Most thyroid cancers are not just treatable; they’re highly curable, and the newest guidelines make the path to cure gentler than ever. We welcome Dr. Michael Miller, radiation oncologist at Virginia Oncology Associates, to break down who thyroid cancer affects, how it’s found, and why the 2025 American Thyroid Association (ATA) guidelines lean into less invasive care without sacrificing outcomes. 
  
We start with the basics: the demographics of thyroid cancer, why young women face a higher risk, and the simple steps that lead from a neck lump to diagnosis. From there, we compare the old “one-size-fits-all” approach to today’s options, including active surveillance for select low-risk patients and hemithyroidectomy that preserves half the gland and often avoids lifelong hormone replacement. Dr. Miller demystifies radioactive iodine therapy by explaining how thyroid cells’ appetite for iodine turns a small capsule into targeted internal radiation, and why modern doses are a fraction of what was used two decades ago, cutting side effects and shortening isolation.  
  
Not all cancers listen to the rules, so we also cover advanced and metastatic scenarios, where radioactive iodine may lose its punch. Here, targeted therapies like lenvatinib and sorafenib bring new options and new hope, guided by molecular insights. Finally, we map the aftercare that keeps people safe: thyroglobulin as a reliable tumor marker, neck ultrasound as a simple, precise surveillance tool, and the indispensable role of a skilled endocrinologist in long-term follow-up. If you or someone you love has questions about a thyroid nodule, family history, or the path from diagnosis to recovery, this conversation offers clarity, practical steps, and trusted resources.  

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Resources: 

American Thyroid Association (ATA): https://www.thyroid.org/ 

ATA Low Iodine Diet: https://www.thyroid.org/low-iodine-diet/ 

Previous episode with Dr. Michael Miller: https://cancercareconnections.buzzsprout.com/2167428/episodes/15842196-revolutionizing-cancer-care-advances-in-radiation-oncology 

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Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.