Endocrine Practice 27 ( 2021) page 691-97 Schumm M. et al
Dr.Guttler’s Comments:
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Post lobectomy TSH of 87 115 patients had TSH >2.
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Older patients should think twice about a lobectomy unless necessary.
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Pre-lobectomy TSH > 1.8 was a risk factor for post op hypothyroidism.
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80% of the patients developed hypothyroidism post surgery.
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This study was on thyroid cancer cancer patients.
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Imagine what happens when patients with a benign suspicious nodules are rushed off to lobectomy without outside opinions.
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This paper confirms what endocrinologists always knew that lobectomy was a risk for causing not only surgical complications,a scar but thyroid hormone replacement for life.
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Do the surgeons or your primary tell you about the high risk of life time thyroid hormone replacement?
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They need to tell the patient they will need frequent visits to titrate the thyroid hormone dose post surgery for life.
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Many low risk thyroid cancers are small <1.5 cm. Consider ablation therapy with Radiofrequency RFA instead of surgery.
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Also small thyroid cancers can also be followed by Active surveillance.
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Before the surgery call me for an opinion and evaluation for ethanol and RFA.
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Call 310-393-8860 or thyroid.manager@thyroid.com
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Ask for Alicia
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Dr.G.
2 Comments
What is considered a low risk cancer? I am a 41 yo female.
I had a bad bout of thyroiditis which lead to a US finding a 1.5 cm nodule. I had a FNA with atypical results due to nuclear atypia. The sample was sent to Thyroseq and it showed it had CCDC6/RET gene fusion. They said that it is >95% chance it is cancer and are recommending a thyroidectomy due to my family history of Graves (mother, maternal grandmother and maternal uncle) and Graves antibodies present. Is Radiofrequency RFA something I should consider with this diagnosis? I’m afraid to have to supplement thyroid the rest of my life.
Hi Anne,
Thyroid RFA is used to treat small thyroid cancer as alternative to surgery.
The electrode ablates the small cancer usually with one 20 minute session in my office.
The area is biopsied in 3-6 months to proof the cancer is ablated.
The removal of half your thyroid will result in 80% chance you will have to take thyroid for life.
Thyroid RFA leaves the rest of the thyroid intact and there is no need for thyroid hormone after the procedure.
Call me at 310-393-8860 or email to thyroid.manager@thyroid.com and ask for Alicia for details.
DR.G.
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