Global rise in thyroid cancer, notably in Greece is linked to environmental pollution and stress. Diagnosis via endocrinologist involves medical history, ultrasound, and blood tests. Surgery is often needed. Spyros Michas, a thyroid-parathyroid surgeon of Athens Hospital, provides us with valuable info.
In recent years, there has been an increase in the incidence of malignancy in the thyroid gland on a global level.
In Greece, this increase has been particularly noticeable in the last 3-5 years, accompanied by an appearance in younger age groups!
The cause of this change in the disease’s behavior is not fully understood, but it is considered that both environmental pollution (electromagnetic waves- mobile antennas-networks-nuclear accidents of the past-diet) and psychosomatic stress (stress) play an important role.
How thyroid diseases are treated and what diagnostic tools do we have today that contribute to the early detection of thyroid diseases?
The endocrine surgeon of Athens Hospital, Spyros Michas, provides answers to important questions regarding the treatment of hyperparathyroidism, thyroid cancer, and other endocrine diseases.
Visit to the endocrinologist and diagnosis
If there is a relative who has a problem with their thyroid, if we notice any swelling in our neck or if we feel palpitations, we must undergo the necessary examination and visit the endocrinologist.
The doctor should take a detailed history, palpate the thyroid gland and neck area, and recommend thyroid ultrasound and blood tests (TSH-FT4-T3-antiTPO-antiTG-Calcitonin).
Then, he will evaluate the results and further monitoring or treatment will be recommended.
Regarding parathyroid glands, in recent years, the percentage of patients we discover early for hyperparathyroidism and other parathyroid diseases has increased. This is due to two imaging tests: ultrasound and scintigraphy (sestamibi).
For patients who require surgical treatment, it is necessary to emphasize the need to consult a surgeon specialized in thyroid surgery to minimize the chances of complications.
What information does thyroid ultrasound provide?
The most crucial examination in the assessment of thyroid pathology is the ultrasound. In the overwhelming majority of patients with thyroid cancer, blood tests are normal.
Ultrasound, especially that performed directly preoperatively and intraoperatively by the surgeon, is a valuable tool in his hands, helping him to make the right decisions, to make the right plan for each case and, therefore, to offer the patient the maximum possible effectiveness and safety.
Ultrasound examination is a dynamic examination. Essentially, it provides a detailed “map” of the neck area, covering all structures in the area (thyroid-parathyroid-arteries-lymph nodes, etc.) and their peculiarities.
With ultrasound, we obtain information that we cannot have with any other diagnostic tool, such as non-palpable nodules either due to position (posterior surface of the gland) or size (<1.5 cm), nodules with suspected malignancy characteristics, lymph nodes of the neck with altered architecture (indirect indication of malignancy in the thyroid gland).
However, even when there is thyroid dysfunction (hypothyroidism-hyperthyroidism), and thus pathological blood tests, the possibility of malignancy is not excluded.
Performing the ultrasound by the surgeon intraoperatively often reveals findings that even change the type of surgery that will be performed. In this way, we can avoid a large number of repeated surgeries.
The advantages of minimally invasive parathyroidectomy
Hyperparathyroidism is the primary disease of the parathyroid glands and indicates the overproduction of parathormone (above normal levels) by one or more parathyroid glands. The continuous action of parathormone causes significant and threatening health damage to the human body through the increased calcium in the circulation it causes. The solution is exclusively surgical.
The term “minimally invasive technique” means completing a surgical operation by causing minimal tissue damage. This goal can be achieved using various types of technology and surgical techniques.
One of the best and most reliable applications of modern technology is intraoperative ultrasound. With ultrasound-guided Parathyroidectomy, we have smaller (minimal) tissue damage, smaller incisions, shorter duration of surgery, accuracy in the result through imaging techniques.
In this way, the Surgeon does not need to search to find the problematic Parathyroid gland, the size of a pea, throughout the neck area, performing large incisions, while also avoiding the increased number of re-interventions, extensive tissue damage, and several surgical complications.
We thank Spiros Michas for the valuable information. Spiros Michas is specialized in Thyroid-Parathyroid surgery and is Director of the Surgical Department at ” Athens Hospital.”