Special services, conservative treatment options
Why should one consider non-surgical alternatives?
||Our institute is one of the few in
Europe that offers a unique spectrum of methods for the diagnosis
and treatment of thyroid nodules and cysts.
Our goal is optimum clarification/diagnosis and, whenever possible,
conservative (i.e. non-surgical) treatment of nodules and cysts. In
many cases we enable the patient to avoid thyroid surgery.
Thyroid surgery is often recommended to patients because of the presence
of a large thyroid cyst, or "cold nodule", which is suspected
to be cancerous, or because of bothersome symptoms (difficulty swallowing,
strange feeling in the neck) caused by large, frequently readily visible
nodules. The most frequent outcome of surgery is, however, merely
a benign histological diagnosis of the nodule or cyst. According to
a recent, highly-ranked American study (Hauch et al., Annals of Surgical
Oncology, 2014) thyroid surgery is frequently associated with transient
or even enduring complications (7 to 11% when one thyroid lobe is
removed, and 14 to 24% when the thyroid gland is completely removed).
Another key factor in this regard is how often the surgeon in question
carries out thyroid surgery.
Possible disadvantages of thyroid surgery
If surgery is chosen, the following are unavoidable: hospital
admission, a convalescence period (typically 2 weeks), a permanent
scar in the neck region, as well as in many cases a life-long thyroid
medication/regular check-ups and an associated risk of under or over-dosage.
According to studies, in 5 to 10% of patients incur temporary (days
to months) or in a lower percentage persistent damage to the laryngeal
nerve and attendant vocal impairment, which, of course, can be a significant
problem for certain professions. Occasionally, the so-called "parathyroid
glands" are unintentionally removed, especially in cases in which
the entire thyroid gland is removed (total thyroidectomy), These lentil-sized
glands which are located close to the thyroid, secrete a hormone that
plays a central role in the regulation of calcium and phosphorus metabolism.
A loss of parathyroid tissue requires lifelong, calcium and vitamin
D supplementation and regular check-ups to ensure proper calcium and
phosphorus levels and renal function. The time spent in hospital and
in convalescence is often an organizational and financial burden for
the self-employed, and for mothers of young children.
Given the above issues, it would appear reasonable to explore whether
or not there are alternative ways to treat thyroid cysts and/or nodules.