Why A Team of Experts?

The “C” word. It can be overwhelming without genuine support, and support is often found in the care approach, especially with one’s relationship to their doctors. Trust. Having a team who contribute to an individual’s treatment plan may effectively alleviate anxiety that is frequent with a diagnosis. Confidence. Overcoming mental barriers is simply the hardest yet significant hurdle for someone whose been diagnosed with cancer. Often, success is when patient and practitioner see a way forward together.

Doctors Melanie Goldfarb, MD, Lin Rose, MD and Sarah Rettinger, MD complete Saint John’s Cancer Institute’s Thyroid Team; a thyroid surgeon and an endocrinologist. “When being diagnosed with thyroid cancer and thyroid conditions, other institutions will set you up with a team but, they are separated. The great thing about Saint John’s, particularly, is how well the endocrinologists and thyroid surgeons work seamlessly together in one place,” says Dr. Goldfarb.

A Thyroid Surgeon

Considered a “one-stop-shop,” by many, Dr. Goldfarb’s clinic includes an ultrasound and a diagnosis typical on your first visit. If a biopsy is needed, that too will be done and a definitive answer of benign or cancer nodules can be concluded on your initial consultation. If surgery is necessary, that also can be scheduled for another date while in your initial consultation.

Though thyroid nodules are more common in post-menopausal women, and 5-10 percent of those are cancerous, the most common cancer in women under the age of 40 years old is thyroid cancer, menopause excluded. Thyroid cancer is significantly curable.

– Dr. Goldfarb

An Endocrinologist

Endocrinologists are like medical oncologists for thyroid cancers. They correct dosages for hormone medications. You would follow up with an endocrinologist post-surgery to start medication immediately and you will visit your endocrinologist more often than your thyroid surgeon.

Dr. Lin expounds, “Patients always ask me, ‘Am I going to be the same person once my thyroid is out? Is thyroid hormone going make me fat or make my hair fall out?’ This is a common concern. They do have a permanent condition of hypothyroidism. However, they never have a drop in hormones levels to reach a hypothyroidism state. The concern with hypothyroidism is, will they have weight gain because of slow metabolism, hair changes, or feel with fatigues or difficulty with thinking due to brain fog. We never let their hormones drop.” In other words, even though hyperthyroidism is permanent, it is not a concern when taking regular hormone medications. That’s a burden absolved.

Interview Between Experts: Dr. Goldfarb, Dr. Lin, and Dr. Rettinger Explain the Process of Thyroid Cancer Treatments

Dr. Goldfarb, Dr. Lin, & Dr. Rettinger talk with staff inside Saint John’s Cancer Institute.

What is radioactive iodine?

Radioactive Iodine is treatment for overactive thyroid that contains high doses of radiation. It is typically given after the thyroid is taken out to destroy any remaining thyroid tissue, and notably treats papillary and follicular thyroid cancers. Radioactive iodine involves swallowing a liquid capsule.

What are the numbers Dr. Lin said during this interview?

When looking for proper dosages of hormone medications, Dr. Lin says feeling bad or good is not how they go about figuring out treatments. They “look at the numbers.” What she means is, they look at your thyroid labs and your function tests to determine appropriate dosages.

What is a thyroidectomy?

A thyroidectomy is a complete or partial removal of the thyroid gland to treat disorders like cancer, non-cancerous tumors, or an overactive gland.

What is Hashimoto’s Disease?

Hashimoto’s Disease is an autoimmune disease that causes inflammation of the thyroid gland, and the most common form of hyperthyroidism. An endocrinologist is who you see for treatment. If a nodule showed up with a scan, or ultrasound, then you would see a thyroid surgeon, whether it was benign or cancerous.

There is no causality for Hashimoto’s and thyroid cancer. The two conditions are unrelated to one another. For example, if you are at risk for Hashimoto’s, it doesn’t necessarily mean you will then get thyroid cancer. Interestingly, if you have your thyroid removed from having cancer, it also gets rid of your Hashimoto’s.

If you have bad Hashimoto’s disease, it’s better to take out the thyroid and let the replacement hormone therapy do its job better than a “not so functioning” thyroid gland.

– Dr. Goldfarb

About the Author

Eleanor Zeri