Dr.Guttler’s Patient Thyroid Blog Post: Why are so many patients with small thyroid cancers looking for alternatives to surgery?
1. Two major breakthroughs in 2018 have FDA approval of radiofrequency ablation RFA and the use of Active surveillance AS instead of surgery. AS is long term follow up with no surgery unless the small nodule grows.RFA is a minimally invasive method to ablate the small nodule. Both are used and the patient can choose what is the best for them.
3. AS has the potential for rescue surgery later if the nodule grows. RFA has a high success rate in ablating the cancer and after one year the patient has no indication for extensive follow up as the AS patients. RFA can also remove the cancer without the need for thyroid hormone replacement therapy as with thyroid surgery.
4. More accurate diagnosis of thyroid nodules BEFORE surgery with molecular markers, advanced TiRads ultrasound and PET/CT for Class III and IV cytology can decrease exploratory surgery by 50%.
5. Patients are shopping around for information on these methods to decrease their chance of an exploratory surgery.
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