Nodules, goiter and cancer, with the option of treatment without surgery when the case allows it.
Start hereSantiago, Santo Domingo and San Francisco de Macorís; and, if you are coming from abroad, a virtual evaluation before you travel.
He knows how to operate on the tumor and when surgery is not the answer.
See the specialtyA surgical oncologist trained in the Dominican Republic, Mexico and Seoul. How he thinks and how he decides.
Meet the doctorClear articles on what a patient needs to know before a consultation: what the report says, what the options are and what to expect afterwards.
After thyroid surgery there are three things to monitor during recovery at home, and all three have a name, a timeframe and a solution: the hormone that has to be replaced, the calcium that can drop in the first days and the voice that can change for a few weeks. This is what to expect from each, with the figures from the literature and the signs that deserve a call.
5 min read
A thyroid cancer of one centimeter or less has its own name, papillary microcarcinoma, and a peculiarity that unsettles people: in many cases the guidelines allow deferring surgery and monitoring it instead. This is what the American guideline and the Japanese consensus say, with the numbers from ten years of follow-up and with the cases in which the answer is still surgery.
7 min read
Some nodules neither compress nor show and, even so, it is advisable to treat them, because they produce thyroid hormone independently of the pituitary. They are called autonomous, and with them the question is not whether to treat, but how. This is what the guidelines say about each option, with the numbers.
5 min read
When the nodule is mostly fluid, treating it is simpler than it seems, and the technique the guidelines put first is not radiofrequency. This is what each guideline says depending on how much fluid the nodule has, what each technique achieves and when you move from one to the other.
5 min read
They are the two categories most often seen at the consultation and the hardest to interpret, because they sit in between: neither «quiet» nor «suspicious». What follows explains what each says about the nodule, at what size it is biopsied, how often the ultrasound is repeated and what it means when the radiologist does not call for a biopsy.
5 min read
The first consultation decides much more than it seems: with the right studies in hand you leave with a plan, and without them, you leave with another appointment. This is what to bring, what to mention even if it seems unrelated, and the six questions that deserve an answer before you go.
5 min read
Having several nodules in the thyroid is far more common than it seems, and most of them require nothing at all. What decides between watching and treating is not the number of nodules but four specific situations, and it helps to know them before the consultation.
6 min read
More and more patients from the United States, Puerto Rico and Europe travel to treat a thyroid nodule without surgery. The doubts that come up are almost always the same, and they tend to appear once the trip is already booked. These are the ones worth settling beforehand, with any clinic, and how they are answered here.
4 min read
The procedure is not usually scheduled the same day as the consultation, and the reason is not bureaucratic: there are three blood tests the guidelines always require, two matching biopsies and a short list of medications that are adjusted days in advance. These are the documents to bring to the consultation and the details to mention.
4 min read
Radiofrequency shrinks the nodule rather than removing it. That difference has consequences worth knowing in advance: one to two in ten nodules regrow in long-term follow-up, and about one in eight needs a second treatment.
4 min read
You go home the same day, with no stitches and no dressing, and that makes the following week surprising: there are discomforts that are expected and a short list of signs that do deserve a call. Here are both, with the numbers from the literature.
4 min read
You leave the hospital with a wound, some instructions and many questions there may not have been time to ask beforehand. This is what repeats in almost every cancer surgery, whether breast, neck, chest or abdomen: follow-up, medications, food, rehabilitation and the signs to watch.
4 min read
It is the question that weighs most when someone compares operating with not operating, and it deserves an answer with numbers. The difference between removing half of the thyroid gland and treating the nodule from within is large, though it does not amount to zero against one hundred.
4 min read
It looks like a repeated formality, and it is just the opposite: it is how it is confirmed, before treating, that what is about to be heated and reabsorbed is not hiding a cancer. The guidelines require it, and there is a study that explains why, with numbers worth knowing.
3 min read
When a nodule is benign and bothersome, there are two ways to treat it: remove it or shrink it from within. Neither is better in the abstract. The choice comes from five specific questions about your nodule, and all of them are answered with the studies in hand.
4 min read
Hypoechoic, solid, irregular margins, microcalcifications: the report describes what the radiologist saw, word by word, and almost none of those words is a diagnosis. This article explains what each one means and which ones really carry weight.
4 min read
Recovery includes moving. Breathing deeply, walking on the first day and moving the shoulder or hip at the indicated time prevent the complications that most delay discharge. These are the instructions almost every patient receives, and the reason behind each one.
3 min read
Cancer is treated with six tools: surgery, chemotherapy, radiotherapy, hormonal therapy, targeted therapy and immunotherapy. Almost nobody gets just one and almost nobody needs all six. Here is what each one does and who decides the combination.
3 min read
A solid tumor is a mass of tissue growing where it should not. The word is frightening, but says less than it seems: benign or malignant, and in which organ, is what really decides what to do.
3 min readIn person in Santiago, Santo Domingo or San Francisco de Macorís, or virtual from wherever you are. If you have no studies yet, the consultation starts right there.
