Adding T3 to Your T4 Treatment with Dr. Martin Milner

Pioneering the Future of Thyroid Care: A Conversation with Dr. Julia Noel

Palo Alto, CA — In a recent episode of the RFAMD podcast, host Philip James welcomed a trailblazer in the field of thyroid treatment, Dr. Julia Noel of Stanford University School of Medicine. Known for her pioneering work in thyroid ablation, Dr. Noel shared insights on the evolving landscape of thyroid care, emphasizing innovative ablation technologies that are reshaping patient experiences.

From Mathematics to Medicine

Dr. Noel’s journey into the medical field was not typical. Initially drawn to mathematics, inspired by her father, she found her calling in surgery, where she could blend problem-solving skills with a hands-on approach. This unique blend of analytical thinking and surgical precision has defined her career.

Ablation Over Surgery: A Paradigm Shift

Central to Dr. Noel’s practice is thyroid ablation, a technique that offers an alternative to traditional surgery. With over thousands of surgeries to her credit, she has been a vocal advocate for techniques like radiofrequency, ethanol, and microwave ablation. These methods, she notes, are crucial in reducing the need for invasive procedures, preserving thyroid function, and improving quality of life.

The Technology at the Forefront

During the interview, Dr. Noel highlighted the rapid advancement in ablation technology. She pointed out that while radiofrequency ablation is currently the most user-friendly and researched method, emerging technologies promise even more groundbreaking developments. These future techniques may not even rely on heat generation, opening new avenues for treatment.

Navigating the Risks

With any medical procedure come risks, and thyroid ablation is no exception. Dr. Noel candidly discussed potential complications like voice changes, discomfort, and nodal rupture. However, she reassured that most of these risks are minor and reversible, underlining the importance of skilled execution and patient awareness.

A Surge in Patient Education

An interesting aspect of Dr. Noel’s work is her approach to patient education and outreach, particularly through social media. She stressed the importance of accurate, high-quality information in guiding both patients and physicians, acknowledging the growing role of digital platforms in patient advocacy.

Challenges in Training and Standardization

As thyroid ablation gains popularity, Dr. Noel emphasized the need for standardized training and guidelines. She expressed concern over the “Wild Wild West” atmosphere as more doctors seek to learn these techniques, underscoring the need for cautious and well-guided adoption of the technology.

The Cost Factor

Addressing the practical aspects of thyroid ablation, Dr. Noel spoke about the variability in insurance coverage and costs in the United States. She noted that while some patients on the West Coast enjoy substantial coverage, others face significant out-of-pocket expenses, highlighting the need for broader insurance acceptance.

Looking to the Future

Dr. Noel’s vision for the future of thyroid treatment is one of optimism, contingent on the acceptance of new medical codes and continued technological innovation. She sees a world where thyroid nodules and cancer are treated more efficiently and less invasively, a testament to the dynamic nature of medical progress.

Dr. Julia Noel’s interview on the RFAMD podcast provides a compelling look into the future of thyroid care. Her dedication to advancing treatment options, patient education, and the safe adoption of new technologies sets a benchmark in the field of thyroid health. As these technologies evolve, Dr. Noel’s insights offer a valuable perspective on the potential for improved patient care and the importance of informed medical choices.

Are you an ablation doctor or searching for one?

Get listed on the directory at www.rfamd.com ✅

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About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.

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Thyroid Ablation: A Game-Changer in Preserving Quality of Life

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Thyroid disorders, particularly those requiring surgery, have long been a concern for patients due to the potential lifelong dependence on medication and associated quality of life changes. However, a significant shift is occurring in thyroid treatment with the advent of thyroid ablation, a technique that is rapidly gaining preference among patients and physicians alike.

The Rise of Thyroid Ablation

In a recent podcast interview on RFAMD, Dr. Erivelto Volpi, a renowned head and neck surgeon from São Paulo, Brazil, shared his extensive experience in thyroid ablation. Dr. Volpi, who has performed around 8,000 thyroid surgeries and 400 thyroid ablations in over 35 years, notes the growing trend towards thyroid ablation. He attributes this shift primarily to the preservation of the patient’s quality of life, a crucial factor often overshadowed in traditional surgical approaches.

Why Patients Prefer Thyroid Ablation

Dr. Volpi explains that most patients seeking thyroid ablation do so not just to avoid surgery but to maintain their quality of life. They fear the changes that lifelong medication post-surgery might bring, having seen friends or family struggle with hormone replacements. Thyroid ablation, which involves radiofrequency or microwave treatment, offers an effective alternative. It shrinks benign thyroid nodules and even treats initial cancers, preserving thyroid function and thus the patient’s pre-existing quality of life.

The Global Perspective and Acceptance

Thyroid ablation is not just a localized phenomenon. Dr. Volpi highlights its rapid adoption worldwide, with countries like South Korea, Brazil, Italy, France, Spain, Turkey, and Egypt leading in this practice. This global acceptance is partly due to patient advocacy and the internet, which have empowered patients to seek the best treatment options, often traveling across borders to access this care.

The Procedure and Its Benefits

Compared to conventional surgery, thyroid ablation is minimally invasive, with fewer complications like voice changes. Recovery is swift, often within 24 to 48 hours, significantly quicker than traditional surgery. This aspect further reinforces its preference among patients.

Are you an ablation doctor or searching for one?

Get listed on the directory at www.rfamd.com ✅

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About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.

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FIND A THYROID ABLATION DOCTOR at www.rfamd.com FOLLOW @DoctorThyroid #thyroid #thyroidcancer #ultrasound 

Introduction

⦿ Host: Welcome by the host of the RFAMD podcast.

⦿ Guest: Introduction of Dr. Giovanni Mauri, a medical professional from Milan, Italy.

Dr. Mauri's Journey into Medicine

⦿ Childhood Influence: Inspired by his father, a radiologist.

⦿ Career Choice: Fascination with radiology and interventional radiology.

⦿ Family Background: His father worked in diagnostic radiology in an oncological hospital.

History of Ablation in Italy

⦿ Early Adoption: Discussion of pioneers in ablation treatments in Italy, starting in the 1980s.

⦿ Development: The evolution of ablation techniques, from ethanol ablation for liver cancers to radiofrequency ablation.

Dr. Mauri's Specialization

⦿ Scope of Ablation: Treating various cancers (liver, kidney, lung, bone, soft tissues) with thermal ablation.

⦿ Focus on Thyroid Ablation: Special emphasis on treating both benign and malignant thyroid diseases.

Patient Success Stories

⦿ Personal Case: A female patient treated multiple times for lymph node metastasis, avoiding further surgery.

⦿ Impact on Patients: Emphasizing the success and life-changing effects of successful thyroid ablation treatments.

Thyroid Surgery vs. Ablation

⦿ Patient Perspective: Benefits in terms of invasiveness and future hormonal treatment.

⦿ Medical Community: Surgeons appreciating the option of ablation to manage resources and time effectively.

Global Trends in Thyroid Ablation

⦿ FDA Approval: The significant impact of FDA approval in the U.S. in 2018.

⦿ Rapid Growth: Thyroid ablation as the fastest-growing field in ablation treatments worldwide.

Dangers of Rapid Growth

⦿ Training and Expertise: Emphasizing the necessity of proper training and the risks posed by inexperienced practitioners.

⦿ Comparison of Techniques: Differences between traditional surgery and ultrasound-guided ablation procedures.

Pioneers in Thyroid Ablation

⦿ Innovations: Introduction of specifically designed needles and techniques in Korea and Italy. ⦿ Global Adoption: The spread of thyroid ablation practices to countries like South America, North America, and Europe.

Risks of Thyroid Ablation

⦿ Medical Risks: Potential damages during the procedure, such as bleeding or nerve damage.

⦿ Technical Challenges: Importance of ultrasound skills and adjunctive techniques to minimize risks.

Risks of Thyroid Ablation

⦿ Medical Risks: Potential damages during the procedure, such as bleeding or nerve damage. 

⦿ Technical Challenges: Importance of ultrasound skills and adjunctive techniques to minimize risks.

Unsuccessful Cases

⦿ Benign Nodules: Rare unsuccessful cases, often due to initial under-treatment.

⦿ Malignant Tumors: Possibility of incomplete ablation, with options for re-treatment.

Selecting the Right Provider

⦿ Criteria for Choosing: Experience of the physician, ideally in a hospital setting for beginners.

⦿ Importance of Supervision: Emphasis on proper environment and supervision for new practitioners.

Addressing Skepticism

⦿ Literature and Communication: Using scientific evidence and open discussions to address concerns.

⦿ Surgical Alternatives: Emphasizing ablation as a reversible option compared to definitive surgery.

Types of Ablation

⦿ Radiofrequency vs. Microwave: Discussion on the advantages and risks of each type in thyroid treatments.

Guidelines and Clinical Experience

⦿ Lag in Guidelines: The delay in incorporating new treatments like ablation into official guidelines.

⦿ Individualized Treatment: Tailoring treatment options based on clinical experience, despite guidelines.

Guidelines and Clinical Experience

⦿ Lag in Guidelines: The delay in incorporating new treatments like ablation into official guidelines.

⦿ Individualized Treatment: Tailoring treatment options based on clinical experience, despite guidelines.

Patient Perception and Decision Making

⦿ Overdiagnosis and Overtreatment: Addressing the issue of overdiagnosis in thyroid cancer and the role of minimally invasive treatments.

⦿ Patient Preferences: Understanding patient choices in treatment options, including active surveillance.

Second Opinions and Treatment Choices

⦿ Changing Treatment Plans: Cases where patients change their mind after seeking a second opinion.

⦿ Informed Decision Making: The importance of providing comprehensive information to patients.

Innovations in Thyroid Treatment

⦿ New Technologies: Exploring new treatments like embolization, expanding the scope of minimally invasive procedures.

Conclusion and Rapid Fire Questions 

⦿ Future of Thyroid Treatment: Predictions about the shift towards ablation in the next decade.

⦿ Importance of Communication: The crucial role of clear communication in discussing cancer treatments with patients.

For podcast inquiries or if you would like to be a guest. Contact: philip@rfamd.com

September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. 

In the world of medicine, it’s not uncommon for patients to feel overwhelmed and uncertain when faced with a diagnosis that requires surgery. For Peter Miller, a 64-year-old man from the UK, this was certainly the case when he was diagnosed with thyroid goiter. Three specialists recommended thyroidectomy as the only viable treatment option, but Peter was hesitant to undergo such a procedure due to the potential risks and complications associated with it.

Fortunately, Peter took matters into his own hands and conducted his own research, which led him to an alternative treatment option – Radiofrequency Ablation (RFA). Through an article written by Philip James and the Philip James YouTube channel, Peter discovered Dr. Roberto Valcavi, an Appalachian doctor in Italy, who had experience performing the RFA procedure.

After discussing his options with Dr. Valcavi via email and video consultation, Peter underwent the RFA procedure in Italy. The results were remarkable – Peter experienced significant improvement in his symptoms, and he was happy to have avoided surgery.

Peter’s story highlights the importance of being an advocate for your own health and well-being. Conducting research, seeking second opinions, and exploring all treatment options are crucial steps in making informed medical decisions. Peter’s success with RFA also underscores the importance of raising awareness about this non-surgical treatment option.

Despite its efficacy, RFA is not widely available in many countries, and healthcare professionals may not be aware of it as a treatment option for thyroid goiter. It is crucial to raise awareness about RFA so that patients have access to all viable treatment options.

Peter’s experience with RFA serves as an inspiration for patients who may be hesitant to undergo surgery for thyroid goiter. Being your own advocate, doing research, and exploring all treatment options can lead to better health outcomes. And with the help of knowledgeable medical professionals like Dr. Valcavi, patients can find the right treatment option that works best for them.

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About Dr. Roberto Valcavi

Roberto Valcavi MD, FACE, ECNU is specialist in Endocrinology and specialist in Internal Medicine. 20 years and 1800+ RFA procedures done; laser since 2000 and radiofrequency ablation starting in 2010.

At present, Dr. Roberto Valcavi is Director of the E.T.C. (Endocrine & Thyroid Clinic) in Reggio Emilia, Italy, dedicated to the diagnosis and therapy of endocrine neck (thyroid, parathyroid, lymph nodes) benign and malignant lesions. 

He is specialized in ultrasound- guided ablative therapy of thyroid nodules by radio frequency (RFA), minimally invasive surgery that is able to effectively treat more than 90 % of benign thyroid nodules and over 80 % of malignant thyroid nodules, saving the thyroid gland.

View Full Profile: Dr. Roberto Valcavi

About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.

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Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.

September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. 

In this interview, Dr. Giovanni Mauri, an interventional radiologist specializing in ablation for the treatment of various conditions including thyroid cancer, shares his insights with Philip James on the Doctor Thyroid and RFAMD podcasts.

Dr. Mauri highlights one of the recent advancements in the field of ablation – the possibility of treating small thyroid cancers (up to one or two centimeters) without surgery. This innovative approach allows for the complete treatment of the cancer while preserving the thyroid gland.

He advises every patient diagnosed with thyroid cancer to be aware that ablation is a valid treatment option. He emphasizes the importance for both physicians and patients to know that this option exists, and encourages patients to seek advice about the possibility of being treated by ablation instead of surgery.

The interview concludes with Dr. Mauri extending an invitation for anyone with doubts about this procedure to reach out to him. His contact information is available in the episode description for those interested in learning more about treating thyroid cancer with ablation.

The discussion provides a fresh perspective on thyroid cancer treatment, focusing on non-surgical options and the potential benefits of ablation. The interview wraps up with a farewell from Italy.

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About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.

• LinkedIn

Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.

September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. 

In a comprehensive interview conducted by Philip James from the RFAMD and Doctor Thyroid podcasts, Dr. Greg Randolph from Harvard Medical School shares his insights on patient-centered approaches for treating thyroid nodules. The interview focuses on thyroid ablation, a procedure that treats thyroid nodules without surgery.

Dr. Randolph emphasizes the importance of not only measuring the volumetric reduction of the nodule after ablation but also considering patient-reported outcomes. These outcomes include the patient’s perception of the nodule, such as whether they still have a lump sensation in their neck or a visible lump. Despite the successful reduction of the nodule size on ultrasound, the patient may still perceive a visual or physical presence, thus it’s critical to include what’s meaningful for the patient in the outcomes.

He also discusses the importance of understanding a patient’s concerns and expectations. Whether it’s a benign nodule or a low-stage malignancy, each patient will have their own concerns and priorities. Some may fear the potential of a hidden cancer while others may be apprehensive about surgical procedures. Hence, the treatment decision should be apparent after a thorough discussion of the patient’s preferences and the medical realities.

Lastly, he stresses the importance of physicians offering a variety of treatment options. For benign nodules or small cancers, patients should have the option to select from different rational treatments. Dr. Randolph also advocates for spending adequate time with the patient, allowing them to ask questions and make informed decisions.

This patient-centered approach fosters a less paternalistic, more collaborative physician-patient relationship, ensuring that the patient’s desires and concerns are addressed during the treatment process.

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About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.

• LinkedIn

Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.

September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it.

We recently had the unique opportunity to converse with esteemed Dr. Erivelto Volpi from Brazil at the Thyroid Ablation Conference held in Italy.

As an authority on thyroid treatments, he took the time to share his insights and valuable experience with us. Just a week before, we had caught up with him at the World Congress on Thyroid Cancer in London, and we were delighted to sit down with him again.

The conference presented a golden opportunity for specialists from around the globe to converge, exchange thoughts, and learn from the experts in the field. One area that stood out more than ever at this conference was the exploration of thyroid cancer treatment with ablation. Dr. Volpi explained, “it is a new field, and in selected patients, we can offer the opportunity to avoid surgery using thermal ablations technologies.”

Dr. Volpi emphasized that it is crucial to understand that ablation is indeed a viable option for treating thyroid cancer. However, patient selection plays an integral role in determining its effectiveness. “Usually, nodules up to one centimeter located inside the thyroid parenchyma are considered suitable cases. The results in terms of the treatment outcomes are exactly the same as those from a conventional surgery,” he noted.

Brazil has been at the forefront of using ablation as a treatment option for thyroid nodules for over a decade. As this methodology is now gaining momentum globally, including in the U.S. and countries like Indonesia, Dr. Volpi offers lessons from Brazil’s experience.

His key piece of advice for doctors new to this treatment method is to begin with benign and small-sized nodules. “When you start to do RFA (Radiofrequency Ablation), always start with benign nodules and not so huge nodules. For patients with cosmetic or symptomatic nodules, RFA is a very good option when starting your learning curve,” he advises. This strategy, he believes, will be beneficial not just for patients, but also for doctors who are beginning to learn this procedure.

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About Dr. Erivelto Volpi

Dr. Erivelto Volpi é um Cirurgião de Cabeça e Pescoço, especialista em doenças da tireoide e da paratireoide.

Dr. Erivelto Volpi teve toda seu treinamento no Hospital das Clínicas da Universidade de São Paulo, onde permanceu por 30 anos, 4 anos como médico residente em Cirurgia Geral e Cirurgia de Cabeça e Pescoçoe 26 anos como médico do Serviço de Cirurgia de Cabeça e Pescoço, onde atuou no atendimento e cirurgias de pacientes e no  treinamento de médicos residentes e estagiários, além da formação de alunos de graduação e pós-graduação.

Sua tese de Doutorado em 2011 foi sobre segurança em cirurgia de tireoide, especificamente na monitorização neuro-fisiológica intra-operatória dos nervos laríngeos (responsáveis pela movimentação das cordas vocais).

Dr. Volpi sempre esteve interessado em tratamentos minimamente invasivos, sendo um dos pioneiros no Brasil na realização de Tireoidectomias Minimamente Invasivas (MIVAT), tendo feito seu treinamento na Universidade de Pisa com o Dr. Paolo Miccoli.

Sempre preocupado em oferecer o melhor aos seus pacientes, Dr. Volpi em 2018 realizou seu treinamento em Ablação por Radiofrequência em Seoul, na Coréia do Sul com o Prof. Baek, o desenvolvedor da técnica de Ablação por Radiofrequência (RFA).

Retornando ao país, foi um dos primeiros médicos a realizar o procedimento, deste então tem tratado pacientes de todo o Brasil e da América do Sul, além de ter uma das maiores experiências da América Latina neste tratamento, hoje Dr. Volpi é responsável por um curso de treinamento em RFA, tendo já treinado médicos do Brasil, América Latina e EUA. 

View Full Profile: Dr. Erivelto Volpi

About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society.

• LinkedIn

Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.

September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. 

A recent interview from the TNT conference on thyroid ablation in Italy, Philip James of the Doctor Thyroid and RFAMD podcasts had a one-on-one discussion with Dr. Catherine Sinclair, a seasoned head and neck surgeon from Melbourne, Australia. Having served at Mount Sinai in New York for 11 years before relocating back to Melbourne in 2021, Dr. Sinclair offers a unique perspective and extensive expertise in thyroid surgery and laryngology.

The Importance of Nerve Protection

As a specialist who’s invested in both head and neck surgery and the voice box, Dr. Sinclair developed a keen interest in thyroid surgery due to the significant risks it presents to the vocal nerves during thyroid procedures, including during ablation. The laryngeal nerves, in particular, tend to be the patients’ greatest concern during thyroid procedures due to the potential damage they might sustain.

Many patients seeking Dr. Sinclair’s services are often singers or professional voice users who want to avoid surgery out of fear for their vocal nerves. As such, they prefer ablation. However, as she explains, it is crucial that they understand the risks to the laryngeal nerves and other vital structures in the area and the strategies used to mitigate these risks during ablation.

Limitations in Nerve Monitoring

In surgery, nerve monitoring is employed to keep track of and protect the nerves. But with ablation, patients are usually awake, which means the conventional nerve monitoring technology can’t be used. This presents a significant area of research on how to protect the nerves when the patient is conscious.

Dr. Sinclair emphasizes that though the risk is slightly lessened with surgery, it still exists. To counter this, specific strategies are used to minimize potential damage, but it’s never a guarantee that no injuries will occur.

Patients’ Preparedness and Awareness

Patients must ask about the surgeon’s experience, the number of ablations performed, and any potential complications that they should worry about. The more experienced the surgeon, the less likely there are to be complications of any kind, nerve injury included.

Contrary to some patients’ assumptions, nerve monitoring isn’t used in ablation since it requires general anesthesia. Early in her ablation experience, Dr. Sinclair used nerve monitoring on patients under general anesthesia. This procedure showed that nerve potentials remain stable as long as lower energy is used at the back of the thyroid gland where the nerves run. Furthermore, by minimizing time spent in the critical zones, nerve injury can be mostly prevented.

Real-time Vocal Assessment

During ablation, Dr. Sinclair often asks her patients to count in a monotone. This simple technique allows her to detect any changes in the voice, a potential indicator of nerve damage due to heat during the procedure. According to her, this method has helped prevent nerve issues.

State of Thyroid Ablation in Australia

Until recently, Dr. Sinclair was the only one performing thyroid ablations in Australia. Now, a colleague has started doing them in Western Australia. However, given the demand and the country’s size, she anticipates more physicians will adopt this procedure. Her main concern is ensuring that it’s done safely, with physicians possessing good ultrasound skills, interventional biopsy skills, and comprehensive knowledge of neck anatomy.

Final Thoughts

Dr. Sinclair’s parting advice to those considering thyroid ablation or thyroidectomy is to have realistic expectations. They should understand that injuries can happen despite the best precautions. However, the experience of the proceduralist can help lessen complications, and there are strategies to reduce the likelihood of nerve damage. Patients should also be well-informed and know what questions to ask their proceduralist before opting for ablation.

Interested parties can reach Dr. Sinclair by email at Catherine@melbournethyroidsurgery.com. She encourages inquiries from both domestic and international individuals.

About Philip James

As the host of the popular RFAMD and Doctor Thyroid podcasts, Philip James remains committed to sharing inspiring stories, valuable insights, and groundbreaking discoveries in the world of healthcare, making a positive impact on the lives of countless listeners.

Philip’s thought-provoking interviews have covered a wide range of healthcare topics, from cutting-edge technologies and surgical advancements to patient experiences and the impact of medical research on society. LinkedIn

Content on the RFAMD and Doctor Thyroid with Philip James websites and podcasts is for informational purposes only and not a substitute for professional medical advice. See our full Legal Disclaimer for details.

September is Thyroid Cancer Awareness Important, surgery isn’t always necessary for treating thyroid cancer. In fact: as many as one in three people have thyroid cancer and do not die from it, rather, with it. 

In a recent episode of the Doctor Thyroid and RFAMD podcasts, Dr. Vaninder Dhillon, an esteemed laryngologist and ENT surgeon from Johns Hopkins, highlighted the critical issue of voice and swallow risks associated with thyroidectomy and thyroid ablation.

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The interview sheds light on the importance of preserving the voice and offered insights into innovative approaches to avoid surgery.

Dr. Dhillon, who has extensive experience in both laryngology and endocrine head and neck surgery, underscored the significance of the voice and swallow outcomes in patients undergoing these procedures. Her research and clinical practice focus on improving outcomes and quality of life for patients who may face post-operative issues with their voice and swallow, as well as those with general voice and swallow complaints.

One of the most common complications after thyroid surgery is vocal cord paralysis, which can have a significant impact on a patient's voice. While the overall percentage of patients experiencing voice issues after thyroidectomy varies, it can be as high as 30 to 50 percent, with temporary paralysis affecting up to 15 percent. Although permanent paralysis is rarer (1-2 percent), it remains a concern for patients.

During the interview, Dr. Dhillon emphasized the importance of differentiating between voice and swallowing outcomes, as the latter is often overlooked. Swallowing complaints are higher than voice complaints, with some studies showing up to 60 percent of patients experiencing temporary swallowing issues post-operatively.

Voice and swallow assessments are crucial before and after surgery. Dr. Dhillon stressed the need for a comprehensive evaluation, including endoscopy and video stroboscopy, to examine the larynx more closely during speech. These assessments help in identifying potential issues with the recurrent laryngeal nerve and the superior laryngeal nerve.

Dr. Dhillon's team has implemented voice and swallow tests before surgery, and they continue to monitor patients post-operatively to ensure any issues are addressed promptly. This proactive approach helps patients feel more confident and informed about the potential risks to their voice and swallow function.

The conversation also discussed the rise of radiofrequency ablation (RFA) as an alternative to surgery. RFA is a minimally invasive technology for treating thyroid nodules and thyroid cancers. While RFA has a lower risk of voice and swallow complications than surgery, Dr. Dhillon stressed the importance of a thorough pre-RFA laryngeal exam to ensure optimal outcomes.

However, Dr. Dhillon acknowledged that more research is needed to fully understand the potential voice and swallow risks associated with RFA. Standardized protocols and patient-reported outcomes can be vital in evaluating these risks and ensuring patient safety during the procedure.

Dr. Vaninder Dhillon highlighted the importance of safeguarding the voice and swallow function in thyroid surgery and ablation. By proactively evaluating and addressing potential complications, patients can make informed decisions and seek appropriate interventions to protect their vocal and swallowing abilities. The ongoing research and innovative approaches in this field offer hope for improved outcomes and a better quality of life for those affected by thyroid conditions.

About Dr. Vaninder Dhillon

Assistant Professor of Otolaryngology – Head and Neck Surgery

Vaninder “Vinny” K. Dhillon, M.D., is an assistant professor of otolaryngology – head and neck surgery at Johns Hopkins University School of Medicine, specializing in both children and adults. She practices out of Johns Hopkins Otolaryngology – Head and Neck Surgery in Bethesda, Maryland. Dr. Dhillon is also affiliated with Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center in Baltimore, Maryland, as well as Sibley Memorial Hospital in Washington, D.C.

Dr. Dhillon has an expertise in endocrine surgery, laryngology, otolaryngology, parathyroid diseases and surgery, swallowing disorders, thyroid diseases and surgery, and voice problems.

Dr. Dhillon earned her medical degree from Keck School of Medicine of University of Southern California. She completed a residency in otolaryngology at Los Angeles County and University of Southern California Medical Center.

View Full Profile: https://www.rfamd.com/vaninder-dhillon/

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About Philip James

In 2013, his laryngeal nerve was severed, shoulder nerve damaged, parathyroids ruined, and residual cancer left behind — all for a 1 cm thyroid nodule.
Later, a vocal cord implant was inserted to help him speak.

The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others.

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