Cancer Care Connections
Cancer Care Connections
Thyroid Truths: Inside the 2025 American Thyroid Association Guidelines
Most thyroid cancers are not just treatable; they’re highly curable, and the newest guidelines make the path to cure gentler than ever. We welcome Dr. Michael Miller, radiation oncologist at Virginia Oncology Associates, to break down who thyroid cancer affects, how it’s found, and why the 2025 American Thyroid Association (ATA) guidelines lean into less invasive care without sacrificing outcomes.
We start with the basics: the demographics of thyroid cancer, why young women face a higher risk, and the simple steps that lead from a neck lump to diagnosis. From there, we compare the old “one-size-fits-all” approach to today’s options, including active surveillance for select low-risk patients and hemithyroidectomy that preserves half the gland and often avoids lifelong hormone replacement. Dr. Miller demystifies radioactive iodine therapy by explaining how thyroid cells’ appetite for iodine turns a small capsule into targeted internal radiation, and why modern doses are a fraction of what was used two decades ago, cutting side effects and shortening isolation.
Not all cancers listen to the rules, so we also cover advanced and metastatic scenarios, where radioactive iodine may lose its punch. Here, targeted therapies like lenvatinib and sorafenib bring new options and new hope, guided by molecular insights. Finally, we map the aftercare that keeps people safe: thyroglobulin as a reliable tumor marker, neck ultrasound as a simple, precise surveillance tool, and the indispensable role of a skilled endocrinologist in long-term follow-up. If you or someone you love has questions about a thyroid nodule, family history, or the path from diagnosis to recovery, this conversation offers clarity, practical steps, and trusted resources.
If this helped you feel more informed and less anxious, subscribe, share with a friend who needs it, and leave a review to help others find the show.
Resources:
American Thyroid Association (ATA): https://www.thyroid.org/
ATA Low Iodine Diet: https://www.thyroid.org/low-iodine-diet/
Previous episode with Dr. Michael Miller: https://cancercareconnections.buzzsprout.com/2167428/episodes/15842196-revolutionizing-cancer-care-advances-in-radiation-oncology
Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.
Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.
Welcome to Cancer Care Connections. Today we're talking with Dr. Michael Miller, a radiation oncologist with Virginia Oncology Associates, about thyroid cancer— who it affects, how it's found, and why modern care focuses on curing the cancer while protecting quality of life. With cure rates above 95 percent for differentiated thyroid cancer, the conversation has shifted from “How much treatment can we give?” to “How little do we actually need?” We'll break down the 2025 American Thyroid Association guidelines, including why many patients now only need a hemithyroidectomy instead of having the entire thyroid removed. We'll also simplify how today's radioactive iodine treatments work, why doses are far lower than in the past, and what's new for advanced cases that don't respond to standard therapy.
Cheryl:Dr. Miller, I remember leaving our conversation feeling so much hope.
Dr. M. Miller:Well, that's encouraging. Thanks. I think that we talked about a lot of advances in radiation oncology and the fact that the field has come so far. And that was fun to talk about and it's fun to implement every day. So I feel hope also. So that's two of us.
Cheryl:Love it. We're going to talk today about treatments for thyroid cancer. But before we get to that, I want to hear a little bit more about you. You've been at Virginia Oncology Associates since 2005. And I'd love to know what brought you here and why you love living in Hampton Roads.
Dr. M. Miller:That's a great question. I mean, I'm just a Pennsylvania boy, quite frankly, and never imagined I'd be living in the South. And I don't think Virginia Beach is necessarily the deep south, but hey, we don't shovel a lot of snow. So true. Yeah. And I came to Hampton Roads in in 2001 for my residency. I did a surgical internship in Columbus, Ohio, and came down to Hampton Roads to do my radiation oncology residency program with the full intention of probably moving back home to Pennsylvania. I mean, what else would I do? Correct? Right. And so I'm here for three or four months. And I thought to myself, wow, this place has got it all. It's got the weather, it's got the beach, it's got lots of cool things to do on the water. And I thought it would be a fantastic place to raise a family. And so I convinced my fiance at the time, who was still in Pennsylvania. I'm like, hey, we we really need to rethink this. You got to get down here. So she did and she agreed. And 25 years later, we're still here.
Cheryl:I think a lot of people feel that same feeling about Hampton Roads. It happened to us too. We thought we'd be here for just a couple of years and 20 years later, right? Raising three kids. Yeah.
Dr. M. Miller:There you go. Yeah, it's a great place. And I'm fortunate to be able to be here and work here and live here. And it's been very, very good for me and my family.
Cheryl:Yeah. Sounds good. Well, we want to talk about advances in the treatment of thyroid cancer. And I know you're passionate about this. So can you start by just talking to us about what thyroid cancer is, some statistics, things we should know about it first?
Dr. M. Miller:Sure, sure. Yeah, thyroid cancer is a cancer and malignancy that I think goes under the radar a little bit. And one of the reasons I'm intrigued by it and passionate about it is because I do think it's under the radar a little bit. It's not a mainstream thing to discuss, like, say, you know, breast cancer and colon cancer and lung cancer, but there's still 45,000 people in the United States diagnosed every year with thyroid cancer. And it's interesting who this typically affects. It's a disease that has a three to one ratio of affecting females. Okay, that's not common unless we're talking about maybe breast cancer or gynecological malignancy, but this is a disease that's located in the head and neck and still has a three to one predilection for females. So that makes it kind of interesting to me. Then when you look at the demographics, who's affected by thyroid cancer? It's actually a disease of young women. The peak diagnosis age group runs from 30 years to 45 years old, young women. And there's a very large subset of women that are diagnosed from age 15 to 30. So we have a lot of young ladies, a lot of young mothers being diagnosed with thyroid cancer. And well, you want to help them, don't you? That's just a group that I think everybody has a soft spot in their heart for. So I think thyroid cancer is absolutely worth discussing, trying to get better at treatment. And that's why I'm excited to be here and talk about it today.
Cheryl:Well, I was interested too, because as we were talking before we started this show, I know people who've been affected by it. And it is interesting to me to hear about advances in treatment. So let's talk about it. Let's say 20 years ago, what treatment for thyroid cancer would be and what it would look like now.
Dr. M. Miller:Yeah. I would tell you that the knee-jerk answer to that is, oh, it looks very, very similar. But boy, the subtleties are a lot different. And I want to, you know, get into that a little bit. I just want to first talk about the different types of thyroid cancer. By far the most common type of thyroid cancer, and what we're going to spend our time talking about today, is called differentiated thyroid cancer. And it has little subgroups, papillary thyroid carcinoma, by far the most common, follicular carcinoma, very common. But it's a group of cancers that patients actually do very, very well. I kind of created a bunch of doom and gloom talking about young ladies and mothers. And yeah, that's gloomy, but the cure rates for differentiated thyroid cancer are essentially 95% or higher. And boy, that makes you feel good. It does. 90% of cancers are these differentiated thyroid cancers. There's medullary thyroid cancer, more aggressive, treated differently. And we're not going to spend a lot of time on it today. We're going to talk about differentiated thyroid cancer. And most of those patients are going to have papillary thyroid carcinoma. And the way you treat this is first, well, let's diagnose it. Let's figure out whether we have it. And most patients are diagnosed because either they felt a lump in their neck or their physician felt a lump on their neck. Or even pretty commonly now, patients will have a scan or an imaging study for some reason. And lo and behold, whoa, whoa, whoa, there's a nodule in the thyroid. Okay, well, we ought to biopsy this thing and figure out what it is. And you'll use an ultrasound guided biopsy to biopsy the thyroid. It's cheap, it's common, it's relatively painless. And sure enough, here we are. Now we're dealing with thyroid cancer, and we're dealing with a papillary thyroid carcinoma. How are you going to treat it? The most important thing we can do is do surgery. It's the first step, it's the most important step. It's the way to remove the cancer. And then the question is, well, what else do we have to do? Well, first with surgery, we're going to learn later that there's a trend toward less surgery, less invasive surgery. Let's remove less tissue. Let's risk less things with this surgery. But to cure this, you still need surgery in one way, shape, or form. The most common thing to do historically was to do a total thyroidectomy, remove the thyroid, the cancer's gone. Yes, there's always some thyroid cells left behind, but we've removed that cancer. And we think we've cured patients that way, and we absolutely have. The next step is if we've done surgery, what's the risk of recurrence? And historically, the great, great, great majority of patients were treated with radioactive iodine after their surgery. Okay, well, what's that going to do for us? Well, it does reduce the risk of recurrence. It kills cancer cells, it kills normal thyroid cells. Okay, is that good? Well, let's think about it and let's talk about it. If we have the thyroid that's been removed and the entire thyroid's out of there, and lo and behold, the cancer's gone, do we really have any further risk? The answer is maybe. And the risk is that there are still microscopic thyroid cells in that neck, sometimes more than microscopic. Operating in the neck is a very, very difficult place to operate. If we just think a little bit about where that thyroid gland sits, you have the trachea, the windpipe. Thyroid lies right over it. You have the voice box right underneath that thyroid. You have the nerves that control the vocal cords of the voice box running right underneath the thyroid. You have a very important blood vessel called the carotid artery. You have the jugular vein. This is important territory to operate in. And even the best surgeons, the best head and neck surgeons, people that are very thoroughly trained to operate in that area, always leave some tissue behind. It's just because of what you're operating in and what's around. So should we get rid of that tissue? The answer has always been yes. And we've always used radioactive iodine to do that. And I think it's worth talking about radioactive iodine just to kind of get an understanding of why this would work. Why would putting a radioactive pill into someone, radioactive iodine, why would that have any effect on thyroid cancer? Well, I don't want to bore everybody to death, but we got to talk about some physiology to understand this. So the only part of the body that really uses the mineral iodine is the thyroid gland. The rest of the body could care less about iodine. It just happens to be along for the ride. We're not going to use it, we don't care, but that thyroid gland really likes it. And it likes it because it uses iodine to produce thyroid hormone. The job of the thyroid is to control metabolism by producing a hormone called thyroid hormone that goes out into the bloodstream and controls our metabolism. Well, if you look at the chemical structure of thyroid hormone, it's got iodine molecules embedded all throughout it. If you just take a look at iodine; iodine, iodine, iodine, iodine, carbon, carbon, iodine. It can't make its hormone without iodine. That's why we need iodine on our diet, because our thyroid needs it. So we're going to take advantage of that physiology. We're going to say, now we have thyroid tissue that's in that neck around all those important structures, and we want to get rid of it. We know we can't cut more out. We really don't want to do anything else like our external beam radiation, which we've talked about before. Let's take advantage of the fact that this tissue, these cells, and for that matter, any potential cancer cells that are elsewhere in the body that maybe we don't know about. Let's take advantage of the fact that they like iodine. And then let's give them special iodine. Let's give them iodine that actually gives off little radiation beams, little x-rays to kill those cells. That sounds like a good plan. Now we put the patient on a special diet. It's a low iodine diet. We have them on that for two weeks. For two weeks, it's a little bit boring, it's a little bit bland, but they get no iodine. By the time we want to give them our special iodine, oh, do those cells want this radioactive iodine. The second thing we do, there is a hormone in the body called TSH, thyroid stimulating hormone. We'll give the patient a shot of thyroid stimulating hormone two days in a row. That makes thyroid cells very, very active, very aggressive. Oh my goodness, do they want iodine? Because they want to make their thyroid hormone. They're being stimulated to the utmost. Okay, so now they haven't had any iodine. We've given them the shots. The cells roaring to go. Now we put special iodine into a simple pill, a capsule of radioactive iodine. It gets down into the stomach, gets absorbed, up through the bloodstream. Those cells, very, very efficiently, suck that iodine out of the bloodstream, up into the thyroid cells. And that's how we kill off those cells. And it actually has a very little effect on the rest of the body because it's kind of a magic bullet, as like we like to call it in the medical world. So it's very targeted therapy, but it's not targeted therapy like our fancy machines we talked about the last time we got together. It's targeted therapy simply by taking advantage of physiology and manipulating that physiology. That's how we kill off those cells. That's radioactive iodine.
Cheryl:So when you're talking about this process, how long have you been able to do this?
Dr. M. Miller:Radioactive iodine has been around quite a while. This is not new treatment. Is there anything new about it? Well, yeah, there are things new about it, but this treatment's been around for 50 years. What's new? Well, first, this low iodine diet is not new, but on the newer end of things. Secondly, the TSH shots. That's newer also, because what we used to do when I first started doing this, there was no TSH shot. What you can do though is you can make someone's own TSH go very, very high on their own. And you do that by not allowing them to take their thyroid replacement hormone. Okay, we took the thyroid out of them. We don't have one. Everybody needs thyroid hormone. You replace that with a pill, it works nicely. To make this treatment efficient, we used to strip away the pill. They weren't allowed to take their thyroid hormone for four to six weeks. When they really, really felt bad, really sick, they were cold, they were sluggish, they complained, check their blood work and say, Oh, I think you're about ready. Wait another week, then treat them with the radioactive iodine. It was barbaric. And now the shots are just so much more efficient. It actually works better too. The shots are more efficient to get that iodine up into the cells than what stripping someone of their thyroid hormone and making them hypothyroid is. So it's pretty cool. And I like that. It really makes you feel better when you have someone come in and they're not sick, they don't feel horrible. They're just ready for their pill.
Cheryl:Right. It's like that magic bullet that you always talk about. I would love to get kind of a timeline for a patient who comes to you. And maybe we can also start with what this patient should be looking out for. You mentioned a lump, you mentioned something visible that someone could see. But for someone listening, maybe it's a relative, maybe it's a patient himself or herself, what should they be looking for to get help? And then what is the timeline like from surgery to the magic bullet?
Dr. M. Miller:The most common symptom is a palpable lump in the neck. And you'll feel it yourself. That's the most common thing. And I would tell you that the great, great, great majority of thyroid cancer patients are asymptomatic, other than that lump. They don't have a hyperthyroid state where they don't have an underlying thyroid disorder. Most of them are what we call euthyroid. Their thyroid works, works really well. They wouldn't even know they had a thyroid problem. They just happen to have this nodule or lump. If it's big enough, it can cause swallowing difficulties, it can cause breathing difficulties, but I would tell you it's usually caught long before that. Patients are in tune with the fact that all of a sudden they have a lump in their low neck. And as I mentioned, a lot of them now, because scans are very prevalent in the medical world, a lot of patients are picked up asymptomatic with a nodule. The other thing that I think patients should be aware of is there's a family history that can also predict for this. And so if you know that grandma had a thyroid cancer, and you know mom and Aunt Betsy had a thyroid cancer, I think we need to be a little bit more diligent. And I think the primary care doctor and your own self can certainly keep an eye on that neck and try to be proactive. But family history, in my opinion, does make a difference and it should put people on alert.
Cheryl:And as far as early detection, I imagine just like other types of disease, early detection is key. But let's say it is detected. What does it look like for that timeline for that patient?
Dr. M. Miller:If we've made this diagnosis, the great majority of people are going to go off and have surgery within a few months. This is typically not a rapidly progressing disease. It's not considered an overly aggressive disease. Emergent surgery is never indicated. Plan it out, get the proper imaging studies, make sure the surgeon has all the tools he needs to remove the thyroid and protect those critical structures and move forward with surgery. Most patients, oh, anywhere from one to three months after their surgery, if they're going to be treated with radioactive iodine, would then move on, start that low iodine diet we mentioned goes on for two weeks, then take their radioactive iodine pill, then go under radiation safety precautions. Oh boy, we better talk about that. You go under radiation safety precautions for a period of time. And you know what? Then they're kind of cut back out into the wild and they're cancer free, and it's time for follow-up and surveillance. And I think we'll talk about that too. But I need to talk about the fact that I'm giving people radioactive material and I'm making them radioactive. When we give patients the radioactive iodine, we give it to them in our office. They take a capsule, they drink a big glass of water, and they go home. Before they leave, we do some measurements, we get a fancy Geiger counter out, we verified, yep, they're radioactive. It was radioactive up here in our mouth, and now it's down in their stomach. Okay, we're good, we're ready to roll. Now we're gonna send them home and they're gonna give off radiation. And depending on the dose that we give of this radioactive iodine, they're gonna give off radiation really to a substantial amount, anywhere from three to seven days. So for three to seven days, patients are gonna have to avoid other people. And historically, they were in the hospital. It turned out that wasn't necessary or a good idea. In the late 90s, we decided let's not put people in the hospital. Let's send them home with some good instructions. So they go home, they separate from their family. For the most part, they sleep in their own bedroom. They can't sleep with anybody for any substantial period of time. We're gonna stay six to eight feet apart, typically gonna use their own bathroom because we do urinate out their radioactive iodine. They're gonna wash their clothes, towels, and bed sheets separately once that three to seven days is over. Hey, they can hang around and watch TV, but you got to stay eight feet apart. So it's just separation. And it's not hard to follow, but it is annoying. And it really means that a lot of people can't go to work for three to seven days, unless they work at home or what have you. So the precautions are it's a lot of common sense, but it does take some planning, especially for young mothers. Two-year-old does not understand why they need to stay eight feet from mama. So that is something that we we always have to plan ahead, and the patients seem to do pretty well with it.
Cheryl:As you were talking about that, I was just thinking about the age of your typical patients. And life is busy. Life is busy for everybody, but especially at that age with young children, carpool, sports for their kids, all the things.
Dr. M. Miller:It can create chaos. It really can.
Cheryl:Doctor, let's talk more about things that are new in 2025, the 2025 American Thyroid Association Management Guidelines.
Dr. M. Miller:Yeah. And honestly, these were just released in August, and these are literally, it's the Bible for treating thyroid cancer. And the last time that these were updated and released was 2015. The reason they're not released on an annual basis or a monthly basis is they're very, very thorough. It's 150 pages. I read them. I'm not a slow reader. It took quite some time. I had a headache. But I read them and it's interesting. I think at least just highlighting those changes is worth talking about. There can be subtle changes, of course, on a regular basis, but when the guidelines come out, it's typically a lot of data behind them, research that's been thoroughly vetted in the previous 5 to 10 years. And this year's guidelines, I think were very, very exciting. Early on, I talked that this shouldn't be a doom and gloom situation. We're going to cure a lot of people. And if you're going to cure 95% of people, depending on the statistics, it can be a little higher, a little lower. But when you're curing that many people, the goal has to shift a little bit from hey, listen, are we being too aggressive? Are we doing too much? Are we putting people through too much? Can we cure just as many people and cause less problems? And that's absolutely what the 2025 guidelines are about. The first thing that I think was really interesting, for the first time, the guidelines have recommended for a substantial number of patients, simple surveillance and no treatment. Oh my goodness. So we're dealing with cancer and now we're not going to treat it. Well, that's not a new theme. That is done in other cancers too. And now, especially with patients that have a small tumor, especially with older patients, especially with patients that have a biopsy that shows that this is not aggressive and are willing to be compliant with ultrasounds of the neck, monitoring blood work. There's a lot of people that will never have to have surgery for this disease. Now we're not worried about the carotid artery. We're not worried about the trachea. We're not worried about the things that could be damaged by the surgery. And we're not worried about radioactive iodine because they never needed any of it. I think that's impressive. And I hope we see more of that moving forward. And I think we will. And the other thing that I thought was interesting is I mentioned that total thyroidectomy has always been the surgery of choice. And there have been select times where just the tumor was taken out. And really what happens there is you take out half of the thyroid, it's called a hemithyroidectomy. Well, the indications, the number of patients that are going to simply have a hemi thyroidectomy, the smaller surgery, is going to be much higher moving forward. A lot more patients with even slightly more aggressive cancers are probably just fine with having half of their thyroid taken out. So what's good about that? Less risky surgery. But these patients never need to take a thyroid pill. They don't need thyroid replacement. They don't need crazy fancy blood work to monitor that thyroid. So we've eliminated a risky portion of the surgery and kept it safer. We've eliminated the thyroid hormone replacement, and we've eliminated the radioactive iodine. Okay, so now again, less can be better. And the recent data shows if we pick these patients properly, they're still going to be cured at 95% without the difficulties. I think that's fantastic too. The other thing is clearly a push for lower and lower doses of radioactive iodine. When I first started doing this, everybody got what I'm going to call a high dose. And it is pretty high. Everybody who got thyroid cancer, go have your thyroid taken out. This is what you get. We're good. We're giving doses now that are one-fifth the dose that I gave most patients 20 years ago. And not everybody is that low, but half the dose, a third of the dose, a quarter dose, fifth of the dose, and the outcomes are just as good. All right. So lower dose, less radiation safety precautions, back to work quicker, less little nagging side effects that you can get, like some nausea, some bad taste in the mouth, some dry mouth. We lower the dose, everything goes better. So 2025 is really highlighted by the fact that yes, we've cured a ton of people, but we probably can do that and be kinder and gentler to them.
Cheryl:I agree with you how exciting those new guidelines are because I'm just thinking about the quality of life for that patient. It has definitely gone up if they feel better. If maybe they don't need to have surgery to get to the place where they feel better. And quality of life is really all that people want, a better quality of life, right?
Dr. M. Miller:Sure. Yeah, and I think this goes a long way to improving those things. And I still think it preserves our cure rate. And uh that's what we want. We want to cure you. We want, we want to keep you whole and keep you happy. And I think that we're pushing towards that.
Cheryl:Yeah. Are there new advances in treatment for disease that has advanced past that level?
Dr. M. Miller:Yeah, there are. And we know you hate to see this in a disease that we think we can cure, but it happens. And sometimes folks are diagnosed with metastatic cancer that can't be cured, or very, very advanced cancer that can't be operated on for concern that you'd have to remove the trachea, remove the voice box, remove these blood vessels that we can't do without. So either unresectable cancer or metastatic cancer is difficult to treat. And very commonly radioactive iodine plays a small but short role in that. And it seems like the radioactive iodine has an initial effect on these diseases. And quickly, the more aggressive diseases that spread, they become resistant to the radioactive iodine, and we have almost no effect with it. And when that happens, fortunately, our medical oncology colleagues do have treatment that is available. And it's targeted therapy, and it's a molecular agent that can attack the specific genetics and molecules of certain cancers, and that leads to germline testing and genetic testing of the cancers themselves. But two drugs that are very effective, they're called multi-targeted tyrosine kinase inhibitors. A lot of big words, doesn't mean that much at this point for us, but pills that can be taken to target these specific radioiodine-resistant thyroid cancers. The first one that came out is called lenvatinib. The second is sorafenib. And again, you need a medical oncologist with expertise with these targeted agents, but it can be very, very effective for folks that 10 years ago, 20 years ago, had basically no hope. And now there's lots of hope.
Cheryl:That is good to hear, as it is a small amount of the population, the 5% you're talking about there.
Dr. M. Miller:Sure.
Cheryl:There there is hope. Yeah.
Dr. M. Miller:But there's hope for them. And this is a much better approach than what we used to have because we had very little to offer. So now they can they can certainly get good treatment.
Cheryl:Let's go back to that conversation for the patients who are in the 95% as far as what happens post-diagnosis, post-treatment, the surveillance and follow-up. Can they live their lives just like it was before?
Dr. M. Miller:I think the great, great majority of them should live a completely normal life. And I think that that's exactly what we need to strive for. I think the 2025 guidelines are going to lean more towards that because of scaling down, de-escalating treatment, but they're still going to need close follow-up because this disease can recur. And we need to be on top of that, if that's the case. Especially if we are de-escalating treatment, there has to be some monitoring. And the best way to monitor the disease is two things. It's blood work. There is a tumor marker called thyroglobulin. It's a protein that's produced by thyroid tissue and thyroid cancer. And if we can follow that tumor marker, thyroglobulin, we're going to have a really good idea whether this disease is cured or not. If your thyroglobulin is essentially undetectable, and five years later, that guy's rising, there's only one explanation, and we got to find it. And so that blood work is very, very important. And there's other blood tests that go with that thyroglobulin, but I think that's the cornerstone. The other thing that's important, cheap and easy, is an ultrasound of the neck. If you can ultrasound that neck, ultrasound that thyroid bed where the surgery took place, take a look at those lymph nodes in the neck. It's a very commonplace with this to come back. It's very easy to do that. And ultrasounds of the neck are part of the follow-up. And I tell you who does the best job with follow-up surveillance for thyroid cancer, it's an endocrinologist. I love the surgeons. Heck, I love oncologists, but when it comes to following these patients, there's no one better than a good endocrinologist. They're masters of this blood work. They do ultrasounds of the neck, often right in their own office. They're very, very skilled. And uh I believe that every thyroid cancer patient should have an endocrinologist that they work with. And I think it's the best way to do it. It's real expertise.
Cheryl:Yeah, that's wonderful. As far as the tips that you're sharing, anything else you'd like to share to somebody listening? Maybe it's a patient, maybe it's a young woman who needs to also be on top of her health. Any last words for them?
Dr. M. Miller:If you listen to this podcast, you know that this is a disease that can be cured and we expect to cure it. But as you mentioned, when things are caught early, it's going to be a whole lot easier. So if you feel that lump in the neck, if you have a family history, this is an easy thing to get surveillance for. An ultrasound of the neck is completely painless. A little bit of blood work, not hard to do. This can be detected and it can be cured. So get it checked out if you fit into that category. And I think the results can be very, very, very favorable.
Cheryl:Do you have any resources, any places that someone can go for more information? Obviously, calling your medical professionals is going to be important, but research is too. So where would you suggest they go?
Dr. M. Miller:Sure, sure. Always work with your medical team. But listen, everybody needs to do their own digging, of course. I think the most impressive website out there for thyroid cancer is the American Thyroid Association. Remember, I put everybody on these low iodine diets. You know what? The American Thyroid Association has a cookbook that you can print right off their website. I've been using it for 10 to 15 years for patients. It has many, many recipes. It makes that diet doable, quite frankly. If you just have a list of five things you're allowed to eat for two weeks, it doesn't go very well. That cookbook's amazing. It's an amazing resource for patients, but there's so much more on that website when it comes to thyroid health, thyroid cancer, what to look for. I can't imagine not looking at that website if we were a patient that was either concerned about thyroid cancer or battling thyroid cancer. So that's my first suggestion. And my next one is our website, virginiacancer.com. I think there's tons of information on that website. Access to different physicians, what they specialize in, who should I talk to, who should I see to? That's an important website too. I like those two, and I would keep those two in mind if I were a patient.
Cheryl:Dr. Miller, as always, wonderful talking to you, learning about advances in treatment and offering hope. Thank you so much for your time.
Dr. M. Miller:Thank you. I appreciate the time. I like doing this. I'm happy to be here. And I'll come back next year if you'll have me.
Host:We'd love to.
Dr. M. Miller:Great. Thank you.
Host:Thank you for joining us today for Cancer Care Connections. If there's one takeaway, it's this: Most thyroid cancers are not just treatable, they're highly curable. And with evolving guidelines, smarter surgery, and more precise use of radioactive iodine, care today is focused on helping people heal fully and get back to their lives with confidence. Remember, long-term follow-up matters. Tools like thyroglobulin testing and simple neck ultrasounds, paired with the expertise of a skilled endocrinologist, provide reliable, reassuring surveillance for years to come. If today's discussion raised questions about a thyroid nodule, family history, or your own health journey, talk with your health care provider and use the resources linked in our show notes. And if you find this episode helpful, share it with someone who might need it.
Host:Don't forget to subscribe to our podcast via Apple Podcasts, Spotify, or anywhere podcasts are available. Or listen online at cancercareconnections.buzzsprout.com. Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com or find us on Facebook or Instagram at Virginia Oncology Associates.