In a podcast episode featuring Dr. Vaninder Dhillon from Johns Hopkins and hosted by Philip James, the discussion centers on the prevalence, detection, and treatment of thyroid nodules, focusing on ablation therapy as an alternative to surgery.

Dr. Dhillon, an assistant professor in the Department of Otolaryngology at Johns Hopkins, specializes in the surgical management of thyroid and parathyroid diseases. She explains that thyroid nodules are quite common in the American population, with an estimated 30 to 50% of people having at least one thyroid nodule, the majority of which are benign. These nodules are often discovered incidentally through advanced imaging technologies or during physical examinations when patients experience symptoms like lumps or pressure in the neck.

The conversation shifts to the treatment of multiple thyroid nodules. Dr. Dhillon points out that while it's not uncommon to have multiple nodules, the treatment approach has evolved. Previously, surgery was the standard treatment, but now, ablation is considered a viable, less invasive option that can preserve the rest of the functioning thyroid gland.

Ablation is particularly effective for patients with multiple benign nodules, especially when the thyroid gland itself is not enlarged. It provides targeted volume reduction of the nodules, aiming to alleviate symptoms such as difficulty swallowing, voice changes, or neck discomfort. However, for patients with an enlarged thyroid gland, surgery might still be necessary if the gland size rather than the nodules is causing symptoms.

Dr. Dhillon also touches on treating malignant nodules, stating that while surgery remains the primary treatment for thyroid cancers in the U.S., ablation can be considered for patients who are not candidates for surgery or have recurrent disease.

The podcast emphasizes a new paradigm in thyroid nodule treatment: surgery is not always necessary, and in many cases, ablation can be an effective treatment. This is particularly significant for patients who wish to avoid surgery and its potential complications, such as the need for lifelong thyroid medication.

Dr. Dhillon encourages those with multiple thyroid nodules to seek expert consultation about ablation, as it could be a suitable treatment option. The episode concludes with a reminder that treatment approaches are changing, and patients have options beyond surgery, reinforcing the importance of discussing these with a healthcare provider specialized in this field. Dr. Dhillon's contact information is provided for those interested in further discussion or treatment.