Episode Transcript
Interviewer: 近年来的进步已经改变了医生诊断和治疗甲状腺癌的方式. However, overtreatment is still a major concern. 那么作为一个病人，你怎样才能确保你得到准确的诊断，然后得到你真正需要的甲状腺癌治疗?
Dr. Jason Hunt 是犹他大学健康和亨茨曼癌症研究所头颈外科肿瘤学临床主任.
Ensuring Accurate Diagnoses of Thyroid Cancer
Dr. 亨特，现在我明白了确保正确治疗的第一步就是得到准确的诊断. 患者如何确信他们的甲状腺癌诊断是准确的?
Dr. Hunt: This is the first step. There is oftentimes some confusion. 大多数病人出现的时候并没有什么对他们的生活质量造成很大的影响. They show up with a lump in the neck. 有时他们甚至不会出现脖子上的肿块. They get a CT scan for something totally different. Maybe they fell and hit their head, went and got a scan in the emergency room, and said, "You have a nodule on your thyroid gland." And that kind of leads this series of events.
They go and see someone to get an ultrasound. 超声波说：“嗯，大发娱乐需要在里面插一根针.“这些结节活检的有趣之处在于，它们通常是不确定的. 所以通常他们回来的时候会说一些诸如, "Atypia of undetermined significance," kind of leaving the patient like, "Well, what is this, and what do I do next?"
Over the past five to 10 years, 实际上，大发娱乐在处理这些情况的方式上有所改变. Previously, 如果你有这种诊断，那是不确定的, we would tell you, "You have a 10% risk of cancer, 但大发娱乐唯一能确定的方法就是做手术, by taking out half of your thyroid gland." And we don't have to do that anymore. We've now kind of honed in more.
世界已经朝着基因的方向发展了很多, so looking at the mutations, looking at specific markers. And a marker is something . . . 通常它是一种蛋白质或肿瘤产生的东西，可能会给你一个暗示或迹象，表明它是癌症.
所以现在不用直接做手术切除一半的甲状腺, we actually talk to you about, "Let's do some more tests.“大发娱乐可能会将其降级为完全良性的结节，不需要任何手术, you don't need anything for.
Overtreatment of Thyroid Cancer
Interviewer: 所以，据我所知，过度治疗甲状腺癌是相当普遍的. I mean, is it still pretty common? Is that still going on?
Dr. Hunt: Yeah, I would say, unfortunately, it is. 我认为很多人仍然像10年、15年前那样对待它. And so more aggressive surgeries are being done. 比实际需要更多的放射性碘仍在进行中.
通常有两个人在照顾你. 一个是外科医生，一个是内分泌学家. 你要确保这两个人都有 . . . 我甚至不想说专业知识，因为如果你住的地方不在大城市附近, 也许你会看到一些做得更一般的人. 但你还是要确保它们是最新的, that they, on a regular basis, are treating patients with thyroid cancer.
这对内分泌学家和外科医生来说很重要. 这将大发娱乐你确保你实际上得到了更先进的治疗.
你也可以参考一些资源. Maybe it helps to give you those questions.
在亨茨曼癌症研究所，大发娱乐是nci指定的癌症中心. 所以我是NCCN甲状腺癌小组的一员，大发娱乐实际上大发娱乐制定指导方针. And that's readily available to everyone out there. 美国甲状腺协会也大发娱乐发布指南, and these are your friends. 我认为如果你接受的治疗没有出现在这些指南中, it's important to ask the question.
Interviewer: 假设有这样一种情况一个病人正在和一个内分泌学家一起工作他可能不了解最新的信息因为很难跟上这些信息.
Dr. Hunt: Sure. It is.
为你的甲状腺癌治疗选择最好的外科医生和内分泌专家
Interviewer: What would be the best approach? What kind of questions could they ask? What kind of information could they bring?
Dr. Hunt: The American Thyroid Association and the NCCN, are really great resources. There are good questions on those websites, especially the American Thyroid Association, 这可以大发娱乐你提出你应该问的问题.
如果你在看外科医生，有很多好的外科医生在那里. 当然，对于大多数甲状腺癌，你不一定要在大学里. There are a lot of good doctors out there.
但是你应该能够问这样的问题：“你多久这样做一次？?" of a surgeon. 你真的希望你的外科医生每年至少做20到30个甲状腺切除术, to stay up to date.
And the endocrinologist, 你只是想确保他们也能看到, on a regular basis, thyroid cancer patients.
Interviewer: Dr. Hunt, thank you for clarifying that for us. 如果你或你所爱的人已经接受了甲状腺癌的诊断，你想进一步教育自己的条件和它应该如何治疗, 大发娱乐还有两个额外的采访可能会有大发娱乐.
First, a deep dive into the diagnosis and treatment of thyroid cancer and why a wait-and-see approach could be the best strategy.
If you and your doctor decide to pursue treatment, 大发娱乐的第二部分是关于你之前可以期待的, during, and after a thyroid cancer treatment.