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Introduction
⦿ Host: Welcome by the host of the RFAMD podcast.
⦿ Guest: Introduction of Dr. Giovanni Mauri, a medical professional from Milan, Italy.
Dr. Mauri's Journey into Medicine
⦿ Childhood Influence: Inspired by his father, a radiologist.
⦿ Career Choice: Fascination with radiology and interventional radiology.
⦿ Family Background: His father worked in diagnostic radiology in an oncological hospital.
History of Ablation in Italy
⦿ Early Adoption: Discussion of pioneers in ablation treatments in Italy, starting in the 1980s.
⦿ Development: The evolution of ablation techniques, from ethanol ablation for liver cancers to radiofrequency ablation.
Dr. Mauri's Specialization
⦿ Scope of Ablation: Treating various cancers (liver, kidney, lung, bone, soft tissues) with thermal ablation.
⦿ Focus on Thyroid Ablation: Special emphasis on treating both benign and malignant thyroid diseases.
Patient Success Stories
⦿ Personal Case: A female patient treated multiple times for lymph node metastasis, avoiding further surgery.
⦿ Impact on Patients: Emphasizing the success and life-changing effects of successful thyroid ablation treatments.
Thyroid Surgery vs. Ablation
⦿ Patient Perspective: Benefits in terms of invasiveness and future hormonal treatment.
⦿ Medical Community: Surgeons appreciating the option of ablation to manage resources and time effectively.
Global Trends in Thyroid Ablation
⦿ FDA Approval: The significant impact of FDA approval in the U.S. in 2018.
⦿ Rapid Growth: Thyroid ablation as the fastest-growing field in ablation treatments worldwide.
Dangers of Rapid Growth
⦿ Training and Expertise: Emphasizing the necessity of proper training and the risks posed by inexperienced practitioners.
⦿ Comparison of Techniques: Differences between traditional surgery and ultrasound-guided ablation procedures.
Pioneers in Thyroid Ablation
⦿ Innovations: Introduction of specifically designed needles and techniques in Korea and Italy.
⦿ Global Adoption: The spread of thyroid ablation practices to countries like South America, North America, and Europe.
Risks of Thyroid Ablation
⦿ Medical Risks: Potential damages during the procedure, such as bleeding or nerve damage.
⦿ Technical Challenges: Importance of ultrasound skills and adjunctive techniques to minimize risks.
Post-Treatment Recovery
⦿ Patient Experience: Comparing recovery to dental work, with minimal pain and quick return to normal life.
⦿ Potential Complications: Rare cases of hematoma, mainly aesthetic concerns.
Unsuccessful Cases
⦿ Benign Nodules: Rare unsuccessful cases, often due to initial under-treatment.
⦿ Malignant Tumors: Possibility of incomplete ablation, with options for re-treatment.
Selecting the Right Provider
⦿ Criteria for Choosing: Experience of the physician, ideally in a hospital setting for beginners.
⦿ Importance of Supervision: Emphasis on proper environment and supervision for new practitioners.
Addressing Skepticism
⦿ Literature and Communication: Using scientific evidence and open discussions to address concerns.
⦿ Surgical Alternatives: Emphasizing ablation as a reversible option compared to definitive surgery.
Types of Ablation
⦿ Radiofrequency vs. Microwave: Discussion on the advantages and risks of each type in thyroid treatments.
Guidelines and Clinical Experience
⦿ Lag in Guidelines: The delay in incorporating new treatments like ablation into official guidelines.
⦿ Individualized Treatment: Tailoring treatment options based on clinical experience, despite guidelines.
Patient Counseling
⦿ Approach to Counseling: The importance of discussing all treatment options with patients.
⦿ Team Collaboration: Multidisciplinary approach in decision-making and patient communication.
Patient Perception and Decision Making
⦿ Overdiagnosis and Overtreatment: Addressing the issue of overdiagnosis in thyroid cancer and the role of minimally invasive treatments.
⦿ Patient Preferences: Understanding patient choices in treatment options, including active surveillance.
Second Opinions and Treatment Choices
⦿ Changing Treatment Plans: Cases where patients change their mind after seeking a second opinion.
⦿ Informed Decision Making: The importance of providing comprehensive information to patients.
Innovations in Thyroid Treatment
⦿ New Technologies: Exploring new treatments like embolization, expanding the scope of minimally invasive procedures.
Conclusion and Rapid Fire Questions
⦿ Future of Thyroid Treatment: Predictions about the shift towards ablation in the next decade.
⦿ Importance of Communication: The crucial role of clear communication in discussing cancer treatments with patients.
For podcast inquiries or if you would like to be a guest.
Contact: philip@rfamd.com