 We have a fantastic guest today. We do. We have with us today Dr. Michael Sullivan, MD, and I love to the second Tuesdays. We always have such interesting guests, and we welcome Dr. Michael Sullivan, who's an endocrine surgeon. Our subject today is thyroid cancer. Yes, ma'am. Thank you both for the opportunity to be here today. Thanks for being here. Well, we'd like to hear how you got here. You told me you're a Jersey boy, so we want to hear about that too. Absolutely. I was born in Burlington County, New Jersey, and the youngest of three children, so bringing up the rear. I did my undergraduate education at Princeton University, so local and again here in Jersey, and followed that with my medical school education at Robert Wood Johnson, just down the road. I moved to New Haven, Connecticut for my seven-year surgery residency at Yale University and followed that with a one-year endocrine surgery fellowship at Harvard University. And are you actually at Jersey Shore? Are you go around the state or to the various campuses or what? So we have what we call the Center for Thyroid, Parathyroid, and Adrenal Disease that's based at Jersey Shore University Medical Center. Did you know that? I did. I know that. Absolutely. We have a wonderful team in place there, and we have begun an expansion project sort of in conjunction with the growth that's going on within the health system as a whole. So I now have offices in Old Bridge at the facility there at Raritan Bay Medical Center, and I also have an office in Holmdale to provide care to patients in this sort of Riverview local community. So we have sort of a multidisciplinary program that we have in place, which is really unique for the area and employs physicians from different areas in order to deliver specialized and streamlined care for individuals with diseases of either the thyroid gland, the parathyroid gland, or the adrenal gland. And to do this we have health care professionals who work together. So in certain instances there are individuals like myself as surgeons, but we also partner with endocrinologists in the community, primary care physicians, and then we have a team at Jersey Shore that can focus on different aspects of patient care. So we have pathologists that we work with, geneticists, we have social workers, we have nurse navigators. So really a huge team of individuals. We like multidisciplinary. We're both social workers. Absolutely. I think it really makes a difference for the patients both because it allows them to have all aspects of their care focused upon at one time, addressed concurrently, but also allows us to do this in an expedient fashion, allows them to really streamline their care so patients can come in at one time and do one stop shopping. How prevalent really are thyroid issues? Absolutely. So they're rather common, especially among individuals of middle age and higher. And we see thyroid problems that come to pass at people of various life stages. Thyroid disorders come in two forms, so we see them really in two manners, one of which is if the thyroid gland is producing too much or too little hormone. So many patients you may know have an underactive thyroid for which they take a thyroid pill. We also see thyroid disorders related to the size of the thyroid gland, so sometimes patients' thyroid glands can grow too big or develop what we call nodules. And so either one of those two issues would be reasons for your physician to begin to explore medical care. What are some of the symptoms that somebody might experience if they were having thyroid issues? Certainly. So I usually tell my patients to think of thyroid hormones sort of similar to caffeine. The thyroid gland is important for digestion and metabolism. So patients who have an underactive thyroid tend to feel very sluggish. They report that they have unexplained weight gain. They may be constipated. Everything sort of slows down within the body and just the opposite for patients who have hyperthyroidism. They tend to get anxious. They are jittery. They may not be able to sleep. They have sweats. They lose weight. All these sort of symptoms and caffeine is a nice way to sort of think about that as a corollary. Other patients develop symptoms related to the size of their glands. So if you imagine, there's only so much real estate inside your neck. As the gland grows bigger, things tend to get pushed out of the way. And so some patients tell us that they have difficulty swallowing or perhaps difficulty breathing when they lie flat. They feel sort of a pressure on their neck. Other patients notice a change in the quality of their voice or even a cosmetic defect. Perhaps they have a lump there that didn't seem to be there in the past that is bothersome to them. So what's on the forefront of research in this area? What are the new things that we can expect in this field? Absolutely. And there are a couple of things that we're looking at right now in terms of thyroid disease and thyroid cancer. Certainly we're trying to develop more accurate screening tests. So for example, when we biopsy a thyroid nodule, it's not uncommon for it the results to be indeterminate, meaning it doesn't necessarily look normal but doesn't necessarily look like cancer. And then we have to guide the patients in terms of what we recommend, how aggressive to be, knowing that the ultimate result may be that there's no cancer there. And so one of the really interesting areas of thyroidology is trying to develop tests that can either look at the patient's genes or look at their DNA in order to figure out whether a nodule should be, whether we should think about that nodule as being more or less aggressive. We're also coming up with all kinds of new treatments. We can tailor to individual patients. Things like chemotherapy or other regimens should a patient have more aggressive thyroid cancer and require treatment. The nice thing is that because the outcomes are so good that in a way, if it isn't broke, we don't have to fix it. So the majority of thyroid cancer patients do so well. And so we continue to tweak our understanding of thyroid cancer and improve our ability to deliver care to patients with the knowledge that we're very lucky to have wonderful success rates thus far.