63: Slow Down and Do Not Rush⎢Thyroid Surgery with a Clear Mind, with Dr. Bryan McIver from Moffitt Cancer Center

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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