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 recent years, innovative methods in thyroid cancer management have drastically changed the field, and potentially the future of cancer treatments overall. A thought-provoking revelation comes from a discussion held at the World Congress on Thyroid Cancer in London, where a paradigm-shifting concept was discussed by two highly respected figures in the field.

Dr. Akira Miyauchi of Kuma Hospital in Kobe, Japan, and Dr. Michael Tuttle from Sloan Kettering Cancer Center, New York, unveiled a practice that goes against traditional medical protocol: favoring active surveillance over immediate surgery in managing papillary thyroid cancer. The method has been utilized at Kuma Hospital for 30 years, and in this time, not one patient has died from this type of cancer. This groundbreaking revelation was discussed in a live interview hosted by Philip James of the Doctor Thyroid podcast.

According to Dr. Miyauchi, the original proposal for this trial of active surveillance was approved and initiated in 1993. It is based on the principle that early intervention is not always critical. Instead, the method favors regular monitoring of the patient’s condition to identify any changes in the cancer’s progression.

“The most important thing might be the unclosing safety of the active surveillance. Compared to immediate surgery, the instances of unfavorable events such as vocal cord paralysis, hypoparathyroidisms, or patients with surgical scars, patients taking Levothyroxine – these instances are significantly smaller in active surveillance” explained Dr. Miyauchi.

The focus of active surveillance is not to disregard treatment but to delay intervention until necessary, allowing for better management of the disease. This, in turn, reduces the risk of complications often associated with early and possibly unnecessary surgery.

However, surveillance does not mean the absence of treatment. Many patients are proactive in their health management, adopting healthier lifestyles, engaging in physical activities, and sometimes utilizing alternative treatments. The goal remains the same: to halt or slow the progression of the cancer.

Dr. Tuttle reiterated that the outcomes and survival rates between early and delayed intervention are largely the same. Importantly, patients who do show a small increase in the size of the cancer or the appearance of small lymph nodes in the neck can still be efficiently treated with delayed surgery. This does not compromise their chance of a full recovery or increase their risk of recurrence or distant metastasis.

In the U.S., where active surveillance has been practiced for around 12 years, Dr. Tuttle’s experience with patients who have needed to switch to surgery has been largely positive. Most were grateful for having been able to keep their thyroid for as long as they did, and many even reported feeling healthier due to the lifestyle changes they had implemented.

“Having seen a few now that are on the other side of that, I can tell you for most people they weren’t upset they weren’t sad that we had to do something but they felt like they’d given it their best” Dr. Tuttle explained.

This approach might, however, require a change in doctors’ attitudes as well. It’s not only about informing patients about their cancer but also managing their anxiety and uncertainty about the ‘wait and see’ strategy. The physicians’ warm-heartedness, their reassuring demeanor, and the trust they establish with their patients are crucial factors that may significantly affect patients’ psychological well-being.

The shift from immediate surgical intervention to active surveillance represents a revolutionary approach to managing thyroid cancer. The results from the Kuma Hospital trial are prompting the medical community to rethink its strategies and consider adopting this new method more broadly. Although active surveillance might not be the right choice for all patients, it presents an alternative and safe option for those with papillary thyroid cancer, potentially improving both their physical and psychological quality of life.

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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.

LinkedIn

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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.

You have been diagnosed with thyroid cancer, and contrary to your doctor's advice, you choose to not proceed with surgery.  Is this a patient trend, and how often are patients making this decision?

In a qualitative analysis, Dr. Louise Davies reports on the experience of US patients who self-identify as having an over-diagnosed thyroid cancer.

How likely is death as result of thyroid cancer?  In a study by H. Harach, he sites that when reviewing random autopsies, thyroid cancer was prevalent in 34% of the cadavers.  

Dr. Davies states, if diagnosed with thyroid cancer, important questions to ask, include:

1. How big is the tumor?
2. How was the tumor discovered?
3. Are there any symptoms?

Dr. Davies says those who choose to opt for no surgery are sometimes called stupid by those who know them, and end up feeling isolated and anxious, with little or no support.  

Louise Davies, MD, MS, FACS is an Associate Professor at Geisel School of Medicine and Dartmouth Institute for Health Policy & Clinical Practice (TDI).

She is Chief, Otolaryngology at Veterans Administration, White River Jct., VT Dr. Davies is an otolaryngologist - head & neck surgeon whose thyroid related research is aimed at defining and documenting the problem of rising thyroid cancer incidence and developing management approaches to the problem in ways that are safe and effective. Clinically, Dr. Davies cares for patients with both head and neck and thyroid cancer and general otolaryngology problems primarily at the VA hospital, with a limited practice at Dartmouth Hitchcock Medical Center. Her career is defined by her goal of helping patients and physicians make good decisions for their cancer care by providing clear, helpful data in useful formats at the needed time and place.

NOTES:

JAMA Abstract: Dr. Davies

Thyroid Stories Project

Dr. Michael Tuttle, from Sloan Kettering

Yasuhiro Itoa and Akira Miyauchi 

Nonoperative management of low-risk differentiated thyroid carcinoma

 

Jonas de Souza participates in both clinical and outcomes research studies on malignancies of the upper aerodigestive tract, especially head and neck cancers. His research focuses on the use of novel therapeutic agents along with measurements of financial burden, patients’ preferences, and the trade-offs between the risks and benefits of cancer therapies. His research has sought to integrate outcomes research, patient preferences, health policy, and economics into clinical practice. His ultimate goal is to increase access to essential cancer therapies by providing policy makers and scientific communities with the required information on patient preferences and on barriers that lie between cancer patients and access to care.   De Souza has authored and presented papers and given lectures on head and neck malignancies, reimbursement methods in oncology, and evidence-based care. He is the principal investigator for a trial examining the role of SPECT-CT in the follow-up of patients with locally advanced head and neck cancers.   De Souza earned his MD from the University of Rio de Janeiro State. He completed his residency specializing in internal medicine at the University of Texas Health Science Center in 2008 and a fellowship focusing on hematology/oncology at the University of Chicago in 2011.   During this episode the following topics are discussed: “Financial toxicity,” or the financial burdens that some patients suffer as a result of the cost of their treatments can cause damage to their physical and emotional well-being.  Financial impact of thyroid cancer Lost income or high out-of-pocket costs for treatment, medication or related care. Like any other side effect, financial toxicity should be disclosed and discussed with the patients. Patients with thyroid cancer had a 41% increased risk for unemployment at 2 years      Jonas de Souza MD, MBA   The High Cost of Cancer Care May Take Physical and Emotional Toll on Patients   Thyroid Cancer Diagnosis Affects Employment, Income

Dr. Jeremy Freeman was born in Hamilton, Ontario and grew up in Toronto. He attended medical school at the University of Toronto, graduating with highest honours. He completed his otolaryngology residency at the University of Toronto.

After receiving his Fellowship from the Royal College of Surgeons of Canada in 1978, he spent two further years of advanced training, one as a Gordon Richards Fellow at the Princess Margaret Hospital in Toronto in Radiation and Medical Oncology and a second year as a McLaughlin Fellow, training in Head and Neck Oncology at the Royal Marsden Hospital in London, UK. He was the first fellow of the Advanced Training Council sponsored by the two head and neck societies.

A Full Professor, he occupies the Temmy Latner/Dynacare Chair in Head and Neck Oncology at the University of Toronto, Faculty of Medicine. He is former Otolaryngologist-in-Chief at the Mount Sinai Hospital stepping down after fulfilling his 10 year appointment. He has an active practice focusing on head and neck oncology with a primary interest in endocrine surgery of the head and neck.

He has given over 500 scholarly presentations, has been invited as a visiting professor and surgeon internationally, and has published over 280 articles in the scientific literature. He has been involved in a number of administrative roles in the American Head and Neck Society and is also on the editorial board of a number of high impact journals focusing on head and neck oncology. He has recently been appointed to the National Institute of Health (in Washington DC) task force on the management of thyroid cancer.

He is the Director of the University of Toronto Head and Neck Oncology Fellowship, considered to be one of the top three such fellowships in North America.

He was the program chair and congress chair of the First and Second World Congresses on Thyroid Cancer held in 2009 and 2013 in Toronto. He was the Keynote speaker at the Congress held in Boston in 2017. He has been invited worldwide to deliver keynotes in the management of thyroid malignancies.

In this episode the following topics are discussed:

• Cost of thyroid surgery in varies depending on jurisdiction
• Surgery and active surveillance is a fixed cost
• Costs after surgery
• TG tests, ultrasound, thyroid hormone costs
• Contrary to some proponents, surgery is not more cost effective than active surveillance
• Hypo parathyroidism leads to daily doses of calcium and vitamin D
• If there is RLN damage, then there could be more surgery and voice therapy
• There are more costs than solely the surgical fee
• Levothyroxine costs
• Ramifications of degree of thyroid cancer
• Thyroid cancer is a low risk of death
• Many people die with thyroid cancer but don’t die from it
• Possibility versus probability
• Emotional expense of malignancy and being labeled survivor
• Lead a normal life or the survivor label
• Lifetime cost of thryoidectomy
• Medical costs and cost of travel, time of work, baby-sitters, and all expenses that go into managing thryoidectomy for ancillary items
• How long can someone live without thyroid replacement hormone post thyroidectomy?
• Quality of life post thyroidectomy
• Psychological wellbeing
• Do not do a FNA for nodule under 1 cm

NOTES

Dr. Jeremy Freeman

Jeremy Freeman's scientific contributions

LinkedIn

 

Thyroid radiofrequency ablation (RFA) is a treatment option for thyroid nodules that aims to remove the nodule while preserving the thyroid gland. This procedure has gained popularity in South Korea and other countries as an alternative to thyroidectomy, a surgery that involves removing the entire thyroid gland. However, the adoption of RFA has been slow in the United States due to insurance companies not covering the procedure, making it too costly for many patients.

Dr. Baek, a specialist in thyroid RFA, believes that the procedure is important for preserving thyroid function and improving the quality of life for patients. In contrast to thyroidectomy, which requires patients to take lifelong hormone replacement medication, RFA allows patients to maintain natural thyroid hormone production.

The cost of thyroid RFA is a significant barrier to its adoption in the United States. While the procedure is cheaper in South Korea and other countries, insurance coverage is a major factor in the affordability of treatment for patients. Insurance companies need to recognize the value of RFA and begin covering the procedure in order for it to become more widely available to patients.

Overall, thyroid RFA is a promising treatment option that has the potential to improve the lives of many thyroid nodule patients. It is important for insurance companies to acknowledge the benefits of this procedure and work towards making it more widely accessible to patients. MORE INFO www.rfamd.com

RFA Doctor Directory: www.rfamd.com

During this video, the following topics are discussed:

✅ Finding treatments that are not over-aggressive and less-invasive.

✅ 70% of women and 50% of men have thyroid nodules

✅ Less than 10% of nodules are cancerous 

✅ Is radiofrequency ablation (RFA) an effective treatment?

✅ Is radiofrequency ablation (RFA) painful?

✅ How long does radiofrequency ablation (RFA) take to show results or shrinkage of the nodule?

✅ Ultrasound can categorize a nodule by low risk, intermediate, or high risk.

✅ Thyroidectomy comes with risks, including: vocal cord paralysis, bleeding, parathyroid damage, and nerve damage.

✅ Patients must educate themselves before seeing a doctor.

 

✅ About Dr. Larian

Babak Larian is a highly experienced, board certified Ear, Nose, & Throat Specialist and Head & Neck surgeon. Dr. Larian is the current Clinical Chief of the Division of Otolaryngology at Cedars-Sinai Hospital in Los Angeles (January 2012 – present).  He graduated with academic and humanitarian distinction, from UC Irvine School of Medicine. In 2002 after completing a 6-year residency program in Ear, Nose, & Throat (otolaryngology) and Head & Neck Surgery at UCLA, he began his professional career. He then went on to become a founding member and later the Medical Director of the Cedars-Sinai Head & Neck Center of Excellence (November 2009 – October 2011).

CONTACT

Email: [email protected]

Phone: 310.461.0300

Website: https://https://www.parotidsurgerymd....

Hyperparathyroidism:  https://www.hyperparathyroidmd.com/doctor-larian/ 

Facebook: https://www.facebook.com/parotidsurge...

Instagram: https://www.instagram.com/babaklarianmd/

✅ About Philip James

He is the host of the popular podcast: Doctor Thyroid

www.docthyroid.com

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.

All the above, the result of a bad thyroid surgery that dampened his quality of life — and left him wondering, what exactly happened — during what should be a low-risk surgery?

His attempts to follow up with UCLA and the UCLA surgeon were ignored.

He then turned to other doctors for answers — this was the beginning of the podcast:

"Doctor Thyroid with Philip James"

100+ episodes later, the Doctor Thyroid podcast is popular amongst patients; allowing them to access information from top doctors, without being limited by geography or economics.

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

When not producing podcast episodes or co-hosting live Q&As for patients with top doctors, he leads the creative team at Doctor Marketing and Philip James Media — a marketing agency dedicated to digital communications serving the sectors of healthcare, payments, and Greentech.

The Doctor Thyroid podcast is available in Spanish and English - and listened to in over 30 countries:

www.doctiroides.com (Spanish)

www.docthyroid.com (English)

✅Please email your requests to [email protected]

LinkedIn: www.linkedin.com/in/philip-james/

Facebook @docthyroid

YouTube @Doctor Thyroid

Twitter @docthyroid

 

Looking for a RFA doctor?

Search the RFA Directory:

www.rfamd.com

Protecting the nerves during RFA and thyroid surgery with Dr. Julia Noel from Stanford Health Care.

Hosted by Philip James.

Supported by www.rfamd.com.

Find an RFA doctor at www.rfamd.com 🔹🔹🔹

During this interview, the following topics are discussed:

→ Stanford University prioritizes anatomic structures, ultrasound, and how to best protect the laryngeal nerve

→ Pre- procedure ultrasound is instrumental in minimizing risk

→ Risk to the laryngeal nerve is minimal during RFA

→ Where to deliver heat is guided by ultrasound

→ If unintended consequences occurs during RFA, they are usually reversible

→ Most risk is affecting a patient’s voice

→ Technique and space — away from structures — can be controlled with extra fluid

→ Dr. Noel has conducted 80+ RFA procedures at Stanford University

→ What should every practitioner know in regard to protecting the nerves?

→ Commitment to ultrasound anatomy is critical

→ Ultrasound guided procedures

→ The Stanford RFA team for conducting a procedure is one assistant MD or Fellow, medical assistant laying out equipment and vital signs

→ Patient due diligence when selecting an RFA doctor is key: it should include vetting providers for their experience with RFA → Ask if the doctor has done RFA procedures, what’s the plan for follow up?

→ With RFA, are fewer thyroidectomies occurring?With RFA in clinic, patients now have more treatment options → “No hammers looking for nails”

→ Who is the ideal candidate for RFA?

→ Solitary, large, benign thyroid nodule is the ideal candidate → Cost is between $5000 - $10,000

→ Reduction in thyroid nodule size is up to 80%

→ RFA can be used for malignant nodules

→ Why did it take so long for the U.S. to adopt RFA?

FDA processes are laborious and time consuming

→ Is RFA painful? Generally “no”

→ RFA fills a void in treatment options for thyroid nodule

→ Preservation of thyroid function is key — the thyroid is preserved

→ Does insurance cover RFA treatment?

→ Sometimes the insurance company will cover the procedure through an appeal process

About Dr. Julia Noel

✅ TWITTER @JuliaNoelMD

✅ WEBSITE https://profiles.stanford.edu/julia-noel

✅ WEBSITE https://rfamd.com/julia-noel/

✅ Grand Rounds Video on YouTube https://www.youtube.com/watch?v=YeiOQ...

✅ About Philip James

✅ Instagram @philipjames360

✅ TWITTER @docthyroid

✅ LinkedIn @Philip James

✅ Website www.philipjames.co

✅ YouTube https://www.youtube.com/c/DoctorThyroid

 🔹🔹🔹

✅ ABOUT Philip James

I shared my story with many of you on my podcast: Doctor Thyroid www.docthyroid.com In 2013, my 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 me speak. The bad result of thyroid surgery dampened my quality of life → and left me wondering, what exactly happened → during what should be a low-risk surgery? My attempts to follow up with UCLA and the surgeon were ignored. So, I turned to other doctors for answers — this was the beginning of the podcast: "Doctor Thyroid with Philip James" 100+ episodes later, the Doctor Thyroid podcast is popular amongst patients; allowing them access to information from top doctors, without being limited by geography or economics. The word I use to describe my work as patient advocate is, ‘tonglen’. Or, using my pain and hardship to help others. When not producing podcast episodes or co-hosting live Q&As for patients with top doctors, I lead the creative team at Philip James Media — we are a marketing agency dedicated to digital communications — serving the sectors of healthcare, payments, and Greentech. The Doctor Thyroid podcast is available in Spanish and English - and listened to in over 30 countries: www.doctiroides.com (Spanish) www.docthyroid.com (English) Please email your requests to [email protected] 🔹🔹🔹

Looking for a radiofrequency ablation doctor? 🔹www.rfamd.com🔹 Dr. Leonardo Rangel and Radiofrequency Ablation (RFA) for Malignant Thyroid Nodules.

During this episode the following topics are discussed:

✅we are treating malignant nodules with radiofrequency ablation therapy ✅We are using radiofrequency ablation therapy since 2006 ✅it is something that we are really experiencing is the treatment of those malignant thyroid nodules with radiofrequency ablation ✅avoid the risk of thyroidectomy ✅surgeons must give patients all treatment options; including no surgery ✅there are some nodules malignant nodules, they are not amenable for radiofrequency due to position, size, or something like this ✅patient consultations take longer because there are more treatment options to consider ✅ the problem of taking the levothyroxine

✅About Dr. Leonardo Rangel Staff da Universidade do Estado do Rio de Janeiro Membro da Sociedade Brasileira de Cirurgia de Cabeça e Pescoço Membro da Sociedade Americana de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço Membro da Sociedade Latinoamericana de Tireoidologia

✅Facebook Rangel MD - Cirurgia de Cabeça e Pescoço @cabecaepescoco

✅Website https://www.rfamd.com/leonardo-rangel/

✅ABOUT RFA MD A guide for locating doctors of radiofrequency ablation. Find radiofrequency ablation doctors from across the world. rfamd.com

✅ Facebook @RFADOCTOR

✅ Instagram @RFADOCTOR

✅ LinkedIn @rfa-doctor-directory

✅ Twitter @RFADOC

✅ Internet www.rfamd.com

✅ ABOUT Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 🔹 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. 🔹 All the above, the result of a bad thyroid surgery that dampened his quality of life — and left him wondering, what exactly happened — during what should be a low-risk surgery? 🔹 His attempts to follow up with UCLA and the UCLA surgeon were ignored. He then turned to other doctors for answers — this was the beginning of the podcast: "Doctor Thyroid with Philip James" 🔹 100+ episodes later, the Doctor Thyroid podcast is popular amongst patients; allowing them to access information from top doctors, without being limited by geography or economics. 🔹 The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 🔹 When not producing podcast episodes or co-hosting live Q&As for patients with top doctors, he leads the creative team at Doctor Marketing and Philip James Media — a marketing agency dedicated to digital communications serving the sectors of healthcare, payments, and Greentech. 🔹 The Doctor Thyroid podcast is available in Spanish and English - and listened to in over 30 countries:

www.doctiroides.com (Spanish)🔹 www.docthyroid.com (English)🔹

✅Please email your requests to [email protected]

✅Instagram @PhilipJames360

✅ LinkedIn www.linkedin.com/in/philip-james/

✅ Facebook @docthyroid

✅ YouTube @Doctor Thyroid

✅ Twitter @docthyroid

✅ Are you looking for an RFA doctor? Find one here: www.rfamd.com

 

Looking for a radiofrequency ablation doctor? 🔹www.rfamd.com🔹

Radiofrequency Ablation 🛑 REMOVE Thyroid Nodules 🛑 NO SURGERY 🛑 Dr Ralph Tufano

During this podcast, the following topics are discussed: ✅advocate for patients to be as well informed as possible and consider all treatment options for thyroid problems, including avoiding surgery whenever possible and radiofrequency ablation. ✅ five thousand dollars out of pocket and save your thyroid with radiofrequency ablation or thyroidectomy and maybe nothing out of pocket with an insurance paid thyroidectomy? ✅if there are isn't if there are options available if there is an option available to avoid surgery and it gives you an equivalent outcome or maybe even better outcome why wouldn't you choose radiofrequency ablation?

✅with radiofrequency ablation now it's exciting because for thyroid nodules they can be removed without doing surgery ✅before radiofrequency ablation all you had was surgery really and obviously with surgery we talked about the possible risks of surgery and of course probably more concerning sometimes to a lot of people is if you take out half of the thyroid even if you're functioning normally with thyroid your thyroid levels you're having normal thyroid function 25% of those patients will still need thyroid hormone ✅the beauty of radiofrequency ablation is that first of all in most circumstances it's no general anesthesia you can do it in the office much like when you go to your dentist and maybe you're getting a cavity filled you get novocaine or lidocaine to numb up the neck area and then under guidance with an ultrasound you take a needle ✅the beauty of that is that the overwhelming majority of times radiofrequency ablation does not change your thyroid function so think about it we're talking about an invasive procedure surgery general anesthesia complication risk ✅ they have a thyroid problem goiter or a nodule that can be treated by radiofrequency ablation that they seriously consider radiofrequency ablation in preserving the thyroid as a treatment option versus a surgery or a thyroidectomy ✅radiofrequency ablation is very effective and more effective than surgery in fact in ablating and controlling papillary micro-cancer without any real complications ✅radiofrequency ablation seems to be a little more focused and maybe a little bit more able to control that destructive process in that area so you can protect those important structures

✅About Dr. Ralph Tufano

Dr. Ralph P. Tufano is the Director of the Division of Head and Neck Endocrine Surgery and conducts thyroid and parathyroid surgery with a focus on optimizing outcomes. He is a recognized world authority on the management of thyroid cancer, thyroid nodules, benign thyroid diseases and parathyroid disease. He has expertise in the management of thyroid cancer nodal metastases, advanced and invasive thyroid cancers as well as recurrent thyroid cancers. His work in molecular markers, improving surgical outcomes, nerve monitoring and exploring novel treatment techniques for thyroid and parathyroid diseases has helped the medical field tailor and personalize treatment for patients with these conditions. Dr. Tufano has performed every type of minimally invasive endoscopic and robotic thyroid and parathyroid surgery over the years and was director of the initial team that developed the now internationally accepted approach for the scarless transoral thyroidectomy and parathyroid surgery.

Website https://rfamd.com/doctors/dr-ralph-tufano/

✅ABOUT RFA MD A guide for locating doctors of radiofrequency ablation. Find radiofrequency ablation doctors from across the world. rfamd.com

✅ Facebook @RFADOCTOR

✅ Instagram @RFADOCTOR

✅ LinkedIn @rfa-doctor-directory

✅ Twitter @RFADOC

✅ Internet www.rfamd.com

✅ ABOUT Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 🔹 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. 🔹 100+ episodes later, the Doctor Thyroid podcast is popular amongst patients; allowing them to access information from top doctors, without being limited by geography or economics. 🔹 The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 🔹 The Doctor Thyroid podcast is available in Spanish and English - and listened to in over 30 countries:

www.doctiroides.com (Spanish)🔹 www.docthyroid.com (English)🔹

✅Please email your requests to [email protected]

✅Instagram @PhilipJamesMedia

✅ LinkedIn www.linkedin.com/in/philip-james/

✅ Facebook @docthyroid

✅ YouTube @Doctor Thyroid

✅ Twitter @docthyroid

✅ ¿Está buscando un médico RFA? Encuentre un médico aquí: www.rfamd.com

🔹 Roberto Valcavi 🔹 MD, FACE, ECNU Reggio Emilia, Italy

RFA for benign nodules, for cystic nodules, for hyper functioning nodules, benign nodules, and now for malignant micro-papillary tumors.

During this episode the following topics are discussed:

The six steps that go into the RFA

STEP 1: setup of the patient. The setup of the patient is in an operatory room -- the safety of a operatory room is by far greater than the setting of an ambulatory room so

STEP 2: prepare for anesthesia.

STEP 3: electrode needle insertion; it is done at the point exactly at the point transistorically...

Step 4: preparation in regard to the laryngeal nerve…. the laryngeal nerve is the most delicate point. The laryngeal nerve may be cooled.

Step 5: extraction; simply take out the needle and at the same time it must. Use compression; avoids bleeding both internal and external

Step 6: Final check.

✅ About Roberto Valcavi

20 years and 1800+ RFA procedures done; laser since 2000 and radiofrequency ablation starting in 2010.

✅ www.rfamd.com/roberto-valcavi/

✅ABOUT RFA MD A guide for locating doctors of radiofrequency ablation. Find radiofrequency ablation doctors from across the world. rfamd.com

✅ Facebook @RFADOCTOR

✅ Instagram @RFADOCTOR

✅ LinkedIn @rfa-doctor-directory

✅ Twitter @RFADOC

✅ Internet www.rfamd.com

✅ ABOUT Philip James He is the host of the popular podcast: Doctor Thyroid www.docthyroid.com 🔹 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. 🔹 All the above, the result of a bad thyroid surgery that dampened his quality of life — and left him wondering, what exactly happened — during what should be a low-risk surgery? 🔹 His attempts to follow up with UCLA and the UCLA surgeon were ignored. He then turned to other doctors for answers — this was the beginning of the podcast: "Doctor Thyroid with Philip James" 🔹 100+ episodes later, the Doctor Thyroid podcast is popular amongst patients; allowing them to access information from top doctors, without being limited by geography or economics. 🔹 The word he uses to describe his work as patient advocate is, ‘tonglen’. Or, using his pain and hardship to help others. 🔹 When not producing podcast episodes or co-hosting live Q&As for patients with top doctors, he leads the creative team at Doctor Marketing and Philip James Media — a marketing agency dedicated to digital communications serving the sectors of healthcare, payments, and Greentech. 🔹 The Doctor Thyroid podcast is available in Spanish and English - and listened to in over 30 countries:

www.doctiroides.com (Spanish)🔹 www.docthyroid.com (English)🔹

✅Please email your requests to [email protected]

✅Instagram @PhilipJamesMedia

✅ LinkedIn www.linkedin.com/in/philip-james/

✅ Facebook @docthyroid

✅ YouTube @Doctor Thyroid

✅ Twitter @docthyroid

✅ Are you looking for an RFA doctor? Find one here: www.rfamd.com