Doctor Thyroid – Details, episodes & analysis

Join us as Dr. Emad Kandil, a leading expert in thyroid ablation, sits down with Philip James in the heart of New Orleans. In this candid and insightful conversation, Dr. Kandil shares his journey from aspiring engineer to becoming a renowned thyroid surgeon, influenced by a life-changing event involving his younger brother.

Against the backdrop of the city's iconic Café du Monde and a rigorous CrossFit session, the two explore the complexities of thyroid surgery, discussing why Dr. Kandil often advocates for ablation over traditional thyroidectomies to preserve patients' quality of life.

As the conversation unfolds, viewers examine Dr. Kandil’s commitment to research, patient care, and innovation. They venture from the cafe to the gym and finally to Dr. Kandil's clinic, where modern technology meets compassionate healthcare. For anyone considering thyroid surgery or seeking alternatives, this episode explores non-surgical options and the science behind thyroid ablation.

Discover how one surgeon’s philosophy and approach redefine patient outcomes—one thyroid at a time.

About Dr. Emad Kandil Dr. Emad Kandil is a renowned expert in endocrine and oncological surgery. He is the Chief of General, Endocrine, and Oncological Surgery at Tulane University in New Orleans, Louisiana. He holds the prestigious Elias Hanna Chair in Surgery and is celebrated for his groundbreaking work in minimally invasive thyroid treatments, including thyroid ablation. Dr. Kandil has performed over 1,000 thyroid ablation procedures, establishing himself as a leading figure in using this innovative treatment approach in the United States. www.emadkandil.com

About Philip James Philip James hosts the Doctor Thyroid podcast, a platform that provides patients with information on alternative thyroid treatments. His work focuses specifically on minimally invasive procedures like thyroid ablation. He aims to help patients avoid unnecessary thyroid surgeries, a mission close to him after his own experience with an unneeded surgery. www.docthyroid.com

In this interview with Dr. Emad Kandil, a leading expert in thyroid ablation, patient Elizabeth shares her journey of receiving conflicting medical advice regarding her thyroid nodule.

After consultations with multiple doctors in New York who recommended surgery, Elizabeth sought an alternative in New Orleans with Dr. Kandil, who offered a less invasive option—thyroid ablation.

This video explores the benefits of microwave ablation (MWA) as an effective treatment for thyroid nodules, avoiding the complications of surgery and long-term medication dependency.

Dr. Kandil provides in-depth insights into the procedure, its success rates, and how it preserves thyroid function, challenging the traditional approach of immediate surgical intervention. For those with suspicious thyroid nodules, this discussion highlights the importance of seeking second opinions and understanding all available treatment options before making a decision.

About Baird Medical

Baird Medical LLC, established in 2012 and headquartered in Guangzhou, China, is a leading developer and provider of minimally invasive medical devices specializing in microwave ablation (MWA) technology. In the U.S., the company continues to expand its reach, recently receiving FDA clearance to market its microwave ablation devices for thyroid treatment.

@BairdMedical www.bairdmed.com NASDAQ: BDMD

Baird Medical’s Assistance Center
888-508-6228 or erichuang@bairdmed.com

About Dr. Emad Kandil

Dr. Emad Kandil is a renowned expert in endocrine and oncological surgery. He is the Chief of General, Endocrine, and Oncological Surgery at Tulane University in New Orleans, Louisiana. He holds the prestigious Elias Hanna Chair in Surgery and is celebrated for his groundbreaking work in minimally invasive thyroid treatments, including thyroid ablation. Dr. Kandil has performed over 1,000 thyroid ablation procedures, establishing himself as a leading figure in using this innovative treatment approach in the United States.
www.emadkandil.com

About Philip James

Philip James hosts the Doctor Thyroid podcast, a platform that provides patients with information on alternative thyroid treatments. His work focuses specifically on minimally invasive procedures like thyroid ablation. He aims to help patients avoid unnecessary thyroid surgeries, a mission close to him after his own experience with an unneeded surgery.
www.docthyroid.com

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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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

Dr. Maria Papaleontiou

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

American Thyroid Association

Cedars-Sinai clinical trial

MSKCC thyroid cancer active surveillance

THYCA Support Group

 

Active Surveillance of Thyroid Cancer Under Study

 

What Happens When Thyroid Cancer Travels to the Lungs?

Fabian Pitoia, M.D., serves as the Head of the Thyroid Section of the Division of Endocrinology and Investigation Area Coordinator at the Hospital de Clinicas of the University of Buenos Aires (UBA). He works also as an Proffessor of internal medicine at the Faculty of Medicine (UBA).

Dr Pitoia serves as a Full Member of the Argentine Society of Endocrinology and Metabolism, of the Latin American Thyroid Society, the Endocrine Society and he is a Correspondent Member of the American Thyroid Association.

In this episode Dr. Pitoia addresses the following topics:

• 10% of thyroid cancer patients will have distant metastatic disease
• The disease will travel to lungs, bones, or both
• Treatment with RAI is most effective for those under 40 years old
• Evaluation of metastatic thyroid cancer in the lungs is a CT scan
• In 2006, there was a change in the treatment of the disease
• Adverse events of medication
• The coordination between the endocrinologist and the oncologist 

RESOURCES

ResearchGate

Dr. Pitoia - Facebook

Dr. Pitoia - web site

Dr. Pitoia - Twitter

Thyroid Cancer Alliance

American Thyroid Association

Hospital de Clínicas de la Universidad de Buenos Aires - Ciudad Autónoma de Buenos Aires.  Consultorio privado: Pte. J.E. Uriburu 754 - Piso 2. Teléfonos: 49545488/49525496  fpitoia@glandulatiroides.com.ar

 

Bienvenido al episodio 33 de Doctor Thyroid con Philip James.   

El invitado de hoy es Dr. Fabian Pitoia.  El Dr. Pitoia es un experto endocrino mundial, que aparece en muchas publicaciones y conferencias mundiales, donde habla de cáncer de tiroides. El Dr Pitoia es médico endocrinólogo, está encargado de la Sección Tiroides de la División Endocrinología del Hospital de Clínicas de la Universidad de Buenos Aires.

En este episodio, el Dr. Pitoia responde las siguientes preguntas:

• ¿Qué es la enfermedad metastásica en relación con el cáncer de tiroides?  
• Hay una tendencia de este enfermedad?
• ¿cómo se descubre la enfermedad metastásica?
• cuando se trata de cáncer de tiroides es un procedimiento típico para los médicos para detectar la enfermedad metastásica?
• si un paciente no responde a RAI (radioactiva), ¿qué es una opción de tratamiento? ¿Podemos hacer vigilancia activa
• cuando hay metástasis en los pulmones, ¿es lo mismo que el cáncer de pulmón?
• 600 milicurios de RAI .... ¿Hay peligro para este alto de una dosis?
• ¿hay efectos secundarios o peligros a los medicamentos usados ​​para tratar la enfermedad metastásica que no responde a la radiación?
• se le informa a un paciente de la enfermedad metastásica, y este es un área de estrés para los pacientes con cáncer de tiroides, ¿puede decirle a un paciente algo para reducir la ansiedad relacionada con la enfermedad metastásica?
• si un paciente tiene enfermedad metastásica, ¿es necesario un médico especial para el tratamiento?
• ¿cómo sabemos si un médico se especializa en la enfermedad metastásica?
• ¿hay una página web o recursos adicionales para aprender más sobre la enfermedad metastásica?

Recursos:

Dr. Pitoia - Facebook

Dr. Pitoia - pagina web

Dr. Pitoia - Twitter

ResearchGate

Thyroid Cancer Alliance

American Thyroid Association - Español

Hospital de Clínicas de la Universidad de Buenos Aires - Ciudad Autónoma de Buenos Aires.  Consultorio privado: Pte. J.E. Uriburu 754 - Piso 2. Teléfonos: 49545488/49525496  fpitoia@glandulatiroides.com.ar

El término nódulo tiroideo se refiere a cualquier crecimiento anormal de las células tiroideas formando un tumor dentro de la tiroides. Aunque la gran mayoría de los nódulos tiroideos son benignos (no cancerosos), una pequeña proporción de estos nódulos sí contienen cáncer de tiroides. Es por esta posibilidad que la evaluación de un nódulo tiroideo está dirigida a descubrir un potencial cáncer de tiroides.

En esta entrevista, el Dr. Castro explica los siguientes temas:

• ¿Qué es un nódulo tiroideo?
• ¿Cuáles son los síntomas de un nódulo tiroideo?
• ¿Cómo se diagnostica el nódulo tiroideo?
• Punción de la tiroides con aguja fina
• Ecografía de la tiroides
• ¿Cómo se tratan los nódulos de la tiroides?
• Cuando la observación activa es la opción de tratamiento en lugar de una tiroidectomía
• Niños con nódulos tiroideos

M. Regina Castro, MD es consultante en la División de Endocrinología de la Clínica Mayo de Rochester, MN. Es Profesora Asociada de Medicina. Es Directora Asociada del Programa de entrenamiento en la especialidad de Endocrinología, y Directora de la rotación de Endocrinología para la Residencia de Medicina Interna. También es miembro del Grupo de Tiroides de la Clínica Mayo. Ella sirvió de 2009 a 2015 como Editor de Sección de la Tiroides para el Programa de Autoevaluación de AACE y ha sido autora de varios capítulos sobre Hipertiroidismo, Nódulos de Tiroides y cáncer

Notas

Nódulos Tiroideos

Regina Castro Publications

American Thyroid Association en Español 

 

 

In this episode Dr. Bernet describes that Hashimoto’s thyroiditis is an autoimmune condition that usually progresses slowly and often leads to low thyroid hormone levels — a condition called hypothyroidism. The best therapy for Hashimoto’s thyroiditis is to normalize thyroid hormone levels with medication. A balanced diet and other healthy lifestyle choices may help when you have Hashimoto’s, but a specific diet alone is unlikely to reverse the changes caused by the disease.

Hashimoto’s thyroiditis develops when your body’s immune system mistakenly attacks your thyroid. It’s not clear why this happens. Some research seems to indicate that a virus or bacterium might trigger the immune response. It’s possible that a genetic predisposition also may be involved in the development of this autoimmune disorder.

A chronic condition that develops over time, Hashimoto’s thyroiditis damages the thyroid and eventually can cause hypothyroidism. That means your thyroid no longer produces enough of the hormones it usually makes. If that happens, it can lead to symptoms such as fatigue, sluggishness, constipation, unexplained weight gain, increased sensitivity to cold, joint pain or stiffness, and muscle weakness.

If you have symptoms of hypothyroidism, the most effective way to control them is to take a hormone replacement. That typically involves daily use of a synthetic thyroid hormone called levothyroxine that you take as an oral medication. It is identical to thyroxine, the natural version of a hormone made by your thyroid gland. The medication restores your hormone levels to normal and eliminates hypothyroidism symptoms.

You may hear about products that contain a form of thyroid hormones derived from animals. They often are marketed as being natural. Because they are from animals, however, they aren’t natural to the human body, and they potentially can cause health problems. The American Thyroid Association’s hypothyroidism guidelines recommend against using these products as a first-line treatment for hypothyroidism.

Although hormone replacement therapy is effective at controlling symptoms of Hashimoto’s thyroiditis, it is not a cure. You need to keep taking the medication to keep symptoms at bay. Treatment is usually lifelong. To make sure you get the right amount of hormone replacement for your body, you must have your hormone levels checked with a blood test once or twice a year.

If symptoms linger despite hormone replacement therapy, you may need to have the dose of medication you take each day adjusted. If symptoms persist despite evidence of adequate hormone replacement therapy, it’s possible those symptoms could be a result of something other than Hashimoto’s thyroiditis. Talk to your health care provider about any bothersome symptoms you have while taking hormone replacement therapy.

Victor J. Bernet, MD, is Chair of the Endocrinology Division at the Mayo Clinic in Jacksonville, Florida and is an Associate Professor in the Mayo Clinic College of Medicine. Dr. Bernet served 21+ years in the Army Medical Corps retiring as a Colonel. He served as Consultant in Endocrinology to the Army Surgeon General, Program Director for the National Capitol Consortium Endocrinology Fellowship and as an Associate Professor of Medicine at the Uniformed Services University of Health Sciences. Dr. Bernet has received numerous military awards, was awarded the “A” Proficiency Designator for professional excellence by the Army Surgeon General and the Peter Forsham Award for Academic Excellence by the Tri-Service Endocrine Society. Dr. Bernet graduated from the Virginia Military Institute and the University of Virginia School of Medicine. Dr. Bernet completed residency at Tripler Army Medical Center and his endocrinology fellowship at Walter Reed Army Medical Center. Dr. Bernet’s research interests include: improved diagnostics for thyroid cancer, thyroidectomy related hypocalcemia, thyroid hormone content within supplements as well as management of patient’s with thyroid cancer. He is the current Secretary and CEO of the American Thyroid Association.