Thyroid Awareness Month – Why Not All Thyroid Cancers Need Aggressive Treatment

Rodrigo Arrangoiz MS, MD, FACS, FSSO

Why Not All Thyroid Cancers Need Aggressive Treatment

Not all thyroid cancers behave the same. Modern care is personalized—the goal is to treat what matters while avoiding unnecessary treatment.

🧠 The key concept: Risk-adapted management

Many thyroid cancers—especially low-risk papillary thyroid cancers—are:

Slow-growing Unlikely to spread Associated with excellent long-term survival

Because of this, more treatment is not always better.

⚖️ Treatment options today

Depending on risk, options may include:

Active surveillance (careful ultrasound follow-up, no immediate surgery) Thyroid lobectomy instead of total thyroidectomy Selective use of radioactive iodine (not routine for everyone)

➡️ These approaches are evidence-based and safe for appropriately selected patients.

📉 Why avoid overtreatment?

Unnecessary aggressive treatment can:

Increase risk of hypocalcemia and voice changes Require lifelong thyroid hormone replacement Affect quality of life without improving outcomes

🦋 What matters most

Treatment decisions should be guided by:

✔️ Tumor size and ultrasound features

✔️ Pathology and risk of recurrence

✔️ Patient age, preferences, and values

✔️ Expertise of a multidisciplinary thyroid team

👨‍⚕️ Dr. Rodrigo Arrangoiz, MD

Surgical Oncologist – Thyroid, Head & Neck, Breast

Mount Sinai Medical Center

đź“Ś Take-home message:

The best thyroid cancer treatment is the right treatment for the right patient—not the most aggressive one.

đź“š References

Haugen BR et al. ATA Guidelines for Differentiated Thyroid Cancer. Thyroid Tuttle RM et al. Active surveillance for low-risk papillary thyroid cancer. JAMA Brito JP et al. Overdiagnosis and overtreatment of thyroid cancer. BMJ

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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