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Treatment of thyroid diseases in Germany is currently developing at an accelerated pace: new technologies are being introduced, highly selective drugs are being developed, highly selective drugs are being developed and surgical techniques are being modified. All this is provoked by a significant increase in thyroid diseases among the population, regardless of age. Perhaps this is due to the deteriorating environmental situation, diet and lifestyle. There is no precise answer.
The thyroid gland and thyroid-related diseases
The thyroid gland is an internal secretion organ located in the neck region. The hormones that this gland synthesizes affect the work of all human organs and systems. Thus, the symptoms of thyroid diseases can vary widely: problems with heart rhythm, weight loss or gain, weakness, irritability, swelling, decreased intelligence and much more. On the other hand, most often the disease is asymptomatic for a long time, and are detected accidentally, at the next preventive examination. This situation is most typical for thyroid cancer.
The most common thyroid disorders:
- Autoimmune thyroiditis (Hashimoto’s disease).
- Hypothyroidism or hyperthyroidism.
- Goiter (diffuse, nodular, mixed).
- Thyroid cancer.
Treatment of thyroid diseases, as well as any other organ, can go two ways — conservative and surgical. In this case, the principle of «first pills, and if it does not help — surgery» does not always work. Often surgery is the only correct solution, and the sooner it is carried out, the better for the patient. In any case, before deciding on treatment methods, doctors in German clinics require a complete and thorough examination.
Diagnostic procedures for thyroid disorders:
- Ultrasound of the thyroid gland is the first method of examination. Most often it is ultrasound of the thyroid, made prophylactically, allows you to detect the problem at an early stage. This method is safe, can be carried out an unlimited number of times. This is an opportunity to «see» the organ, its structure, assess the presence of nodules, tumors.
- Thyroid biopsy is the next «step» after ultrasound. If there are suspicious areas, nodules, cysts, the doctor takes from it a few cells for histologic examination (ie, determine whether the formation is malignant or benign). thyroid treatment in Germany
- The procedure can be performed either under local anesthesia, giving an ultrasound-guided injection and taking the material, or during surgery to remove the thyroid gland.
- Radioisotope scan of the thyroid gland. Helps to detect the tumor focus, if it is not visible on ultrasound, as well as visualize metastases. However, without a biopsy on the malignant nature of the tumor on this method can not be judged.
- Blood test for thyroid hormones (T3,T4,TTG), antibodies to thyroid cells. Allows you to judge the functional work of the organ, identify the autoimmune nature of the disease. Any replacement therapy is selected only under strict control of this analysis.
This is not an exhaustive list of tests that may be needed. Depending on the specific situation, this list can be expanded.
Once the doctor determines the diagnosis, a treatment regimen will be selected.
When may thyroid surgery be necessary?
If the diagnosis is cancer, surgery is necessary as soon as possible. The technique itself will be discussed below.
If hyperthyroidism (thyrotoxicosis) is resistant to drug treatment, a complete or partial thyroidectomy (removal of the thyroid gland) is performed.
If there are large nodules on the thyroid gland, especially if they squeeze neighboring tissues (larynx, nerves, vessels), it is necessary to remove them.
Thyroid cancer treatment in Germany
If the diagnosis of cancer is confirmed, in most cases a total thyroidectomy is performed — the thyroid gland and adjacent lymph nodes are completely removed. Sometimes partial removal of the gland is possible (for example, if it is a microtumor, less than 10 mm, and the rest of the tissue is intact).
All operations are carried out as minimally traumatic as possible, using microincisions, subsequently almost invisible externally.
In German clinics, the «Schnell Test — quick test» is used during surgery. This is a test for the presence of tumor cells. Immediately during the operation, the surgeon is able to get an answer whether the cells are cancerous or benign, which affects the amount of tissue to be removed.
Further, a big plus in the surgical treatment of thyroid diseases in Germany is that the neuromonitoring technique has been used here for more than 15 years. Previously, a very frequent complication of thyroid surgeries was damage to the recurrent nerve, resulting in hoarseness and even complete loss of voice. Today, German doctors have eliminated this complication: neuromonitoring precisely determines the position of the recurrent nerve during surgery. This avoids accidental trauma to the nerve.
Germany also uses Cyberknife technology to treat the thyroid gland. This latest achievement of the latest generation of medical technology, the Kiberknife G4, allows localized treatment even in areas that cannot be reached surgically.
After surgical treatment, radioiodotherapy is prescribed. Radiation and chemotherapy are practically not used here as they are considered less effective and have more side effects.
Radioiodotherapy for the treatment of thyroid cancer was first used in 1949, and this was a turning point in treatment. This method has shown tremendous positive results even among neglected patients. It significantly reduces the frequency of recurrences and distant metastases, and gives patients a chance for full recovery.
The essence of such treatment is that iodine isotopes are injected into the blood, which accumulate only in the cells affected by thyroid tumor, while completely destroying them. This allows, firstly, to maximally affect the infected cells, secondly, to destroy thyroid tumor metastases in case of their localization in other organs (even if initially they are unknown), thirdly, to minimize side effects.
Such therapy is carried out for 4-6 days, after which a control study for tumor activity is appointed, and the dose of hormone replacement therapy is selected.
There are several clinics in Germany that treat the thyroid gland.
One of them is the clinic of Prof. Schumm Dreger in Munich. The chief specialist is among the top twenty best endocrinologist surgeons in the world.
Prof. Schumm Dreger has worked successfully for a long time at the Munich City Hospital Bogenhausen, where she was head of the Clinic of Endocrinology. She is an active member of various professional societies, in particular she is a member of the administrative board of the European Federation of Physicians, the board of the Association of German Endocrinologists and many others. She has published more than half a thousand scientific papers.