Health

Empowerment
Disorder
objective - for
Course –
laypeople to have an
Fundamentals
understanding of the
and
FUNDAMENTALS
Generalities in
and GENERALITIES in
Medical
the MEDICAL
Management
MANAGEMENT of
of Goiter –
GOITER – Part 3.
Part 3
 February 19, 2022
Health 1400H - 1500H
Empowerment Via Zoom
Disorder
objective - for
Course –
laypeople to have an
Fundamentals
understanding of the
and
FUNDAMENTALS
Generalities in
and GENERALITIES in
Medical
the MEDICAL
Management
MANAGEMENT of
of Goiter –
GOITER – Part 3.
Part 3
 Health
Empowerment ROJoson PEP Talk
Disorder
objective - for
Course – I have a Patient
laypeople to have an
Fundamentals Empowerment
understanding of the
and Program in which I
FUNDAMENTALS
Generalities in like to empower the
and GENERALITIES in lay people or
Medical
the MEDICAL patients to take
Management
MANAGEMENT of control in the
of Goiter – management of
GOITER – Part 3.
Part 3 their health.
 There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
 My PEP TALK today
Health is entitled:
Empowerment
Disorder Fundamentals and
objective - for
Course – Generalities in
laypeople to have an
Fundamentals Medical
understanding of the Management of
and
FUNDAMENTALS GOITER, Part 3. This
Generalities in
and GENERALITIES in is part of the Health
Medical
the MEDICAL Disorder Course.
Management
MANAGEMENT of
of Goiter –
GOITER – Part 3.
Part 3
Fundamentals Contents: PART 1
and • What is a goiter?
Generalities in • What are the common types of goiter?
Medical • What are the causes of goiter?
• How common are the goiters?
Management
of Goiter

• Clinical diagnosis of goiter

• Paraclinical diagnostic procedures for goiter PART 2
Fundamentals Contents: PART 3
and • Treatment for goiters
Generalities in • Health restoration and maintenance
Medical
Management
of Goiter
Fundamentals Definition of Terms in Title AND Delimitation of
and Coverage of Talk:
Generalities in
Fundamentals – simplest and essential facts and
Medical theories which can serve as a basis or foundation
Management and support for advanced information
of Goiter
Generalities – general statements of info, not
covering specifics and details

Medical Management – diagnosis and treatment

by physicians
Fundamentals Treatment for Goiter
and
Generalities in
Medical
Management
of Goiter
Fundamentals Treatment for Goiter
and Formulation of treatment plan starts with the
Generalities in pretreatment diagnosis.
Medical
Management There must be a pretreatment diagnosis that is as
of Goiter specific as possible to serve as the basis for the
plan.
Must have
- name of the disease causing the goiter (or the
name of the thyroid disease)
- extent of the disease, example, the stage of a
thyroid cancer
Fundamentals Treatment for Goiter
and After formulating the pretreatment diagnosis,
Generalities in including determining the extent of the disease
Medical and other factors with effect on treatment,
Management first thing to do before considering and comparing
of Goiter the options of treatment methods or modalities is
to spell out the specific objective or goal of
treatment:
For cancers: whether curative or palliative.
For non-cancers: whether curative or just control
Fundamentals Treatment for Goiter After the physician
and has decided on the
Procedures Benefit Risk Cost Availability
Generalities in (goal of goal of treatment, he
treatment)
gives or lists the
Medical Option1         various options of
Management Option2        
treatment and then
of Goiter Option3        
gives data on the
BRCA.
With the data given,
the patient is asked
what s/he prefers.
Fundamentals Treatment for Goiter Example of BRCA
and comparative analysis
Generalities in of treatment
Medical procedures
Management Procedures Benefit (goal of Risk Cost (PhP) Availability
treatment)
of Goiter
Option1 greatest survival rate acceptable 5000 available
Option2 rate < 1  > 3 acceptable 6000 available
Option3 least survival rate acceptable 3000 available
Fundamentals Treatment for Goiter Example of BRCA
and comparative analysis
Generalities in of treatment
Medical procedures
Management Procedures Benefit (goal of Risk Cost (PhP) Availability
of Goiter treatment)
Option1 Lowest recurrence rate acceptable 5000 available
Option2 rate < 1  > 3 acceptable 6000 available
Option3 Highest recurrence rate acceptable 3000 available
Fundamentals Treatment for Goiter Example of BRCA
and comparative analysis
Generalities in of treatment
Medical procedures
Management Procedures Benefit (goal of Risk Cost (PhP) Availability
treatment)
of Goiter Option1 most effective acceptable 2000       available
Option2 effectivity <1 >3 acceptable 3000 available
Option3 least effective acceptable 4000 available
Fundamentals Treatment for Thyroid Cancer
and
The usual goals of thyroid cancer treatment
Generalities in
include 
Medical Curative goal
• eradicating known tumors / cancers entirely,
Management
preventing the recurrence or spread of the
of Goiter
primary cancer, and
Palliative goal
• relieving symptoms if all reasonable curative
approaches have been exhausted. 
Fundamentals Treatment for Thyroid Cancers
and Thus, objective of
At the time of treatment, a patient may present in
Generalities in treatment is primarily
a cancer stage in which the goal is at best
Medical palliative only (relieving symptoms). These are dependent on the
Management usually the patients with advanced cancers. stage or extent of
of Goiter cancer at the time of
treatment.
For patients presenting with early staged cancers,
the goal is curative that is, eradicating the
tumors / cancers entirely and preventing the
recurrence or spread of the primary cancer.
Fundamentals Treatment for Thyroid Cancers
and
4 common types of thyroid cancers
Generalities in
• Papillary carcinoma
Medical For curative goal:
Management • Follicular carcinoma • Primary treatment modality: OPERATION
of Goiter • Medullary carcinoma • May be followed by radioactive iodine
therapy
• Anaplastic carcinoma • May be followed by medical suppressive
therapy using levothyroxine

For palliative goal:

• Chemotherapy
• Radiation therapy
Fundamentals Treatment for Thyroid Cancers
and
4 common types of thyroid cancers
Generalities in
• Papillary carcinoma
Medical
Management • Follicular carcinoma
of Goiter • Medullary carcinoma
• Anaplastic carcinoma OPERATIONS:
• Thyroidectomy (subtotal / total)
• Neck dissection (different kinds)
Fundamentals Treatment for Non-Cancer Goiters Goals of treatment
and Curative vs control
Goiters with functional disorders
Generalities in
• Hyperthyroidism
Medical • Some don’t recur
Management • Hypothyroidism after treatment!
of Goiter • Some recur!
Goiters with non-functional disorders and benign
Only time will tell!
conditions
• Colloid adenomatous goiters NO GUARANTEE FOR
CURE!
May need lifetime
maintenance meds!
Fundamentals Treatment for HYPOTHYROIDISM Goals of treatment
and Curative vs control
Medical therapy (NO OPERATION as this will
Generalities in
aggravate the hypothyroidism)
Medical • Some don’t recur
Management after treatment!
of Goiter Replacement therapy – thyroid hormones, usually • Some recur!
levothyroxine – usually lifetime!
Only time will tell!

NO GUARANTEE FOR
CURE!
May need lifetime
maintenance meds!
Fundamentals Treatment for HYPERTHYROIDISM Goals of treatment
and Curative vs control
3 options for goiters that are small to moderate in
Generalities in
size:
Medical • Some don’t recur
• Medical therapy with anti-thyroid drugs
Management after treatment!
of Goiter • Operative therapy • Some recur!
• Radioactive iodine therapy
Only time will tell!

For huge-size goiters, operative therapy is NO GUARANTEE FOR

recommended! CURE!
May need lifetime
maintenance meds!
Fundamentals Treatment for COLLOID ADENOMATOUS Goals of treatment
and GOITERS Curative vs control
Generalities in
4 categories:
Medical • Some don’t recur
• Diffuse colloid adenomatous goiter
Management after treatment!
of Goiter • Colloid cyst • Some recur!
• Solitary colloid adenomatous goiter or nodule
Only time will tell!
• Multiple colloid adenomatous goiter
NO GUARANTEE FOR
CURE!
May need lifetime
maintenance meds!
Fundamentals Treatment for COLLOID ADENOMATOUS
Options:
and GOITERS • Monitor without
Generalities in meds
4 categories:
Medical • Meds (levothyroxine)
• Diffuse colloid adenomatous goiter
Management • Operation
of Goiter • Colloid cyst
• Solitary colloid adenomatous goiter or nodule • Operation is
recommended for
• Multiple colloid adenomatous goiter
huge-size goiter.
• Small to moderate
ones, no operation
(monitor without
meds or with meds)
Fundamentals Treatment for Non-Cancer Goiters Goals of treatment
and Curative vs control
Goiters with functional disorders
Generalities in
• Hyperthyroidism
Medical SURVEILLANCE OR • Some don’t recur
Management • Hypothyroidism MONITORING NEEDED – LIFE after treatment!
of Goiter TIME! • Some recur!
Goiters with non-functional disorders and benign
Only time will tell!
conditions
• Colloid adenomatous goiters NO GUARANTEE FOR
CURE!
May need lifetime
maintenance meds!
Fundamentals Post Treatment Health Restoration and
and Maintenance
Generalities in
After treatment for any type of goiter,
Medical
• Non-cancer goiters
Management
of Goiter • Cancer goiters (particularly)
there must be surveillance or follow-up or check-
up – usually lifetime – for recurrence.

Early detection of recurrence  early treatment

 better outcome!
Fundamentals Post Treatment Health Restoration and
and Maintenance
Generalities in
Patients may be taking maintenance meds for
Medical control of disease – may be lifetime!
Management
of Goiter
Patients are advised to have a healthy lifestyle to
promote health restoration and maintenance.

Except for ANAPLASTIC THYROID CA (fortunately

rare) and advanced cancers, the rest can still have
a long life after treatment.
Fundamentals CONTENTS: Summary
and Treatment for GOITERS Take Away
Generalities in Health Restoration and Maintenance
Medical PART 3
Management
of Goiter
Fundamentals Be always in touch with reliable medical Take Away in
and information on fundamentals and relation to
Generalities in generalities in medical management of Patient
Medical goiter. Empowerment
Management
Knowledge is power; it gives power.
of Goiter
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of goiter.
 Health
Empowerment
Disorder
objective - for
Course –
laypeople to have an
Fundamentals
understanding of the
and
FUNDAMENTALS
Generalities in
and GENERALITIES in
Medical
the MEDICAL
Management
MANAGEMENT of
of Goiter –
GOITER – Part 3.
Part 3