Voices of Wisdom: A Podcast for Thyroid Clinicians

What happens when the evidence is incomplete, the terminology changes and the old follow-up habits no longer fit? In Part 2 of this thoughtful conversation, Dr. Julie Ann Sosa takes listeners into the gray zones of the 2025 ATA guidelines, from pathology and posterior tumors to surveillance limits and the future of decision support. It is a engaging conversation about where thyroid cancer care is becoming more precise and where the field still has hard questions to answer.

In Part 1 of their discussion, Dr. Dana Hartl and Dr. Julie Ann Sosa unpack the years-long process behind the update and the biggest shifts already changing how clinicians think about surgery, surveillance and personalized care. It is an inside look at guideline-making that feels as revealing as the recommendations themselves.

In part 2, we examine evolving surgical paradigms in medullary thyroid carcinoma, including staged surgery, de-escalation strategies and the use of frozen section findings to guide extent of resection. Dr. Lorenz also discusses follow-up after limited surgery and when neoadjuvant RET inhibitor therapy may make previously unresectable disease operable.

This two-part episode focuses on surgical decision making in medullary thyroid carcinoma, from patient selection to preoperative workup. Dr. Kerstin Lorenz explains how calcitonin levels, ultrasound findings and genetic considerations shape staging, imaging choices and the initial extent of surgery, with an emphasis on avoiding overtreatment while preserving curative intent.

In this second part of their discussion, Dr. Dana Hartl sits down with Dr. Zubair Baloch for a practical conversation on what actually makes thyroid FNA cytology reliable. The episode challenges common assumptions about “adequate” sampling and why that single step quietly shapes every diagnosis that follows. They also tease how molecular testing and AI can help, and when they can mislead, if the fundamentals are not right.

Thyroid cytology can be clear at the extremes, but uncertainty dominates the middle ground. In this episode, Dr. Zubair Baloch explores why indeterminate nodules challenge clinicians and how context, judgment, and collaboration shape better decisions. It’s a thoughtful look at what lies beyond Bethesda—and why everything matters.

In this episode, Dr. Dana Hartl speaks with Dr. J.P. Brito from the Mayo Clinic about the art and science of thyroid hormone replacement therapy. Together, they explore balancing TSH suppression, managing persistent symptoms, and understanding when “normal” lab results don’t tell the full story. Tune in for expert insights that challenge assumptions and highlight the power of individualized care.

What if surgeons could see nerve function in real time—and prevent injury before it happens? In this episode, Dr. Catherine Sinclair reveals how intraoperative neuromonitoring is reshaping thyroid surgery worldwide. From technical nuances to global access challenges, listeners gain a rare insider’s look at how innovation is transforming surgical precision.

Dr. Lisa Orloff shares practical, experience-driven tips for optimizing thyroid cancer ultrasound—from honing diagnostic skills and scanning overlooked areas to guiding surgery and follow-up care. Her expert insights help clinicians improve accuracy, integrate ultrasound into patient management, and adopt interactive techniques for better outcomes.

What happens when a cancer diagnosis impacts more than just your health? In this episode, Dr. Carrie Cunningham joins us to explore financial toxicity in thyroid cancer—what it is, why it matters, and how we can measure it. She also shares surprising insights about global policies and the promising role of AI in reducing patient burden.

What changes when thyroid tumors once considered inoperable become surgical candidates? Dr. Mark Zafereo joins Dr. Dana Hartl to explore how neoadjuvant therapy reshapes surgical timing, decision-making, and long-term care for patients with aggressive thyroid cancer. This discussion uncovers clinical judgment calls, imaging insights & evolving surgical strategies you won't want to miss.

What makes a thyroid tumor truly unresectable? In this episode, Dr. Dana Hartl speaks with Dr. Mark Zafereo about how molecular testing and targeted neoadjuvant therapies are redefining surgical eligibility for patients with anaplastic thyroid cancer. Listen in as they explore the evolving role of BRAF/MEK inhibitors, imaging strategies, and real-world decision-making in complex cases.

In the continuation of this episode of Voices of Wisdom, Dr. Dana Hartl hosts Drs. Fabian Pitoia and Iwao Sugitani for a global discussion on thyroid cancer management. Together, they examine real-world cases and explore differing international approaches to active surveillance, surgery and treatment strategies. Gain insight into how cultural values and evolving guidelines shape care decisions around the world.

In this thought-provoking episode of Voices of Wisdom, Dr. Dana Hartl hosts Drs. Fabian Pitoia and Iwao Sugitani for a global discussion on thyroid cancer management. Together, they examine real-world cases and explore differing international approaches to active surveillance, surgery and treatment strategies. Gain insight into how cultural values and evolving guidelines shape care decisions around the world.

In Part 2 of this episode of Voices of Wisdom, Dr. Dana Hartl continues her conversation with Dr. David Pattison, diving deeper into radioactive iodine therapy for thyroid cancer. They discuss the biological mechanisms of I-131, key differences from external beam radiation, and evolving strategies for personalized treatment. Dr. Pattison also explores future advancements, including re-differentiation therapy and the role of nuclear medicine in optimizing patient care. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe

Dr. Dana Hartl speaks with Dr. David Pattison about radioactive iodine therapy for thyroid cancer, breaking down different isotopes, their applications, and the importance of theranostics. They discuss how pre-therapy imaging can help personalize treatment and avoid ineffective therapies. Dr. Pattison also explains the role of dosimetry and how institutions like Royal Brisbane and Women’s Hospital optimize care for thyroid cancer patients. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe

Pour nos francophones, notre animatrice et notre invité (tous deux francophones) ont généreusement enregistré leur interview en anglais et en français. Le Dr Dana Hartl interviewe le Professeur Martin Schlumberger pour démystifier les idées reçues sur le cancer de la thyroïde et ses liens avec les radiations. Ils abordent des facteurs clés tels que la dose de radiation, l'âge lors de l'exposition et les mesures proactives qui réduisent les risques, en s'appuyant sur les enseignements tirés des incidents de Tchernobyl et de Fukushima. L'épisode souligne l'importance de soins fondés sur des preuves et d'une communication efficace avec les patients concernant les risques liés aux radiations. N'hésitez pas à envoyer vos questions ou suggestions pour de futurs épisodes à [email protected]. Pour vous abonner et recevoir des informations sur les prochains webinaires TIROxMDS, cliquez ici : tiro.expert/subscribe

For French speakers, our host and guest (both fluent in French) generously recorded their interview in English and French. Dr. Dana Hartl interviews Professor Martin Schlumberger to debunk myths about thyroid cancer and its links to radiation. They discuss key factors like radiation dose, age of exposure, and proactive measures that reduce risks, using insights from Chernobyl and Fukushima. The episode underscores the importance of evidence-based care and effective patient communication about radiation risks. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe

In this episode of Voices of Wisdom, Dr. Janice Pasieka hosts Dr. Angela Leung to discuss managing thyroid cancer during pregnancy. They delve into the complexities and reassuring aspects of monitoring thyroid nodules in pregnant women, emphasizing a multidisciplinary approach for optimal care. Dr. Leung shares valuable insights on the timing of surgical interventions and the special considerations for radioactive iodine treatment post-pregnancy. The episode highlights the importance of tailored patient care and long-term planning. Tune in to learn about the nuanced strategies for handling this challenging clinical scenario. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe

In the latest episode of TIRO’s Voices of Wisdom podcast, Dr. Janice Pasieka hosts Dr. Erik Alexander, a leading endocrinologist from Brigham and Women's Hospital in Boston, to discuss the evolving role of molecular diagnostics in thyroid cancer management. They delve into the types of molecular testing available, particularly Afirma and ThyroSeq version 3, highlighting their diagnostic and prognostic applications for intermediate thyroid nodules. Dr. Alexander shares insights on when to utilize these tests, their impact on clinical decisions, and the significance of understanding molecular signatures in advanced disease. The episode wraps up with Dr. Alexander revealing a hidden gem in Boston offering a unique historical experience for visitors. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe

In the second part of this special episode of Voices of Wisdom, Dr. Janice Pasieka, Dr. Ashok Shaha and Dr. Mark Urken continue their discussion on the unexpected challenges surgeons face during thyroid cancer surgeries. They delve into critical decisions when encountering extensive nodal disease and the intricacies of preserving the recurrent laryngeal nerve. The conversation highlights the importance of preoperative evaluations and the emotional and technical complexities surgeons navigate in the operating room. Each expert shares their unique approaches and invaluable insights, offering listeners a deep dive into the art of thyroid surgery. Tune in for a compelling conclusion that combines medical expertise with personal anecdotes from these renowned surgeons. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe

In this special two-part episode of Voices of Wisdom, Dr. Janice Pasieka hosts a fascinating discussion with renowned thyroid cancer surgeons, Dr. Ashok Shaha and Dr. Mark Urken. They delve into the unexpected challenges surgeons face during thyroid cancer surgeries, particularly when encountering unexpected tracheal invasion. The experts share their preoperative strategies and intraoperative decision-making processes, offering invaluable insights for both seasoned and aspiring clinicians. The episode is filled with practical advice and thought-provoking analogies that highlight the complexities of thyroid cancer surgeries. Tune in to part one to gain unique perspectives from these surgical giants and stay tuned for part two, where the conversation continues. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe 

In this episode of Voices of Wisdom, host Janice Pasieka and expert guest Eyal Robenshtok dive into the revolutionary approach of active surveillance in thyroid cancer treatment. They explore how this method challenges traditional surgery-first strategies, offering valuable insights for clinicians. Discover the criteria for selecting patients for active surveillance and the nuanced considerations that come into play. The discussion also touches on the evolving landscape of patient care and the significance of a cohesive medical team. Tune in to learn from top-tier international expertise and get a glimpse of Robenshtok's favorite travel spot. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe 

Welcome to the inaugural episode of TIRO's Voices of Wisdom podcast, hosted by Dr. Janice Pasieka, a surgical endocrinologist from Calgary. This series promises to be an essential resource for clinicians managing thyroid cancer, providing practical advice through discussions with international experts. In this episode, Dr. Michael Tuttle of Memorial Sloan Kettering shares his insights on managing rising thyroglobulin levels in post-treatment follow-ups. The conversation covers detailed protocols for follow-up care, the importance of specialist consultations, and a strategic approach to the challenges of persistent disease markers. This podcast aims to complement TIRO's existing educational materials, enhancing the clinicians' toolkit with actionable knowledge for complex clinical scenarios. Feel free to send your questions or suggestions about future episodes to [email protected]. To subscribe to receive info about upcoming TIROxMDS webinars, click here: tiro.expert/subscribe