84: Diagnosed With Thyroid Cancer?  —  Stop —  Do Not Rush Into Surgery ? Dr. Bryan McIver - Moffitt Cancer ...

Bryan McIver, MD, PhD Dr. McIver contributes to Moffitt Cancer Center almost 20 years of clinical experience in the care of patients with endocrine diseases, specializing in the evaluation of patients with thyroid nodules and thyroid cancer. He has a particular interest in the management of patients with advanced and aggressive forms of cancer and the role of genetic and molecular techniques to improve the accuracy of diagnosis; to tailor appropriate treatment to a patientdisease. Dr. McIver has a long-standing basic research interest in the genetic regulation of growth, invasion and spread of thyroid tumors of all types. His primary research focus is the use of molecular and genetic information to more accurately diagnose thyroid cancer and to predict outcomes in the disease. Dr. McIver received his MB ChB degree from the University of Edinburgh Medical School in Scotland. He completed an Internal Medicine residency at the Royal Infirmary of Edinburgh, followed by a clinical fellowship and clinical investigator fellowship in Endocrinology at the School of Graduate Medical Education at Mayo Clinic in Rochester, MN. Prior to joining Moffitt, he was employed as Professor and Consultant at the Mayo Clinic and Foundation in the Division of Endocrinology & Metabolism. Amongst his most proud accomplishments, Dr. McIver counts his two commitment to education of medical students, residents and fellows; his involvement as a founding member of the World Congress on Thyroid Cancer, an international conference held every four years; and his appointment as a member of the Endowed and Master Clinician Program at the Mayo Clinic, recognizing excellence in patient care.  
In this episode, the follwoiung 
By sixty years old, more common to have nodule than not
Most nodules are benign
When to do a biopsy
How to interpret the results of biopsy
Advances in thyroid cancer
Ultrasound technology advancements
Molecular markers
Cytopathology categorizations
Molecular marker technologies
Gene expression classifier
Afirma
Identifying aggressive cancer
Types and sub-types of thyroid cancers
Invasive and aggressive thyroid cancers
Papillary versus anapestic thyroid cancer
Biopsy results in 2 - 3 hours
Clinical studies that have transformed thyroid treatment
Less aggressive surgery and less radioactive iodine
Targeted chemotherapies
Immunotherapy
The importance of clinical trial environments, or thoughtful philosophy
The minimum necessary surgery
Do not rush into thyroid cancer surgery
NOTES:
American Thyroid Association
Bryan McIver, MD, PhD
Ian D. Hay, M.D., Ph.D.
Hossein Gharib, M.D.
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