You have been diagnosed with a small papillary thyroid cancer. What do you do about it?

You have been diagnosed with a small papillary thyroid cancer. What do you do about it?

Dr. Guttler’s comments:

  1. A study in Mayo Clin.Proc. ( Nov 2021 96 2823-30 ) by Ian Hay et al, found 600 cases of thyroid cancer from 1935-2018. 89% were papillary and the median tumor size was 1.5 cm ( 0.9-2.5 cm )

  2. The 8 decade study found the incidence of significant thyroid cancer had not changed.

  3. The diagnosis of an indolent small thyroid cancer has the same emotional psychological and financial burden as a significant cancer.

  4. These cancers <1.5 cm do not need surgery.

  5. 8 decades with over diagnosis of small papillary thyroid cancer should lead to change in our approach to these indolent cancers.

  6. Don’t biopsy < 1 cm nodules.

  7. Active surveillance leaves the cancer in the neck for years.

  8. Radiofrequency ablation is a new treatment with the advantages of ablating the cancer in situ leaving the healthy thyroid intact and avoiding the lobectomy surgery with 80% chance you need thyroid hormone. Avoids the usual fear and anxiety for patients just doing Active surveillance.

  9. Call me if you have a small papillary thyroid cancer and your surgeon want to take out your lobe or worse wants to do a total thyroidectomy.

  10. 310-393-8860 or email to thyroid.manager@thyroid.com.

  11. Ask for Alicia for details.

  12. Dr.G.

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