Endocrine Cancers

The Endocrine Program at Smilow Cancer Hospital provides patients with evaluation, diagnosis, and treatment of both cancerous and benign tumors of the thyroid, parathyroid, adrenal glands, pituitary gland, hypothalamus, and pancreas. It is one of the largest multidisciplinary endocrine programs in the country.

We have the only endocrine surgery program in the state of Connecticut and our team is devoted to providing compassionate, state-of-the-art care. Our surgeons are specially trained and collaborate with specialists both within Yale and externally in order to provide the most comprehensive, leading-edge surgical treatment available. In collaboration with the Smilow Cancer Hospital Cancer Genetics and Prevention Program, patients are screened and evaluated for hereditary endocrine tumor disease.

In addition, clinical trials testing new therapies and treatment options are offered to patients with medullary or anaplastic thyroid cancer. Patients treated by our Program benefit from highly specialized procedures, such as innovative, minimally invasive operations. The emphasis of the Program is on the safest, most successful surgery with the least amount of discomfort, scarring, and the fastest recovery time for every patient. Your treatment plan will be tailored to your individual diagnosis and referrals to support services will be provided as needed.

The Endocrine Program at Smilow Cancer Hospital offers several specialized approaches to patient care. These include the use of a parathyroid four-dimensional CT Scan, an advanced imaging technique used to localize parathyroid tumors before surgery is performed, and the use of Rapid PTH (parathyroid hormone) assays, which allow for real-time testing while patients are still in the operating room. The use of Rapid PTH-assays is essential in determining if all the tumor has been removed, or if further exploration is needed before surgery has ended. This provides the surgeon with the confidence to know a patient’s surgery has been successful, and decreases the length of surgery and recovery time.

Specialized surgical expertise is essential for the management of all endocrine tumors. The Endocrine Surgery Training Program at Yale is accredited by the American Association of Endocrine Surgeons and serves as a respected training center for the best and brightest general surgeons. Our surgeons are internationally recognized for their minimally invasive techniques and their groundbreaking research in benign and malignant endocrine disorders. Some of the latest and most innovative procedures offered include:

• Minimally Invasive Parathyroidectomy: Removal of one or more of the parathyroid glands, which are small, pea-shaped glands located in the neck on either side of the trachea and next to the thyroid gland. This is performed with a focused approach, often using a gentle, local, cervica block anesthesia technique. This enables the patient to vocalize during surgery, ensuring the vocal cords are protected
• Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): A novel, minimally invasive technique for removal of the thyroid that leaves no visible scarring. Yale was the first center in the world, outside of Asia, to employ this novel technology.
• Retroperitoneoscopic Adrenalectomy: This approach allows for direct access to the adrenal gland without the need for invasive procedures in patients deemed to have smaller tumors. This results in less scarring and pain with a quicker recovery for patients.
• Laparoscopic or Open Transabdominal Adrenalectomy: Based on the individual patient, and especially in the management of large adrenal tumors, either a laparoscopic or open surgical approach may be preferable. Your surgeon will tailor the approach to fit you the best.
  

Traditional external beam radiation therapy and chemotherapy play a small role in the treatment of endocrine tumors, but occasionally are required. While surgery is the most common and important treatment modality for endocrine tumors, another type of treatment that is widely used and effective in thyroid cancer is radioiodine therapy, which uses radioactive iodine to ablate any remaining cancer cells. This is a safe and very well tolerated treatment administered by the Endocrine Program at Smilow. Following treatment, hormone therapy treatment may be administered to slow the growth of any remaining tumor cells and lower the chance of a recurrence.

Our multidisciplinary Tumor Board meets weekly to discuss patient cases and to develop an optimal treatment plan for each of our patients. The Endocrine Program commonly treats rare cancers, such as parathyroid carcinoma, advanced thyroid cancer, adrenal cancer, and pheochromocytoma/paragangliomas, which benefit from this multidisciplinary approach and specialized expertise.