The Latest in Thyroid Cancer Therapy

I am your thyroid cancer expert. Don't let surgeons, nuclear medicine specialists, or oncologists control your care.

• No more routine radiation therapy.
• Low risk cases may not need radioiodine.
• Pre-op thyroglobulin cancer marker testing is necessary to validate it as a good marker.
• Complete staging to see if you are low risk even years after the surgery.

I have 30 years experience in thyroid cancer research and patient care. I use the world famous thyroglobulin TG cancer marker testing of Carole Spencer at USC. Carole freezes prior samples to run simultaneously with your new sample to ensure accuracy. Any increase in TG will be easily noted when both samples are run together.

I personally review all slides from surgery to make a prognostic score. I avoid the overuse of radiation therapy in low risk cases. We use non invasive Ultrasound of the thyroid, and cancer marker testing with TG as our main follow up testing on low risk cases. I avoid the morbidity of hypothyroidism caused by thyroid withdrawal to do scanning. I use Thyrogen for TG[PR2][PR3][PR4] marker testing and scanning. The USC Cancer Group has been in the forefront of new approaches to management of thyroid cancer. My center is visited by thyroid cancer patients from all over the world seeking second opinions.

I can review your case via web second opinion, or see you in my cancer center for a complete re-evaluation of your [PR5]cancer therapy plan. The details of my services are listed on the Second Opinion section of thyroid.Com: "It is never too late to see a thyroidologist, if you have thyroid cancer."

1. If you are deemed low risk, you may only get thyroid hormone suppression therapy, while monitoring TG and ultrasound.
2. If your TG is slow to respond, or if there is a question if you are truly low risk, I can ablate the remnant thyroid with a safe non-cancer-causing dose of radioiodine to be able to better assess TG levels for recurrence.
3. We can use thyroid hormone chemotherapy to stop cancer cell growth, not just use thyroid hormone to replace the thyroid gland you had removed. The dose of thyroid hormone is increased in cancer cases to suppress TSH.
4. After surgery, thyroid hormone cancer suppression is the most important therapy. Most patients and doctors are not aware of this.
5. Failure to properly use thyroid hormone to suppress cancer growth is a serious problem. A recent case is an example of this: After total thyroidectomy, and 400 millicuries of radioiodine-131, and poor suppression of TSH for 3 years in a low risk case, I began to use T4 as a cancer therapy. While her TSH was either normal or high for the 3 years since her cancer surgery, it was rapidly reduced to non-detectable levels on my regimen. Her cancer blood TG test of >300 after surgery and 400 MCI of RAI-131, was reduced to <1 in 6 months.
6. The USC Cancer group expressed that pre-surgery TG cancer marker testing was essential for proper postop care. Most physicians do not get this before surgery. It is very important information. It will tell you how good a marker it is during the rest of your life. It cannot be replaced after surgery. If it is high pre-op, then it is a very good marker test. However, if it is low, it will be a poorer marker, and make it more difficult to be sure of recurrence. If you do not know the TG, you need to treat them all as low producers.
7. If you get biopsied and are told it is cancer, but no TG was drawn, you most wait 30 days to get an accurate TG value. The biopsy will cause false elevation of the TG!
8. Other cancers should be treated by oncologists, but thyroid cancer is a thyroid hormone cancer and is best treated by an expert in thyroid disease. Check www.thyroidologists.com for a thyroidologist near you, see me in person in California, or see me by virtual internet second opinion. I have the thyroid testing ability to follow you from my center in California by international thyroid blood mailer kits.
9. Get smart, and get modern second opinion advise from true thyroid experts.

IT IS NEVER TOO LATE!

Good Luck,
Richard Guttler M.D.