Helen's Treatment
After Dr. Shaha operated on Helen, he met with Dr. Tuttle to discuss if radioactive iodine was necessary for her treatment. This decision is usually based upon a number of factors, including the type of surgery performed, the extent of the cancer, and the results of the pathology report.
The team works together to determine a patient's treatment plan. "If you go somewhere else, the endocrinologist may say one thing and the surgeon may say another," says Dr. Shaha. "They may not talk to each other, but if they do, there is often a considerable dichotomy."
When evaluating Helen's case, Dr. Shaha and Dr. Tuttle decided that radioactive iodine was not required, but hormone medication -- to replace the hormones the thyroid normally makes and to decrease the risk of recurrence -- would be needed. In general, their treatment philosophy is to treat thyroid cancer using as little therapy as possible. As Dr. Tuttle says, "We determine an appropriate minimal therapy that can achieve a good outcome -- not giving too little therapy and not giving too much."
Ten days after her surgery, Helen came back to Memorial Sloan-Kettering for a follow-up appointment with Dr. Shaha, and she met Dr. Tuttle for the first time. He explained to Helen about their decision not to use radioactive iodine, but told her that it may be necessary sometime in the future. Dr. Tuttle says, "It is not a once-in-a-lifetime decision. It is based on the data we have from surgery and pathology. I reserve the right to change my mind every six months. Patients are usually perfectly fine with that."
Helen's doctors continue to be pleased with her progress and see her every six months for follow-up appointments.
