Dr. Allen Ho is a fellowship-trained head and neck surgeon who focuses on head and neck tumors, including HPV(+) throat cancers and thyroid malignancies. As director of the Head and Neck Cancer Program and co-director of the Thyroid Cancer Program, he leads the multidisciplinary Cedars-Sinai Head and Neck Tumor Board, which provides consensus management options for complex, advanced cases. Ho’s research interests are highly integrated into his clinical practice. His current efforts lie in cancer proteomics, HPV(+) oropharyngeal cancer pathogenesis, and thyroid cancer molecular assays. He has presented his research at AACR, ASCO, AHNS, and ATA, and has published extensively as lead author in journals that include Nature Genetics, Journal of Clinical Oncology, Cancer, and Thyroid. Ho serves on national committees within the ATA and AHNS, and is principal investigator of a national trial on micropapillary thyroid cancer active surveillance (ClinicalTrials.gov ID: NCT02609685). He maintains expertise in transoral robotic surgery (TORS), minimally invasive thyroidectomy approaches, and nerve preservation techniques. Ho’s overarching mission is to partner with patients to optimize treatment and provide compassionate, exceptional care.
Weighing treatment options for thyroid cancer, with deep consideration for the patient’s lifestyle, could become the new norm in assessing whether surgery is the best path.
Dr. Allen Ho states, “if a patient is a ballerina or an opera singer, or any other profession that could be jeopardized due to undesired consequences of thyroid cancer surgery, then the best treatment path maybe active surveillance.” Undesired consequences of thyroid cancer surgery could be vocal cord paralysis, damage to the parathyroid glands resulting in calcium deficiencies, excessive bleeding or formation of a major blood clot in the neck, shoulder nerve damage, numbness, wound infection, and mental impairment due to hypothyroid-like symptoms. Or in the case of a ballerina, undesired scarring could jeopardize a career.
The above risks occur in approximately 10% of thyroid cancer surgeries. Although, some thyroid cancer treatment centers have a much more reduced incidence of undesired consequences, while others much higher.
In order to address the above and remove the risk of thyroid cancer surgery, Cedars-Sinai has become the first west coast hospital to launch an active surveillance study as optional treatment for thyroid cancer. The study includes 200 patients from across the country who have chosen the wait and see approach rather than hurry into a surgery that could result in undesired, major life changes. By waiting, this means these patients will dodge the need to take daily hormone replacement medication for the rest of their lives as the result of a thyroidectomy.
Other active surveillance research
Although this is the first study for active surveillance on the west coast, other studies are ongoing, including Sloan Kettering as directed by Dr. Tuttle, Kuma Hospital in Kobe as directed by Dr. Miyauchi, and the Dartmouth Institute as directed by Dr. Louise Davies.
The team
Dr. Ho says the “de-escalating” of treatment for thyroid cancer will become the new trend. The active surveillance thyroid cancer team at Cedars-Sinai is orchestrated to the patient’s needs, and includes the pathologist, endocrinologist, and surgeon.
NOTES
Active Surveillance of Thyroid Cancer Under Study
21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
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
NOTES:
PAST EPISODES
The past year has been fascinating and highly fruitful year for Dartmouth Institute Associate Professor Louise Davies, MD, MS. A 2017-2018 Fulbright Global Scholar, Davis spent several months in Japan at the Kuma Hospital in Kobe, Japan, studying the hospital's pioneering surveillance program for thyroid cancer. Davies, the chief of otolaryngology-head & neck surgery-at the Veterans Affairs Medical Center in White River Junction, Vermont, has researched U.S. patients' experiences of monitoring thyroid cancers they self-identify as overdiagnosed, and has found that such patients often feel unsupported, even ostracized. Following her stay in Japan, Davies, who also develops and teaches courses in qualitative research methods in Dartmouth Institute's MPH programs, spent several months in the U.K. at the Health Experiences Research Group (HERG) at Oxford University. There, she learned skills that will help her develop web-based materials to raise public awareness about surveillance, surveillance programs, and overdiagnosis in general.
As if the year wasn't packed enough, Davies also visited the site of the Fukushima Daiichi nuclear power plant, site of the 2011 nuclear accident in Japan. Unrelated to her Fulbright work, Davies is a member of an international task force organized through the International Agency for Research on Cancer, a branch of the World Health Organization. The task force will make recommendations on the monitoring of the thyroid gland after nuclear accidents. Learn more about her incredible year and what's next for her research in overdiagnosis!
Q: As a practicing physician, how did your interest in overdiagnosis develop?
A: My interest in over diagnosis grew from my work with Dr. Gil Welch, dating back to 2004. He was and is a mentor to me, and we developed the work on thyroid cancer together. I have always had an interest in making sure that patients receive care that aligned with their values. The problem of overdiagnosis is particularly intriguing because if people do not understand the concept, they may undergo treatment that, had they understood more about their risks, they might not have elected. Finding ways to solve that problem has been a fascinating focus for me.
Q: Is overdiagnosis and/or overtreatment in thyroid cancer on the rise, if so what accounts for this increase?
A: Thyroid cancer incidence has more than tripled in the U.S. over the past 30 years. The majority of the increase has been due to the detection of small cancers, which we know exist as a subclinical reservoir in otherwise asymptomatic people. As more attention has been drawn to the problem of overdiagnosis, the rate of increase has slowed, which has been gratifying to see; although it has not stopped completely or reversed. In the most recent national guidelines on the treatment of thyroid cancer (from the American Thyroid Association), there has been a clear suggestion that treatment should be more conservative for the small cancers that are so commonly detected now. It is not yet clear how much of an impact these new guidelines have had on practice patterns.
Q: You've studied the experiences of patients who are diagnosed with thyroid cancer but choose not to intervene. What are some of the commonalities you've found?
A: The patients who were the first to understand that their small, asymptomatic thyroid cancers picked up incidentally might not need immediate intervention, but instead could be monitored through regular checkups and active surveillance did not receive a lot of support from the medical community. Many managed their cancer by keeping it a secret, which can be stressful in itself, and several stopped getting follow ups-the recommended care if surveillance rather than interventions chosen for a small thyroid cancer. This was a unique group of patients who represented the first people to undertake what is a new and incompletely understood treatment option in the U.S. As such, they are probably more representative of people going against medical convention than thyroid cancer patients who elect to undertake surveillance, per se.
Q: What will/have you been looking for when evaluating the surveillance program at Kuma Hospital? How will you combine this with your own U.S. pilot data?
My goal in going to Kuma Hospital last fall was to understand more about the active surveillance program they have there. They were the first in the world to run such program and collect data on it, and have been doing so since 1993. I wanted to understand their data on active surveillance in more detail. I wanted to understand the patient experience of being on surveillance, and how the program worked operationally. I was able to do all those things and gathered patient experience data through a survey as well as interviews. I also was lucky to get to spend a fair amount of time in the operating room, where I learned a number of new surgical techniques that will advance my own practice in thyroid surgery. My goal is to report what I learned at Kuma Hospital as broadly as possible, so that people in the U.S. begin to feel comfortable adopting active surveillance as a method of managing the early thyroid cancers that are appropriate candidates for surveillance.
What's next for you in overdiagnosis research?
My work on the task force about thyroid monitoring after nuclear power plant accidents has given me a new appreciation for the complexity of public health communication about risk, emergency preparedness, and the problem of over diagnosis when it comes to policy setting. I hope to be able to continue to contribute in other ways to the broader public health discussion about over diagnosis. In my next steps looking at the epidemiology of thyroid cancer, I plan to focus on understanding more about why we see such variation in thyroid cancer incidence across geography, age groups, and gender.
NOTES
Thyroid cancer and overdiagnosis
21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
El Dr. Duque es un Cirujano de Cabeza y Cuello, formado en la Universidad de Miami, actualmente trabaja en el Hospital Pablo Tobon Uribe de Medellin.
Al años opera unos 220 pacientes con problemas de tiroides, de estos la mayoría con cancer de tiroides.
El Dr. Duque ha escrito un libro titulado !Uuuyy. TENGO CANCER DE TIROIDES¡
(Antes de inciar esta entrevista , me gustaria dejar claro que el fin de esta entrevista es informativo. Muy respetuosamente le solicitaria todos los que se unen a esta entrevista, No hacer preguntas sobre casos personales, o mencionar nombres de personas o medicos tratantes , el fin de estas y otras entrevistas que hago es informar.)
Temas de este entrevista uncluye:
Doctor Carlos Simón Duque Fisher
Médico de la Universidad Pontificia Bolivariana y Otorrinolaringólogo de la Universidad de Antioquia en Medellín, Colombia. Residencia en Otorrinolaringología en la Universidad de Antioquia.
Fellowship , Entrenamiento exclusivo en Cirugía de Cabeza y Cuello (1996 a 1998) y posteriormente un Fellowship en Rinología y Cirugía Endoscópica de Senos para nasales (2004 a 2005) ambos en el Departamento de Otorrinolaringología de la Universidad de Miami, USA.
En esta entrevista escuchamos del autor y cirujano, Dr. Carlos Duque, que explica los siguientes temas sobre el cáncer de tiroides:
Información Adicional
American Thyroid Association en español
Dr. Eduardo Faure
Especialista en Endocrinología. UBA
Médico egresado de la Facultad de Medicina de la Universidad Nacional de Rosario. Especialista en Endocrinología egresado de la Facultad de Medicina de la Universidad de Buenos Aires. Especialista recertificado por AMA (Asociación Médica Argentina) / SAEM (Sociedad Argentina de Endocrinología y Metabolismo) años 2003 y 2009. Realizó su formación como Endocrinólogo en el Servicio de Endocrinología del Complejo Médico PFA Churruca-Visca. Buenos Aires. Argentina. Se sub-especializó en el área de Tiroides. Actualmente se desempeña como Médico de Planta del Servicio de Endocrinología del Complejo Médico PFA Churruca-Visca. Es Jefe de la Sección Tiroides de dicho Servicio. Sus trabajos de investigación se basan fundamentalmente en Tiroides.
Fue docente de Fisiología de la Cátedra de Fisiología Humana de la Facultad de Medicina de la Universidad Nacional de Rosario. Es docente de la Carrera de Médicos Especialistas en Endocrinología de la Universidad de Buenos Aires. Es colaborador Docente de la Unidad Docente Hospitalaria “Churruca-Visca” dependiente de la Facultad de Medicina de la Universidad Nacional de Buenos Aires. Fue docente estable de la Carrera de Especialización en Endocrinología Ginecológica y de la Reproducción en la Universidad Favaloro. Es Miembro Activo de las siguientes sociedades: Sociedad Argentina de Endocrinología y Metabolismo y de la Sociedad Latinoamericana de Tiroides. Forma parte del Departamento de Tiroides de la Sociedad Argentina de Endocrinología y Metabolismo. Es invitado por Sociedades Nacionales e Internacionales como disertante en temas relacionados con Tiroides. Ex Director de la Sociedad Latinoamericana de Tiroides (LATS). Chair de la Educational Task Force de la Sociedad Latinoamericana de Tiroides (LATS).
Durante este episodio, escuchamos más detalles sobre lo siguiente:
NOTES
Professor Akira Miyauchi (Figure 1) is President and COO of Kuma Hospital, Center of Excellence in Thyroid Care, Kobe, Japan. He is a Japanese endocrine surgeon, and a pioneer in active surveillance, and visionary in regard to treatment of thyroid cancer. World renowned researcher, and lecturer. As the associate professor of the Department of Surgery, Kagawa Medical University, he proposed and initiated a clinical trial of active surveillance for low-risk papillary micro cancer in collaboration with Kuma Hospital in 1993. In 2001, he was appointed the President of Kuma Hospital. Since then, he has been keen on the study of evaluating treatments for papillary micro cancer, observation versus surgery.
During this episode, the following topics are discussed:
Total cost of surgery is 4.1x the cost compared to the cost of active surveillance. In the U.S., the cost is higher.
By providing patient an active surveillance brochure prior to FNA, they are more open to not proceeding with surgery for small thyroid cancer management.
Patient voice restores to near normal when repair of laryngeal nerve is done correctly. All surgeons should be executing this to perfection.
When doing next stretches one-day post surgery, patients report feeling much better and less pain, even one year after surgery.
Protocol for delaying surgery depends on the patient’s age. Older patients are less likely to require surgery. 75% of patients will not require surgery for their lifetime.
NOTES
21: Diagnosed with Thyroid Cancer and You Say No to Surgery with Dr. Louise Davies
PAPERS and RESEARCH
Estimation of the lifetime probability of disease progression of papillary microcarcinoma of the thyroid during active surveillance
Dr. José A. Hakim realiza más de 400 cirugías al año. Es cirujano general. Especialista en cirugía de cabeza y cuello en relación con el cáncer.
En este entrevista, hablamos sobre:
This episode is recorded from Boston and the World Congress on Thyroid Cancer, where leading doctors and researchers have gathered to share the latest medical research and trends related to thyroid disease.
At the Congress, Dr. Okamoto presented on Thyroid Cancer Guidelines Around the World
He helped write the Japanese guidelines on thyroid cancer. He is Professor & Chair of the Department of Surgery at Tokyo Women’s Medical University.
Key points from this episode include:
NOTES
Book: Treatment of Thyroid Tumor: Japanese Clinical Guidelines
RELATED EPISODES
This episode is recorded from Boston at the World Congress on Thyroid Cancer, where thyroid doctors and researchers gathered to share the latest medical research and medical improvements related to thyroid disease.
Dr. Özer Makay is an expert in nerve monitoring during thyroid surgery, and has been a guest faculty member in South Korea, Italy, France, the Netherlands, Germany, Belgium and Bulgaria.
He has received 17 awards and honors for his scientific studies. He has authored a 300-page book on nerve monitoring during thyroid surgery.
This episode covers the following topics:
Also discussed are thyroid cancer trends in Turkey including:
Biography: In the words of Dr. Özer Makay
I was born in 1974 in the Netherlands. After finishing the primary school there, I completed my secondary and high school educations at Bornova Anatolian High School in Izmir/Turkey. I graduated from Ege University, School of Medicine and started my residency at the General Surgery Department of Ege University, School of Medicine. During my studentship, I did my surgical internship at London King’s College Hospital. During my surgical residency, in 2002, I received education regarding “Laparoscopic Surgery” at Free University Hospital, Amsterdam from Prof. Miguel Cuesta and carried out scientific studies there. I had the opportunity to meet with the robotic surgery system here and did use this system at the experimental investigation laboratory.
After being a specialist registrar in May 2005, I started to work at the division of “Endocrine Surgery” of the General Surgery Department of Ege University. During my fellowship, I worked under the supervision of Prof. Enis Yetkin, Prof. Mahir Akyıldız and Prof. Gökhan İçöz. During this period, I became the first Turkish surgeon to have the right to get the title “Fellow of European Board of Surgery – div. Endocine Surgery” by passing the “UEMS Board Examination for Endocrine Surgery”. At the Ege University, we started the “Laparoscopic Adrenalectomy Programme’ in 2008, together with Prof. Dr. Mahir Akyıldız. Besides, the “Robotic Surgery Programme’ was launched in 2012. I promoted to “Associate Professor of Surgery” in 2012. I have been invited to become a member of the European Board of Endocrine Surgery Committee. This makes me the first Turkish member of this committee. Besides, I was chosen as “the national representative” of a “European Union Health Project” concerning this area.
To date, I own more than 80 national and international publications. Furthermore, I participated in more than 30 national and international scientific meetings as speaker, instructor and guest surgeon. I served as president, scientific secretary or organization/scientific committee member for national and international congresses and meetings. I had been in South Korea, Italy, France, the Netherlands, Germany, Belgium and Bulgaria as guest faculty member. I received 17 awards and honors because of my scientific studies presented during national and international scientific congresses. I speak English, Dutch and German fluently and Spanish at elementary level.
My essential areas of interests are “endocrine surgery” and “robotic surgery”. As Ege University, we are the most experienced center of our country regarding “robotic adrenalectomy”.
NOTES
Doctor Califano es Endocrinóloga del Instituto de Oncología AH Roffo, Universidad de Buenos Aires.
Es miembro del Departamento de Tiroides de la Sociedad Argentina de Endocrinología y Metabolismo y de la Sociedad Latinoamericana de Tiroides.
Es coautora del Consenso Multisocietario Argenino para el Manejo del Cáncer de Tiroides Diferenciado.
En esta entrevista, discutimos lo siguiente:
I sometimes get asked, why am I doing this podcast?
What started out as a pet project is now being listened to in over 30 countries and with as many as 20000 downloads per episode. So far, thyroid patients are embracing the opportunity to hear from the world’s leading thyroid doctors, and gaining the information needed to make better decisions related to health.
So why did I start Doctor Thyroid?
My motivation for doing this podcast is to help patients avoid bad experiences related to thyroid cancer and thyroid disease, including bad surgery. And, provide resources to help make better health decisions and improve quality of life.
My thyroid surgery resulted in errors, which have downgraded my quality of life significantly. Knowing what I know now, I would have picked a different surgeon, or chosen no surgery at all. Because, as this interview will discuss, although perceived as safe, thyroid surgery is not without risks.
To be published next month, new research reveals thyroid surgery errors are five times more likely than previously reported.
The study was conducted by Dr. Maria Papaleontiou. She is an Assistant Professor of Internal Medicine with an appointment in the Division of Metabolism, Endocrinology and Diabetes. She graduated medical school from the prestigious Charles University in the Czech Republic and subsequently spent several years conducting research at the Geriatrics Division at Weill Cornell Medical College. She then completed her internal medicine residency at Saint Peter’s University Hospital in New Jersey and her endocrinology fellowship at the University of Michigan. She joined the faculty at the University of Michigan in 2013. She is a recipient of Fulbright and Howard Hughes Medical Institute scholarships. Dr. Papaleontiou’s practice focuses on thyroid disorders and thyroid cancer. She is especially interested in the treatment of endocrine disorders in older adults. She also conducts health services research in the field of thyroidology and aging.
NOTES
Complications from thyroid cancer surgery more common than believed, study finds
National Cancer Institute (NCI)
RELATED DOCTOR THYROID INTERVIEWS
Dr. Ralph Tufano: Be Careful, Not All Surgeons Are Equal and Here is Why
Dr. Gary Clayman: The Single Most Important Question to Ask Your Surgeon
Dr. Allen Ho: Rethinking Thyroid Cancer – When Saying No to Surgery Maybe Best for You
Dr. Rashika Bansal is a PGY-2 resident in Internal Medicine at St. Joseph's Regional Medical Center in Paterson, NJ. Her major research has been with diabetes prevalence and awareness in rural India, with special interest in thyroid disease.
In this episode Dr. Bansal shares the research she presented at AACE 2017 and ENDO 2017, regarding the poor readability scores for thyroid cancer web sites.
The challenge for these web sites and health institutions is to translate thyroid education from complex to simple and easy to understand. Currently, many patients are not following with treatment, citing confusion after being exposed to the various thyroid cancer education resources.
NOTES
Thyroid Education Scores Low for Readability
Thyroid patient education materials not adequately targeted to patient reading level
Weighing treatment options for thyroid cancer, with deep consideration for the patient’s lifestyle, could become the new norm in assessing whether surgery is the best path.
Dr. Allen Ho states, “if a patient is a ballerina or an opera singer, or any other profession that could be jeopardized due to undesired consequences of thyroid cancer surgery, then the best treatment path maybe active surveillance.” Undesired consequences of thyroid cancer surgery could be vocal cord paralysis, damage to the parathyroid glands resulting in calcium deficiencies, excessive bleeding or formation of a major blood clot in the neck, shoulder nerve damage, numbness, wound infection, and mental impairment due to hypothyroid-like symptoms. Or in the case of a ballerina, undesired scarring could jeopardize a career.
The above risks occur in approximately 10% of thyroid cancer surgeries. Although, some thyroid cancer treatment centers have a much more reduced incidence of undesired consequences, while others much higher.
In order to address the above and remove the risk of thyroid cancer surgery, Cedars-Sinai has become the first west coast hospital to launch an active surveillance study as optional treatment for thyroid cancer. The study includes 200 patients from across the country who have chosen the wait and see approach rather than hurry into a surgery that could result in undesired, major life changes. By waiting, this means these patients will dodge the need to take daily hormone replacement medication for the rest of their lives as the result of a thyroidectomy.
Other active surveillance research
Although this is the first study for active surveillance on the west coast, other studies are ongoing, including Sloan Kettering as directed by Dr. Tuttle, Kuma Hospital in Kobe as directed by Dr. Miyauchi, and the Dartmouth Institute as directed by Dr. Louise Davies.
The team
Dr. Ho says the “de-escalating” of treatment for thyroid cancer will become the new trend. The active surveillance thyroid cancer team at Cedars-Sinai is orchestrated to the patient’s needs, and includes the pathologist, endocrinologist, and surgeon.
About Dr. Allen Ho
Allen Ho, MD, is a fellowship-trained head and neck surgeon who focuses on head and neck tumors, including HPV(+) throat cancers and thyroid malignancies. As director of the Head and Neck Cancer Program and co-director of the Thyroid Cancer Program, he leads the multidisciplinary Cedars-Sinai Head and Neck Tumor Board, which provides consensus management options for complex, advanced cases. Ho's research interests are highly integrated into his clinical practice. His current efforts lie in cancer proteomics, HPV(+) oropharyngeal cancer pathogenesis, and thyroid cancer molecular assays. He has presented his research at AACR, ASCO, AHNS, and ATA, and has published extensively as lead author in journals that include Nature Genetics, Journal of Clinical Oncology, Cancer, and Thyroid. Ho serves on national committees within the ATA and AHNS, and is principal investigator of a national trial on micropapillary thyroid cancer active surveillance (ClinicalTrials.gov ID: NCT02609685). He maintains expertise in transoral robotic surgery (TORS), minimally invasive thyroidectomy approaches, and nerve preservation techniques. Ho’s overarching mission is to partner with patients to optimize treatment and provide compassionate, exceptional care.
NOTES
MSKCC thyroid cancer active surveillance
Active Surveillance of Thyroid Cancer Under Study
Dr. Schneider specializes in endocrine surgery, treating diseases of the thyroid, parathyroid, and adrenal glands. He utilizes several minimally invasive techniques to treat endocrine disorders (endoscopic thyroidectomy, minimally invasive parathyroidectomy, laparoscopic adrenalectomy, focused exploration for recurrent thyroid cancer).
This episode explores the following topics:
NOTES:
Dr. David Schneider
http://www.uwhealth.org/findadoctor/profile/david-f-schneider-md-ms/8885
El Dr Fabián Pitoia es Médico Endocrinólogo, es Jefe de la Sección Tiroides y Coordinador del Área Investigación de la División Endocrinología del Hospital de Clínicas - Universidad de Buenos Aires, es Docente adscripto de la Facultad de Medicina - Jefe de Trabajos prácticos de Medicina B (Facultad de Medicina - UBA) y Docente de la Carrera de Especialistas en Endocrinología y Metabolismo de la UBA.
Especialidad recertificada en Diciembre de 2013.
El Dr Pitoia tiene más de 200 publicaciones de sus investigaciones, más de 50 listadas en Pubmed, ha sido primer autor de las Guías Latinoamericanas para el diagnóstico y tratamiento del cáncer de tiroides, también el primer autor de las Guías Intersocietarias Argentinas para manejo de pacientes con cáncer de tiroides 2014.
En esta entrevista, discutiremos:
Notes:
https://www.facebook.com/Dr.Pitoia/
Dr. Babak Larian is a highly experienced, board certified Ear, Nose, & Throat Specialist and Head & Neck surgeon. Dr. Larian is the current Clinical Chief of the Division of Otolaryngology at Cedars-Sinai Hospital in Los Angeles. Dr. Larian's Center For Head and Neck Surgery is located in Beverly Hills, California.
In this episode, Dr. Larian discusses his experience treating thyroid disorders, including his medical missions to Central America. During this interview, you will hear greater detail about the following topics:
NOTES:
Dr. Babak Larian
P: 310.461.0300
American Thyroid Association Guidelines
http://www.thyroid.org/professionals/ata-professional-guidelines/
El Dr. Carlos Simon Duque es un especialista en cabeza y cuello de Colombia. En esta entrevista, discutiremos una visión general del cáncer de tiroides, incluyendo las siguientes preguntas:
¿Qué debe saber un paciente antes de la cirugía, qué esperar?
Después de la cirugía, un paciente puede sentir síntomas como hipotiroidismo. ¿Cómo lo manejas mejor?
¿Cuáles son algunas de las luchas mas complicados que usted ve con sus pacientes después de la tiroidectomía?
¿Qué pacientes recuperan mejor? ¿Qué puede hacer un paciente para sentirse mejor después de la cirugía?
¿Cuándo es el mejor momento del día para tomar la medicina de la tiroides?
Usted ha trabajado tanto en los Estados Unidos como en Colombia, ¿cuáles son algunas de las diferencias en la atención y el tratamiento?
¿Qué has descubierto a lo largo del camino, que le dirías a usted de 30 años de edad si puede?
¿Actualmente está trabajando en algún estudio o investigación?
Hear about the advances in thyroid ultra sound technology, along with the patient process from diagnosis to surgery. Key topics in this episode include how to research a surgeon, requesting a second opinion, selecting the best hospital, and the challenges faced when operating on the neck.
This episode features Dr. Joseph Sniezek, who is the Medical Director of Head & Neck Endocrine Surgery for Swedish Health Services.
Too often, the time between being told by your doctor to get an ultrasound to biopsy, often results in anxiety and a disconnect between surgeon - radiologist - pathologist. Now, with better technology, especially in the area of ultra sound, the multiple trips to specialists can be eliminated.