Brendan C. Stack, Jr., MD, FACS, FACE

Parathyroid and Thyroid Surgeon

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@elonmusk Stay the course Elon!

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat. Thanks for everyone’s participation tonight on behalf of @AHNSEndo

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@AHNSEndo Indeed. And the learning curve is more advanced in Korea, Italy, and Brazil. The US is lagging behind currently. There are always exceptions, though.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat
A.6. Only seek ablative treatments from a person with strong ultrasound skills and ablative training and experience. Don’t be afraid to ask!

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat. A.5. Ablation methods (ethanol, energy) have their limits. Most have to due with size and location in the neck (nerves, arteries)

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@ThyCaInc I think we are seeing the front edge of an increase which will likely settle down as one of several options for treating small malignant tumors and recurrences.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@ThyCaInc It is the type of a radioactive molecule or compound given. With thyroid cancer it’s iodine (I). It comes as I131, I125, and as other isotopes.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat certainly surgery is preferred for larger and multiple neck nodes, but I think the future looks promising for ablative technologies to treat small, single, lateralized nodes.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@DJerauld @ThyCaInc That could have been a small met in the node present at your thyroid surgery which grew later over time.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat The vast majority of recurrences happen in the thyroid bed or adjacent central neck. Distant recurrences are NOT but are metastases.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

Surveillance is the key following surgery. The longer you go without a recurrence, the lower the subsequent risk.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

A.2 #AHNSchat. The risk of recurrence is reported over a wide range. There are many variables and risk factors for recurrence. For DTC (papillary and follicular) the risk of recurrence is generally low, way less than 10%.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

Q1. #AHNSchat. Total thyroidectomy is not always required. For smaller tumors without positive lymph nodes can be managed with a hemithyroidectomy (lobectomy). If your disease does not require RAI, then total is not necessary.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

Hello to all!@ #AHNSchat

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat coming in 40 minutes!

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@AHNSEndo Be patient and perhaps add lifestyle and diet changes to you prescriptive regime.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat. Great discussion. Thanks to ThyCa, AHNS and all participants and organizers!

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@AHNSEndo Highly variable, possible to do, successfully done in most cases, frequent focus of frustration in a small group of patients.

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

#AHNSchat. A5. Ongoing surveillance is really important. It might be done by the surgeon or endocrinologist. It is based on blood tests and ultrasounds of the neck. Time between office visits may increase over time with good test results and may end after 5 years clear….

[Brendan C. Stack, Jr., MD, FACS, FACE @bstack53183322]

@AHNSEndo Congratulations.