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Transforming Thyroid Cancer Care

Transforming Thyroid Cancer Care


With cases more than doubling in the past seven years and tripling in the last 12 years, thyroid cancer is the most rapidly increasing cancer in the United States. It is the fifth most common cancer in women, and it’s estimated that between 4 percent and 7 percent of the adult population has a palpable thyroid nodule. This number increases to 50 percent for those over the age of 65, when you include smaller nodules seen on radiology studies.

Boston Medical Center’s multidisciplinary Endocrine Oncology Clinic, a unique model of care and the only one of its kind in Boston, is transforming the treatment of patients with thyroid nodules, thyroid cancer and hyperthyroidism. Based in BMC’s Thyroid Health Clinic, the oncology clinic brings together a distinguished team of specialists in endocrinology, surgery, nuclear medicine, medical and radiation oncology, and pathology that collaborates as needed on personalized treatment of each patient.

Each is a leading expert in his or her field. Both Stephanie L. Lee, MD, PhD, director of the Thyroid Health Clinic in BMC’s Section of Endocrinology, Nutrition and Diabetes, and Gerard Doherty, MD, surgeon-in-chief at BMC, for example, are part of the team that developed national guidelines for the management of thyroid nodules and cancer.

“BMC is unique,” says Dr. Lee. “There are no other integrated programs like ours in the area. We work across disciplines to provide comprehensive, customized treatment for each patient—from diagnosis to surgery to long-term management. We find this approach creates better communication between physicians and patients and enables us to take the best care of patients.”

“With nine endocrinology specialists with expertise in thyroid disease, we are the largest thyroid group in Boston,” Dr. Lee continues.

State-of-the-art, patient-centered care

BMC’s thyroid and parathyroid program is patient-centered. Doctors come to the patients, who are able to see multiple specialists in one visit and in one location. Tests and procedures are performed in the clinic, which is convenient for patients and allows them to receive results quickly and, with their doctors, make timely treatment decisions.

The clinic offers in-depth, state-of-the-art expertise in both ultrasound (the endocrine suite has a dedicated area for ultrasound) and fine-needle aspiration biopsies. If a nodule is found, referring physicians need to make only one referral to the Thyroid Health Clinic. The thyroid doctor will personally perform the ultrasound and ultrasound guided thyroid biopsy, if needed. Patients do not need separate appointments in radiology for the diagnostic thyroid ultrasound and then return for the ultrasound-guided thyroid biopsy. Surgeons are available in some clinic sessions so physicians can review ultrasound images together and decide on the surgical plan.

The clinic also offers in-depth expertise in both ultrasound (the endocrine suite has a dedicated area for ultrasound) and ultrasound-guided biopsies.

If a patient with thyroid cancer needs to receive radioactive iodine treatment, Lewis Braverman, MD, or Dr. Lee perform these treatments and the long-term follow-up for tumor recurrence in the Thyroid Health Clinic.

Although thyroid cancer patients make up an important portion of patients, BMC provides the same exceptional level of expertise in treating other endocrine neoplasms, such as parathyroid tumors, adrenal tumors, pituitary adenomas and pancreatic tumors. The clinic has special expertise in non-oncology conditions of thyroid disease, including hyper and hypothyroidism, thyroid dysfunction during pregnancy, autoimmune thyroid disease, goiter and benign thyroid nodules, and disorders of bone and calcium. The team also treats a growing number of patients with obesity and diabetes mellitus.

Patients also have access to advanced imaging at BMC, which includes SPECT/CT scans. This advanced imaging technique takes and then merges images from two scans—nuclear imaging with SPECT and CT—to provide more precise, three-dimensional information about the location of a biologically active nodule, such as a parathyroid adenoma, adrenal adenoma or a thyroid cancer metastasis. This advanced imaging technique greatly improves the sensitivity and specificity of locating benign and malignant endocrine tumors.

An expert surgical team

The surgical team is led by internationally renowned surgeon Dr. Gerard Doherty, BMC’s surgeon-in-chief. In addition to his treatment of thyroid disease, he is a recognized expert in the evaluation and surgical treatment of adrenal tumors, endocrine pancreas tumors and parathyroid disease.

“Surgery at BMC is customized for each patient,” says Dr. Doherty, “based on the preoperative evaluation, mapping of lymph nodes and ultrasound findings. As a result, we have a more specific definition of what operation each individual patient needs, and the operation is tailored to the disease they have. It’s not one size fits all.”

Call 617.638.7470 to schedule an appointment.