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Thyroid & Parathyroid Program

Our goal is to provide you with expertly coordinated, compassionate care to help you return to your healthiest best.

From the discovery of a nodule or lump, through surgery and treatment, our collaborative team of specialists is here to support you using evidence-based guidelines and a well-established clinical pathway.

Your team of specialists

Whether your journey begins in primary care, endocrinology or oncology, all of the specialists involved in your care work together to ensure the scope of your care and your care plan is as thoroughly explored and seamlessly executed as possible.

They meet regularly to discuss your care plan, providing you with an exceptionally high level of coordinated care.

Your team includes:

  • endocrinologists
  • surgeons
  • radiologists
  • pathologists
  • oncology experts 

Leading-edge services

Our services include:

  • ultrasound-guided fine needle aspiration biopsy
  • molecular genetic testing
  • paratracheal lymph node mapping for thyroid cancer patients
  • intraoperative parathyroid hormone testing
  • intraoperative recurrent laryngeal nerve monitoring
  • outpatient thyroidectomy for most patients
  • trans-oral endoscopic thyroidectomy by vestibular approach (TOETVA) in optimal candidates
  • bilateral axilla-breast approach (BABA) robot-assisted thyroidectomy

Our programs

Our specific programs can help you find treatment:

Thyroid 

If you have nodules within the thyroid gland, you will be initially referred to the endocrinology team for further evaluation.

The initial tests that are generally ordered include a thyroid ultrasound and thyroid function tests.

After review of the imaging and lab results, as well as an in-depth discussion of your past medical and family history, your endocrinologist will determine whether you need an ultrasound-guided fine needle aspiration biopsy. This is typically performed in the endocrinologist’s office.

  • If the results are benign (noncancerous), serial ultrasounds are often used to monitor for further growth of the nodules.
  • If nodules are malignant (cancerous), you will be referred to a surgeon for removal of the tumor.
  • If the nodules are indeterminate, there will be further evaluation by the endocrinologist. In some cases, we can use advanced genetic testing of our biopsies to help with decision-making.

There are also other conditions of the thyroid gland that require further evaluation and possible surgical intervention, such as:

  • enlarged thyroid gland causing compressive symptoms or disfigurement
  • overactive thyroid glands that cannot be controlled with medication or radiation therapy.

The thyroid cancer conference

Your case will be discussed at our monthly thyroid cancer conference, where our team of specialists meets to review all patients who have been newly diagnosed with thyroid cancer.

This is an opportunity for radiologists to review imaging, pathologists to present biopsy results and for our clinical team to custom design the best treatment options for each patient, based on the latest guidelines from the American Thyroid Association and the National Cancer Care Network.

Parathyroid

Parathyroid disease is usually suspected when your calcium levels are elevated. This is often found in routine lab work done at your annual physical.

You'll be referred to an endocrinologist for initial testing, which generally includes blood tests, a 24-hour urine test and a bone density scan.

Imaging of the neck will be ordered to look for a parathyroid adenoma if:

  • blood and urine tests indicate a primary hyperparathyroidism (elevated parathyroid hormone levels contributing to high calcium levels)
  • bone density scan shows osteoporosis
  • and/or you have a history of kidney stones

If you meet the criteria for for removal of the parathyroid adenoma, you will be referred to a surgeon.

If your endocrinologist thinks you may not benefit from surgery, other medical treatments will be pursued to help manage the symptoms of primary hyperparathyroidism.

We use the most advanced imaging technologies, including a unique CT imaging test that was developed by our team of experts at EvergreenHealth.

Other technological advances including minimally invasive surgical approaches and the use of rapid intraoperative parathyroid hormone testing ensure the best possible outcome

Endocrine

Our endocrine program offers:

  • ultrasound-guided fine needle aspiration biopsy
  • molecular genetic testing
  • paratracheal lymph node mapping for thyroid cancer patients
  • intraoperative parathyroid hormone testing
  • intraoperative recurrent laryngeal nerve monitoring
  • outpatient thyroidectomy for most patients
  • trans-oral endoscopic thyroidectomy by vestibular approach (TOETVA) in optimal candidates
  • bilateral axilla-breast approach (BABA) robot-assisted thyroidectomy

Surgical options

If surgical treatment is recommended for your thyroid or parathyroid tumor, you'll begin by meeting with one of our endocrine surgeons.

EvergreenHealth is the only hospital on the Eastside that employs board certified, fellowship trained endocrine surgeons. They provide high quality, safe and effective treatment for tumors and cancers of the thyroid and parathyroid glands. 

Their many years of experience help ensure low complication rates and excellent oncologic outcomes.

We offer innovations such as outpatient surgery and minimally invasive approaches, including robotic options for some patients.

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