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Vaninder Dhillon MD as a panelist from #JohnsHopkins in Washington DC #AHNSChat

A2. It is important that patients have a fully informed discussion with their surgeons centered around guidelines about the indications for partial versus total thyroidectomy #ahnschat

A3. All patient with a concern for an atypical nodule or thyroid nodule with FNA diagnosis of thyroid cancer, should undergo a screening ultrasound of their cervical lymph nodes. #ahnschat

I think this is a very good point about having a surgeon who knows how to use the nerve monitor! The technology is best used when the surgeon knows how to interpret concern for injury or not during surgery #ahnschat

A5. As a voice and swallow specialist as well as an endocrine surgeon, I am curious to know, for those who had nerve injury or voice concerns after surgery, how fast were you diagnosed, and treated.. #ahnschat

A7. Gene testing involves a host of assays, which all have different values in whether they help in ruling IN or OUT the risk for cancer. #ahnschat

A7. Every patient should have a discussion with their surgeons as to whether it will add value to the surgery decision making process #ahnschat

Thank you all for your answers. Very stimulating! And thank you to ThyCa Inc. and #AHNSChat. Goodnight everyone.

Vaninder Dhillon, endocrine surgeon. Johns Hopkins University #ahnschat

#ahnschat A1. Recurrent thyroid surgery is challenging given need to identify surgical landmarks altered by scar tissue. Strong imaging is important in preoperative planning

#ahnschat Ellen Benya Great question. good objective imaging like CT with contrast and ultrasound are my choice for guiding surgery for recurrence.

#ahnschat I am in agreement with Dr. Chen. Prior to any reoperative surgery it is important to confirm vocal fold mobility by directly looking at the vocal folds through a laryngoscopy or videostroboscopy in the office (camera examination)

#ahnschat 'watch and wait' is supported by the guideline recommendations, but is dependent on each individual patient, their type of thyroid cancer and the location of their cancer. it is important as a patient to discuss this with your surgeon and team, including the pro/ con

#ahnschat A4. additional surgery may not be a good idea for any patient with any co-morbidities or medical issues that doesn't allow them to undergo surgery, where the risks of surgery outweigh any benefit of providing increased survival.

#ahnschat patient preference is also very important, if this is a choice and the non surgical option can provide oncologic benefit!

#ahnschat A5. An experienced, trained endocrine surgeon who has not only experience in thyroid and parathyroid surgery, but reoperative thyroid cancer surgery (for recurrence). Also, a surgeon who works with a multidisciplinary team with other specialists in a high volume center

#ahnschat We have been fortunate to evaluate responses with our ThyCa members of patients who have undergone recurrence. Having the support before, during and after thyroid cancer surgery and reoperative surgery is a lifelong commitment.

#ahnschat Look for a surgeon and a team who will commit to working with you as you navigate this terrain, and keep you informed, offer all options and provide guidance every step of the way

#ahnschat Thank you to all of our patients, and for the questions tonight!