying aggressive cancer
  • Types and sub-types of thyroid cancers
  • Invasive and aggressive thyroid cancers
  • Papillary versus anapestic thyroid cancer
  • Biopsy results in 2 - 3 hours
  • Clinical studies that have transformed thyroid treatment
  • Less aggressive surgery and less radioactive iodine
  • Targeted chemotherapies
  • Immunotherapy
  • The importance of clinical trial environments, or thoughtful philosophy
  • The minimum necessary surgery
  • Do not rush into thyroid cancer surgery

NOTES:

American Thyroid Association

Bryan McIver, MD, PhD

Ian D. Hay, M.D., Ph.D.

Hossein Gharib, M.D.

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1