September 9, 2025 • 33 mins
Hashimoto’s, Hormones, Neck Checks & the Future of Thyroid Screening
Thyroid cancer is on the rise among midlife women—and most don’t even know they’re at risk. In this eye-opening episode of Asking for a Friend, Dr. Rashmi Roy, Director of Thyroid Surgical Services at the Clayman Thyroid Center and one of the world’s most experienced thyroid surgeons, explains why traditional blood work often misses thyroid cancer completely—and what women can do about it.
You’ll learn:
✅ Why thyroid cancer rarely shows symptoms and often doesn’t appear on routine thyroid labs
✅ The difference between thyroid disease (hypothyroidism, Hashimoto’s) and thyroid cancer
✅ The life-saving power of a simple 2-minute self-neck check you can do today
✅ How Dr. Roy’s groundbreaking mobile screening program is catching cancers at a higher rate than mammograms and pap smears
✅ Why she’s advocating for thyroid ultrasounds to become routine preventive care for women over 30
Dr. Roy also shares patient success stories, her journey into thyroid surgery, and practical steps you can take now to protect your thyroid health. Plus, discover her educational YouTube channel, Goiter Guru, where she empowers women with knowledge about thyroid disease and surgery.
👉 If you’re a woman in your 40s, 50s, or beyond, this is a must-listen conversation. Early detection can save lives—and it starts with knowing what to look for.
https://www.thyroidcancer.com/
_________________________________________
💌 Have questions about 1:1 health and nutrition coaching or Faster Way? Reach me anytime at mfolanfasterway@gmail.com
✨ For more tips, science-backed strategies, and midlife health inspiration, sign up for my weekly newsletter:
👉 https://michelefolanfasterway.myflodesk.com/i6i44jw4fq
🎤 In addition to coaching, I speak to women’s groups, moderate health panel discussions, and bring experts together for real, evidence-based conversations about midlife health. If you’d like me at your next event, let’s connect!
OsteoCollective osteoporosis resources and community link: https://app.osteocollective.com/invitation?code=BE98G9
Transcripts are created with AI and may not be perfectly accurate.
Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions regarding a medical condition.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Michele Folan (00:00):
Looking for a speaker who actually gets
midlife women.
I'm Michele Folan, midlifehealth coach and host of the
Asking for a Friend podcast.
Whether I'm speaking to women'sgroups or moderating health
panels, I bring straight talk,humor and science-backed
strategies that motivate womento take action From bone health
to hormones to staying strongfor the long haul.
I make complex health simpleand inspiring.
(00:20):
Want me at your next event.
Reach out through the emaillink in the long haul, I make
complex health simple andinspiring.
Want me at your next event.
Reach out through the emaillink in the show notes Health,
wellness, fitness and everythingin between.
We're removing the taboo fromwhat really matters in midlife.
(00:42):
I'm your host, Michele Folan,and this is Asking for a Friend.
September is Thyroid CancerAwareness Month, a time to shine
a spotlight on a cancer thataffects women in midlife more
than any other group.
The tricky part Thyroid cancerusually has no symptoms.
(01:03):
It doesn't show up on routineblood work and even thyroid labs
can look completely normal.
My guest today, Dr Rashmi Roy,is on a mission to change that.
She's one of the world's mostexperienced thyroid surgeons and
the director of thyroidsurgical services at the Clayman
Thyroid Center in Tampa,Florida.
She performs more thyroidsurgeries each year than nearly
(01:27):
anyone else in the US and hashelped detect countless cases of
thyroid cancer through herinnovative thyroid ultrasound
screening program.
She's now advocating forthyroid ultrasounds to become
routine for women over 40, justlike mammograms, and today
she'll share why a simpletwo-minute neck check could save
your life.
(01:47):
Dr Rajmi Roy, welcome to Askingfor a Friend.
Thanks for having me.
It's a pleasure.
I was telling Dr Roy before westarted that she's going to
teach me a thing or two today.
Despite all the years that Ihad in the medical world and
health field, I know very littleabout the thyroid, so I really
(02:07):
appreciate her being here today.
And you are one of the mostexperienced thyroid surgeons in
the world and I would love toknow what drew you to this
specialty.
Rashmi Roy, MD (02:22):
Yeah.
So ironically I actuallydecided pretty late in my
residency training.
You know I did.
I started out.
I always knew I wanted to dosurgery, I just didn't know what
type.
And so I did a five-yeargeneral surgery residency and
usually people know by theirsecond or third year you know
(02:42):
what type of fellowship or whatthey want to specialize in.
And I didn't.
I just loved everything.
I didn't know what I wanted tocommit my life to.
Nothing really stood out untilI did my what's called an
endocrine surgery fellowship inmy fourth year.
So my fourth year out of fiveyear residency is when I was
introduced to it and just fellin love with it.
(03:03):
It was how delicate the surgeryis, how fine.
You needed to meticulouslydissect everything and the
patient population.
So thyroid disease, endocrinedisease, is usually hit patients
that are women and they're inthe prime of their lives.
They're young, they'remiddle-aged, they're busy,
(03:26):
they're moms, they have theirwhole life ahead of them and
they are in the prime of theirlives.
But then all of a sudden theyget hit with something and I
knew that I could help thesewomen.
Michele Folan (03:35):
Okay, what is it about this little, tiny little
gland that causes midlife womenin particular, such strife?
Rashmi Roy, MD (03:47):
Yeah, so the thyroid itself.
There's different things tothink about the thyroid, but
thyroid disease or thyroidhormone disease, that's what
most patients, most women, feelif something's wrong with their
thyroid.
So the thyroid is I call it asmall but mighty gland.
It's small, it's a butterflyshaped organ, right above your
collarbone, in the middle ofyour neck, and it's responsible
(04:08):
it's like the thermostat foryour body.
It's responsible for yourenergy, your metabolism, your
temperature tolerance and hairnails.
So that little gland is incharge of all those things.
Michele Folan (04:18):
How has the field of thyroid surgery and
awareness changed since youstarted?
Because I have to imaginethings have kind of morphed and
changed.
Rashmi Roy, MD (04:28):
Yeah, so you know I don't like to use the
word epidemic, but thyroidcancer has become almost an
epidemic.
It is so common now.
It's more common in women thanmen, three times more common.
And we're just finding it allthe time because we're doing so
much more diagnostic tests andmore doctors are becoming aware
when they see women to feel yourneck and feel for the lumps and
(04:51):
bumps, and so we're finding itmuch more, much more common than
we used to be.
Michele Folan (04:55):
You know.
I will say this because I toldyou that I was at the doctor
last week and she did feelaround my neck and I assume
that's what she was, that that'swhat she was looking for, but I
can say that was probably notso, maybe even six, seven years
ago I think this is more recentRight, absolutely.
(05:15):
What are the symptoms, thoughthat often get dismissed as just
midlife, that could actually bethyroid related.
Rashmi Roy, MD (05:24):
Yeah, so it's pretty vague, and that's why
they get dismissed, and they canalso be confused with
perimenopausal symptoms.
So this we're just talkingabout thyroid disease and not
thyroid cancer.
But you're tired, you have totake a nap in the day when you
didn't used to, or you're coldwhen other people aren't, so
it's weight gain when you'redoing everything the same,
(05:47):
you're eating the same, you'reexercising the same, and so
those are all kind of symptomsthat could be related to
something being wrong with yourthyroid gland.
And if your thyroid functionhasn't been tested, then you be
an advocate for yourself and youask your primary care doctor to
check your thyroid levels.
Michele Folan (06:03):
I know that there are different thyroid blood
tests that we can get Just aregular old thyroid test.
Is that going to pick this up,or do we need to dig a little
deeper into free T3 and free T4?
Rashmi Roy, MD (06:17):
Yeah, it's a great question.
I think the most common thingis that the common test is
everyone just gets a TSH.
The TSH is a pretty broad range, you know, and so just because
you're in the normal TSH leveldoesn't necessarily mean that
your thyroid is good.
So, yes, free T3, free T4, tsh,and I also think you should get
thyroid antibodies checkedbecause that could be a symptom
(06:40):
of an autoimmune disease of yourthyroid gland.
So that's what I would considera full thyroid panel.
There's many more intricatelittle tests that you can get
done if those are abnormal, butI think that should be.
That's a good, thorough exam ofyour thyroid function.
Michele Folan (06:54):
My next question hypothyroidism and Hashimoto's.
I have no clue what Hashimoto'sis.
I hear it all the time.
I know there's coaches thatcoach women to help them with
their weight loss and thingswith Hashimoto's.
Can you define the difference?
Rashmi Roy, MD (07:16):
So Hashimoto's is the most common cause of
hypothyroidism and soHashimoto's is an autoimmune
disease of the thyroid glandwhere your body essentially
attacks your thyroid and itdecreases the function of your
thyroid gland and Hashimoto's.
For the most part, 85% to 90%of patients can be treated with
(07:40):
thyroid hormone replacement andthey feel well.
But there is a small subgroupof patients that has just
recently been focused on andfound that some patients those
10% patients where surgery isbeneficial for you, which is not
the case if your hypothyroidismis for some other reason, how
would surgery benefit somebody?
Michele Folan (08:00):
with Hashimoto's.
Rashmi Roy, MD (08:01):
Yeah, so it's a great question.
So there was a great study thatcame out of Norway and Sweden
now, maybe about seven years ago, where they looked at these
particular patients, and thesubgroup of patients that
benefit are patients that are onthyroid medication or they've
tried lifestyle changes.
So the best diet forHashimoto's is a gluten-free
(08:22):
diet.
So they've done lifestylemodifications.
They've done a thyroid hormonesreplacement and exercise.
You know, living the healthiestlife you can and you still feel
awful.
So these are patients that haveessentially failed medical
management.
Or there's a group ofHashimoto's patients where their
thyroid function is normal andwe can't put you on medication
(08:44):
because if we put you onmedication now you're going to
be hyperthyroid.
So again, you've failed medicalmanagement.
So those patients once youremove the offending organ
that's producing theseantibodies, then you now have a
chance for the thyroid hormoneto work because it's not
fighting against the organ.
Michele Folan (09:02):
Okay, and then my other question would be how
young do people get Hashimoto's?
Rashmi Roy, MD (09:09):
So usually it's midlife, 30s to 50s, but there
are patients that can get itearlier, but it's usually 30s to
50 years old where you getdiagnosed with it, all right.
Michele Folan (09:20):
And then, why do thyroid nodules form?
Are they always a cause?
Rashmi Roy, MD (09:25):
for concern.
So we don't know why thyroidnodules form, but it's super
common.
As we get older we're morelikely to find thyroid nodules.
You know, to put everyone kindof at ease a little bit, 95% of
thyroid nodules are actuallybenign.
So just because you have athyroid nodule you don't panic.
So they're not always a causefor concern.
(09:46):
But certain characteristics onan ultrasound make it suspicious
.
And if you have thosesuspicious characteristics then
your next step would be a needlebiopsy of that nodule to see if
it's something to be concernedabout or that needs further
intervention.
Michele Folan (10:02):
What is the family heredity connection with
thyroid disease?
Rashmi Roy, MD (10:08):
So you know, patients that have autoimmune
diseases in their family aremore likely to get a Hashimoto's
disease or Graves disease.
So Graves disease is kind ofthe opposite of Hashimoto's.
It causes hyperthyroidism.
So if autoimmune disease isrunning your family you're more
prone to getting those types.
If goiters run in your family,so enlarged nodules, then you're
(10:28):
more prone to get it.
Thyroid cancers there's onlyone genetic thyroid cancer that
you can actually test for with agenetic mutation.
That's a thyroid cancer calledmedullary thyroid cancer.
It's rare.
The most common thyroid cancer,which is papillary thyroid
cancer, there's no geneticmutation that you can get tested
for.
It's rare that it really runsthrough generations of your
(10:51):
families, but it can happen.
So you just need to be aware ofyou know what is your family
thyroid history.
Michele Folan (11:00):
All right, you brought up goiter.
I have to ask what the heck isgoiter and what would your
symptoms be, and why would it beproblematic for someone so?
Rashmi Roy, MD (11:10):
a goiter is essentially an enlarged thyroid.
So you can have a goiter fordifferent reasons.
Hashimoto's you can get what'scalled a Hashimoto's goiter
because the inflammation justmakes it so big.
But most commonly it's causedby large nodules.
So symptoms of a multinodulargoiter mainly are what we call
(11:30):
compressive symptoms, where youhave trouble swallowing.
So if you're eating, you know,bread or meat, you kind of have
an increased effort to swallow.
When you lay down, you kind ofyou have tightness in your neck,
or sometimes with women theyfeel like their necklace is
getting tighter.
So it's a kind of a feeling oftightness in your neck and you
(11:52):
can get something where I callit you're clearing your throat a
lot but you're not sick andthat's the irritation of the
thyroid on your trachea or yourwindpipe.
Michele Folan (12:11):
So compressive symptoms are the most common
side of a goiter.
Ooh, okay, now that'sinteresting because I know
people that have had that happenand I don't think that they say
allergies or GERD.
You know for the constantclearing of the throat, but I
had not heard goiter.
And I didn't mean to laughabout goiter, but it's one of
those things you know, you hear,but it's like, oh, I don't know
what that is.
Yeah, okay, we're going to takea quick break and when we come
back, I want to talk aboutthyroid cancer specifically.
(12:36):
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(13:20):
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All right, we are back.
I want to dig into thyroidcancer, because I know that
often there are no signs thatshow up in blood work.
Why is that, yeah, so that'sthe most common misconception.
Rashmi Roy, MD (13:37):
When patients come into my office they say Dr
Roy, how is this possible that Ihave thyroid cancer when my
thyroid function is completelynormal?
And it's true.
So there is no tumor marker forpapillary thyroid cancer, the
most common thyroid cancer?
There's something calledthyroglobulin, which is a tumor
marker for papillary thyroidcancer, but that is only after
(13:58):
your thyroid has been removed.
So that is a marker for tumorrecurrence if it comes back.
But with your thyroid in placeyou have thyroglobulin.
So there's just no way to testfor it.
And having thyroid cancer, youcould have a full neck of
thyroid cancer and havecompletely normal thyroid
function.
(14:18):
So there's just no blood testto check to see if you have
thyroid cancer.
Michele Folan (14:25):
So you had mentioned before that we're
seeing more thyroid cancer.
Are we to say we're recognizingit more quickly, or the fact
that there may be someenvironmental or lifestyle
factors involved here?
Rashmi Roy, MD (14:38):
Yeah, I think it's a great question.
I think the answer is both.
I think we're finding it morebecause of all the scans that
we're doing.
I think people are more awareof it and there's something
going on that we don't know yetin the environment that's
causing it, and I think there'salso an estrogen link.
There has not been a scientificcausative link that's been
(14:59):
detected yet, but there's got tobe, because if it's three times
more common in women than men,then there has to be, in my mind
, an estrogen component.
Michele Folan (15:08):
Would you suspect a decline in estrogen is
prompting a surgeon diagnosis.
No, I think more estrogen wouldbe causing Okay Interesting.
Is there a way that I canself-diagnose if I have
suspicion that something's goingon?
Rashmi Roy, MD (15:26):
Yeah, so you know, I think that the best
thing that women can do isreally two things.
Number one be aware of yourbody.
Just like we know to do selfbreast exams, you can do your
own self neck check and reallyall that is is taking your
fingers circular motions on yourneck, in the middle of your
(15:46):
neck to the sides of your neck.
You know circular motionsaround your on your neck, in the
middle of your neck to thesides of your neck.
Just feel for any lumps andbumps, feel what your neck feels
like on a normal basis and then, if you detect an abnormality,
then you go further.
So I think that's the firstthing is being aware of your
body and doing a neck check, andthe second is ask your primary
care doctor for a thyroidultrasound.
(16:07):
If you've never had one, thenget one to see what a baseline,
what your thyroid looks like atbaseline.
Michele Folan (16:13):
Oh, could you have thyroid cancer and not feel
anything, though?
Rashmi Roy, MD (16:17):
Absolutely, and so, and that's another reason
why I think you know being anadvocate for yourself to doing
these things is so important,because I would say 90% of my
patients that come in have nosymptoms, so they can't see it.
On blood work they have nosymptoms and then it was just
found.
Michele Folan (16:35):
Incidentally, you know this kind of reminds me of
osteoporosis.
I mean, we're not.
A lot of women are notproactively getting DEXA scans
and they don't know they haveosteoporosis until they have a
fracture.
Right, you're right.
Until it's a little too late,yeah, and we're not typically
really recommending a DEXA scanuntil people are 65.
Well, that's, you know.
(16:56):
The horse is way out of thebarn by then.
So you know, it's just.
This is great awareness.
If you catch thyroid cancerearly, can it be cured?
Absolutely.
Rashmi Roy, MD (17:05):
So thyroid cancer in general has an
excellent prognosis and can becured.
You know, even if it has spreadto lymph nodes in your neck it
can still be cured with surgery,possibly postoperative
radioactive iodine treatment ifneeded.
But the key is early detectionis early cure and hopefully less
surgery and maybe not evenneeding thyroid hormone
(17:27):
replacement afterwards.
So that's the key, just likewith any other cancer.
Michele Folan (17:32):
Yeah, that was going to be my next question.
So what does treatmenttypically look?
Rashmi Roy, MD (17:35):
like yeah, so treatment is surgery.
Surgery is the only option fordefinitive cure for thyroid
cancer and then, if it's moreadvanced and there's extensive
lymph node involvement, then aradioactive iodine pill.
So you know, most patients.
There's no chemotherapy orradiation that's needed, it's
just a one-time, one-dose pillof a radioactive iodine that
(18:00):
patients may need to take.
Michele Folan (18:02):
What other cancers would you be able to use
a radioactive iodine?
Rashmi Roy, MD (18:10):
would you be able to use a radioactive iodine
.
So this is that's.
What's so perfect about theradioactive iodine pill is that
it's only goes to thyroid cellsin the body.
Oh, wow, Okay.
That's why science is very cool.
Michele Folan (18:19):
I told you you're going to teach me something.
Today.
I'm like I'm asking you waymore questions than I thought I
would because I'm like okay,this is okay, I get it.
Okay, this is really good.
You started a thyroidultrasound screening program in
Florida.
What did you discover throughthis process and what makes it?
Rashmi Roy, MD (18:40):
unique, yeah, so I started this in 2022, kind of
out of nowhere, really and thenthe results kept me going and
now it's my passion, so I so,basically, it's a free
ultrasound screening program andit's mobile.
So if a if there's a group ofpeople or a company that wants
(19:02):
to be screened, I take my team,I take my mobile ultrasounds and
I go and I screen women forfree, let them know what they
have, let them know what theirnext steps are, and we have
diagnosed and cured many womenin the Tampa area that had no
idea that they had it, and sothat's been really, you know,
(19:23):
just gratifying for me to knowwhat an impact that this program
has had.
But what's even more so is thedata that's been collected.
And so this program has amalignancy detection rate of
2.4%, which may not seem high ifyou don't know much about
detection rates, but mammogramsand pap smears, which are
(19:46):
standard of care screeningdevices, have a less than 1%
malignancy detection rate, andit's standard.
So my program has a 2.4%malignancy detective rate and no
one gets thyroid ultrasoundsWow.
So my goal is to try to have itbe protocol that women over 30
(20:08):
get a thyroid ultrasound done.
It's non-invasive, it takes twoseconds.
You know why not All right?
Michele Folan (20:15):
I need to ask this what's the mortality rate
of thyroid cancer?
Rashmi Roy, MD (20:21):
So it's not high , it's not, you know so, this
standard.
So papillary thyroid cancer,you know you have a 98 to 99%
five-year survival rate and theyonly go to five years because
once you've hit five yearsyou're going, you're surviving,
so it's not changing yourlifespan.
But there are more aggressivethyroid cancers that again could
(20:42):
be detected with ultrasounds.
There's medullary thyroidcancers, follicular thyroid
cancers and then thyroid cancerthat is the emergency and is the
most fatal is something calledanaplastic thyroid cancer.
And how common is that?
Very rare, but if you have ityou have less than six months to
live.
Oh gosh.
Michele Folan (21:03):
You're working to get this program data in front
of the American ThyroidAssociation and I know you have
some goals for women'spreventive care.
What kind of roadblocks are yourunning into?
Rashmi Roy, MD (21:16):
So you know I'm going against the grain.
So you know, thyroid screeningis not something that people
want to do because of the chanceof overdiagnosis, and so if you
find a nodule, the fear is thatpatients will get more tests
and really overwhelm thehealthcare community.
(21:38):
And there are some thyroidcancers that some patients may
want to observe, and that's fine.
I'm not saying that everythyroid cancer needs to be
treated.
If it's small and you want toobserve it, then that's
completely up to you, but Ithink you should at least know
about it.
And so the roadblock is thatI'm going against the grain and
people don't want to do thescreenings.
(21:59):
But I think that it is, youknow, going above and beyond for
self-awareness.
Michele Folan (22:06):
Yeah, I mean, and I see this becoming a cost
issue.
You know overall, you know it's, you know we, we, we get our
mammograms every year, we'rewe're supposed to get a DEXA
scan, huh, yeah, and there's theadditional blood work that
we're getting and it's like onemore thing to add on to the list
(22:27):
.
And I can see insurancecompanies going to Chang, to
Chang, to Chang.
But on the flip side of that,by being more preventive, which
I hope we're moving in, maybenot needing thyroid hormone
replacement, not needing theradioactive iodine treatment.
Rashmi Roy, MD (23:02):
So there's definitely pros to finding it
earlier, you know, than lettingit progress.
Michele Folan (23:08):
So, as a surgeon who has seen thousands of cases,
what message do you most wantwomen to hear about their
thyroid health?
Rashmi Roy, MD (23:18):
So I just exactly what we're talking about
is preventative care is doingyour neck check?
I'm actually launching acampaign and it's hashtag neck
check.
Where I have on my YouTubechannel, I have a video of how
you do your neck check and we'retrying to spread the word.
So do a video, spread my video,take a picture of yourself and
(23:42):
say hashtag neck check, so thatwe just spread awareness to all
the women that we know in ourlives about thyroid cancer.
Michele Folan (23:49):
Well, and I know, even doing your own self breast
exam is sometimes a push.
So we really need to get theword out there that you can
really do yourself a lot of goodby checking this on your own.
I mean, it's, it's so simple.
It's right here, it's not right.
Rashmi Roy, MD (24:09):
And get an ultrasound.
You know, ask your doctor foran ultrasound, it's easy.
Um so those neck checks andultrasounds.
Michele Folan (24:16):
You mentioned your YouTube channel and it's
called the Goiter guru, which isso cute.
What inspired you to launchthat platform?
Rashmi Roy, MD (24:24):
Yeah, so I, you know, I did it all for fun.
At first I just started doingall these big goiters.
So all these goiters that otherpeople weren't able to do or
wouldn't even attempt, I it just.
It just kind of naturallyhappened and I said you know
what?
This is a fun video, this is afun thing to show patients.
And so it just it just kind ofnaturally happened and I said
you know what?
This is a fun video, this is afun thing to show patients.
Um, and so it just grew Um.
So now I have almost 40,000followers, um, on my channel and
(24:48):
I do these big goiters that godown into the chest where other
surgeons say they have to crackyour chest open.
And I use you know I'll be ableto take it out of just your
neck.
Who wants their chest crackedopen?
Right, obviously.
So then I use it as just kindof something fun and then I use
it as an educational channel.
So not only do I show goiterguru videos about these huge
(25:11):
goiters, but I talk aboutHashimoto's, I talk about
thyroid cancer, I talk aboutwhat you should do if you have a
thyroid nodule.
So it's now become more of aneducational thing as well as fun
.
I talk about myths.
You know what are your, whatare thyroid myths, and then I
have this whole segment on, youknow, busting myths and things
like that.
So it's fun and educational,you know.
Michele Folan (25:33):
I don't know if people realize how common
hypothyroidism and Hashimoto'sare.
I mean there are full-on groupson Instagram and other places.
We don't talk about it thatmuch, but I mean people that
have it are very involved inthat community.
Rashmi Roy, MD (25:52):
Well, they struggle.
When patients come into myoffice with Hashimoto's, I don't
even really have to ask them.
All I say is tell me how you'refeeling, that's it, and it is
the same textbook answers andmost patients break down crying.
I haven't even met thesepatients and they're just you
know, they just are so emotionalabout it because it really is a
(26:15):
devastating disease.
If you can't get it undercontrol, what's the most common
thing.
They complain about Just feelinglike they're on a roller
coaster, that they one day, theyyou know they really high,
highs and really high, lows andreally low, lows, and then just
their life's been taken awayfrom them.
They used to be this activeperson and they just they're
(26:38):
doing life but they're notenjoying life.
They feel like they're missingout on things with their kids.
Some people have to quit theirjobs when it's so severe, so
just their quality of life isawful.
Michele Folan (26:51):
Do you have a patient success story you can
share?
So there's so many I bet, I bet, and I didn't tell you I was
going to ask you that, but Ijust thought I was like oh, you
know what, I'm sure she's gotone that stands out.
Rashmi Roy, MD (27:06):
Yeah.
So I guess there's differenttypes thyroid cancer success
stories, goiter success stories,hashimoto's success stories.
I actually say some of my mostgrateful patients are my
Hashimoto's patients becausethey do get their quality of
life back and so scientificallyyou know they patients shouldn't
(27:29):
get their feel, start feelingbetter.
For three months.
We had a patient actually hewas a well-known surgeon and he
had he had, he had suchdevastating Hashimoto's that it
affected his neurological stateso much he had to quit his job
and he was almost comatose.
(27:49):
Now this is severe, severe case.
We took out his thyroid and Itell you that the next day he
was communicated with his wife,where he was not able to speak
to his wife.
That's how bad his Hashimoto'swas and it's something that I
can't scientifically explainbecause it takes three months
for the antibodies to leave yoursystem.
(28:10):
But I mean, talk about gettingyour life back.
He wasn't able to reallycommunicate anymore, let alone,
you know, function as a surgeon.
So yeah, I mean, the thyroid isa small but mighty gland that
can really affect everything inyour body.
Michele Folan (28:26):
Amazing.
Wow, see, I told you you weregoing to teach me so much today.
I ask all of my guests this,but in particular, I'd love to
ask doctors this, I thinkbecause it sets a great example
for my listeners.
But what's one of your personalnon-negotiables when it comes
(28:47):
to your own health, as a busysurgeon and advocate for health?
Rashmi Roy, MD (28:51):
Yeah.
So I think it's a greatquestion because it goes in line
with everything we're talkingabout and for me, you know I'm
not the greatest at drinking youknow so much water in a day
because I'm in the operatingroom all day, so I'm not the
greatest at getting you knowcertain amount of exercise all
the time because of how busy Iam.
But for me it is keeping upwith your preventative
(29:13):
screenings.
So all the preventativescreenings that we're supposed
to do mammograms, colonoscopiesfor men, you know your PSAs,
things like that that is anon-negotiable for me is to keep
up with that.
Michele Folan (29:26):
So you are good at that, because I often think
that doctors are sometimes theworst patients.
Rashmi Roy, MD (29:32):
We are, and I'll tell you that I didn't have a
primary care doctor foreverbecause I can just order my own
labs and I can just you know.
But the preventative screening,I think, is for me, that's what
I is at the top of my priority.
Michele Folan (29:46):
You know, my dad was a urologist and he finally
had to get some urologicprocedure done, and he was a
little older, it was a TUR,maybe I forget.
But anyway, long story short,as he's there in the hospital
recovering, I said how'd it go?
And he goes.
Well, I'll tell you one thingI'm going to tell all my
(30:06):
patients they should do this.
He goes.
I don't know why I waited solong, but the old saying, the
cobbler's children has no shoes.
It's like the doctor's alwaystelling the patients to go and
do these things, but theythemselves, yeah, I know it's a
real thing.
So anyway, yeah, yeah, for sure.
(30:27):
Dr Rajmi Roy, can you pleasetell our listeners where they
can find you and follow yourwork?
Rashmi Roy, MD (30:32):
Absolutely, so.
I operate exclusively at thehospital for endocrine surgery.
So the hospital for endocrinesurgery is a hospital that is
one of its kind in the country.
It is the only specialtyhospital where that's all that
we do.
So we are in Tampa, Florida, soyou can find me at the hospital
for endocrine surgery,specifically the Clayman Thyroid
(30:53):
Center, and you can find me atmy YouTube channel, Goiter Guru
on YouTube, and get moreinformation about thyroid
nodules and thyroid cancer atour website, which is
thyroidcancercom.
Michele Folan (31:05):
You know, being this dedicated center, do you
get a lot of patients from othercountries, other states, yeah,
so actually 55% of our patientsare out of state, Wow, yeah.
Rashmi Roy, MD (31:19):
And so what's so special about our hospital is,
and especially the thyroidcenter, is I can diagnose you
and operate and cure you in asingle day.
So if you think about that,think about going to schedule an
ultrasound, okay.
So now it's taken three weeksto get the ultrasound.
Now you need a biopsy that'sthree weeks.
Now you need to meet a surgeonthat's three.
(31:40):
Ultrasound Now you need abiopsy that's three weeks.
Now you need to meet a surgeon.
That's three weeks.
Now you need to get the surgery.
That's another three weeks, andthat's, you know, being
optimistic.
So basically, what happens isthe patient fills out a form, an
online form, atthyroidcancercom.
They get a personal call from asurgeon.
If you're out of state, you'llactually get the phone call from
me.
If you're in the state ofFlorida, one of our other
surgeons will call you and Iwill tell you exactly what you
(32:02):
have, what you need, and thenyou come in.
We do our own ultrasound in themorning.
Whatever else we need to do abiopsy, a CAT scan, whatever
your surgery is that afternoon,and if it's just half your
thyroid, you're in the hotel thesame day.
So it's a pretty remarkableplace where we're able to do all
of that.
That's incredible, and that'swhy it's so special that you
(32:23):
know the hospital for endocrinesurgery.
Michele Folan (32:25):
That is so neat.
I wonder if that'll be a modelthat we'll start to see more of.
Rashmi Roy, MD (32:31):
That's what we're.
You know, we thought we wouldbe a model and it's hard to
replicate, but it's also easy toreplicate if you use us as the
model.
Michele Folan (32:41):
Yeah, fascinating , Dr Rashmi Roy, thank you so
much for being here today.
Oh, thank you for having me.
It was a pleasure.
Thank you for listening.
Please rate and review thepodcast where you listen and, if
you'd like to join the Askingfor a Friend community, click on
the link in the show notes tosign up for my weekly newsletter
, where I share midlife wellnessand fitness tips, insights, my
(33:05):
favorite finds and recipes.
Looking for a speaker who actually gets
midlife women.
I'm Michele Folan, midlifehealth coach and host of the
Asking for a Friend podcast.
Whether I'm speaking to women'sgroups or moderating health
panels, I bring straight talk,humor and science-backed
strategies that motivate womento take action From bone health
to hormones to staying strongfor the long haul.
I make complex health simpleand inspiring.
(00:20):
Want me at your next event.
Reach out through the emaillink in the long haul, I make
complex health simple andinspiring.
Want me at your next event.
Reach out through the emaillink in the show notes Health,
wellness, fitness and everythingin between.
We're removing the taboo fromwhat really matters in midlife.
(00:42):
I'm your host, Michele Folan,and this is Asking for a Friend.
September is Thyroid CancerAwareness Month, a time to shine
a spotlight on a cancer thataffects women in midlife more
than any other group.
The tricky part Thyroid cancerusually has no symptoms.
(01:03):
It doesn't show up on routineblood work and even thyroid labs
can look completely normal.
My guest today, Dr Rashmi Roy,is on a mission to change that.
She's one of the world's mostexperienced thyroid surgeons and
the director of thyroidsurgical services at the Clayman
Thyroid Center in Tampa,Florida.
She performs more thyroidsurgeries each year than nearly
(01:27):
anyone else in the US and hashelped detect countless cases of
thyroid cancer through herinnovative thyroid ultrasound
screening program.
She's now advocating forthyroid ultrasounds to become
routine for women over 40, justlike mammograms, and today
she'll share why a simpletwo-minute neck check could save
your life.
(01:47):
Dr Rajmi Roy, welcome to Askingfor a Friend.
Thanks for having me.
It's a pleasure.
I was telling Dr Roy before westarted that she's going to
teach me a thing or two today.
Despite all the years that Ihad in the medical world and
health field, I know very littleabout the thyroid, so I really
(02:07):
appreciate her being here today.
And you are one of the mostexperienced thyroid surgeons in
the world and I would love toknow what drew you to this
specialty.
Rashmi Roy, MD (02:22):
Yeah.
So ironically I actuallydecided pretty late in my
residency training.
You know I did.
I started out.
I always knew I wanted to dosurgery, I just didn't know what
type.
And so I did a five-yeargeneral surgery residency and
usually people know by theirsecond or third year you know
(02:42):
what type of fellowship or whatthey want to specialize in.
And I didn't.
I just loved everything.
I didn't know what I wanted tocommit my life to.
Nothing really stood out untilI did my what's called an
endocrine surgery fellowship inmy fourth year.
So my fourth year out of fiveyear residency is when I was
introduced to it and just fellin love with it.
(03:03):
It was how delicate the surgeryis, how fine.
You needed to meticulouslydissect everything and the
patient population.
So thyroid disease, endocrinedisease, is usually hit patients
that are women and they're inthe prime of their lives.
They're young, they'remiddle-aged, they're busy,
(03:26):
they're moms, they have theirwhole life ahead of them and
they are in the prime of theirlives.
But then all of a sudden theyget hit with something and I
knew that I could help thesewomen.
Michele Folan (03:35):
Okay, what is it about this little, tiny little
gland that causes midlife womenin particular, such strife?
Rashmi Roy, MD (03:47):
Yeah, so the thyroid itself.
There's different things tothink about the thyroid, but
thyroid disease or thyroidhormone disease, that's what
most patients, most women, feelif something's wrong with their
thyroid.
So the thyroid is I call it asmall but mighty gland.
It's small, it's a butterflyshaped organ, right above your
collarbone, in the middle ofyour neck, and it's responsible
(04:08):
it's like the thermostat foryour body.
It's responsible for yourenergy, your metabolism, your
temperature tolerance and hairnails.
So that little gland is incharge of all those things.
Michele Folan (04:18):
How has the field of thyroid surgery and
awareness changed since youstarted?
Because I have to imaginethings have kind of morphed and
changed.
Rashmi Roy, MD (04:28):
Yeah, so you know I don't like to use the
word epidemic, but thyroidcancer has become almost an
epidemic.
It is so common now.
It's more common in women thanmen, three times more common.
And we're just finding it allthe time because we're doing so
much more diagnostic tests andmore doctors are becoming aware
when they see women to feel yourneck and feel for the lumps and
(04:51):
bumps, and so we're finding itmuch more, much more common than
we used to be.
Michele Folan (04:55):
You know.
I will say this because I toldyou that I was at the doctor
last week and she did feelaround my neck and I assume
that's what she was, that that'swhat she was looking for, but I
can say that was probably notso, maybe even six, seven years
ago I think this is more recentRight, absolutely.
(05:15):
What are the symptoms, thoughthat often get dismissed as just
midlife, that could actually bethyroid related.
Rashmi Roy, MD (05:24):
Yeah, so it's pretty vague, and that's why
they get dismissed, and they canalso be confused with
perimenopausal symptoms.
So this we're just talkingabout thyroid disease and not
thyroid cancer.
But you're tired, you have totake a nap in the day when you
didn't used to, or you're coldwhen other people aren't, so
it's weight gain when you'redoing everything the same,
(05:47):
you're eating the same, you'reexercising the same, and so
those are all kind of symptomsthat could be related to
something being wrong with yourthyroid gland.
And if your thyroid functionhasn't been tested, then you be
an advocate for yourself and youask your primary care doctor to
check your thyroid levels.
Michele Folan (06:03):
I know that there are different thyroid blood
tests that we can get Just aregular old thyroid test.
Is that going to pick this up,or do we need to dig a little
deeper into free T3 and free T4?
Rashmi Roy, MD (06:17):
Yeah, it's a great question.
I think the most common thingis that the common test is
everyone just gets a TSH.
The TSH is a pretty broad range, you know, and so just because
you're in the normal TSH leveldoesn't necessarily mean that
your thyroid is good.
So, yes, free T3, free T4, tsh,and I also think you should get
thyroid antibodies checkedbecause that could be a symptom
(06:40):
of an autoimmune disease of yourthyroid gland.
So that's what I would considera full thyroid panel.
There's many more intricatelittle tests that you can get
done if those are abnormal, butI think that should be.
That's a good, thorough exam ofyour thyroid function.
Michele Folan (06:54):
My next question hypothyroidism and Hashimoto's.
I have no clue what Hashimoto'sis.
I hear it all the time.
I know there's coaches thatcoach women to help them with
their weight loss and thingswith Hashimoto's.
Can you define the difference?
Rashmi Roy, MD (07:16):
So Hashimoto's is the most common cause of
hypothyroidism and soHashimoto's is an autoimmune
disease of the thyroid glandwhere your body essentially
attacks your thyroid and itdecreases the function of your
thyroid gland and Hashimoto's.
For the most part, 85% to 90%of patients can be treated with
(07:40):
thyroid hormone replacement andthey feel well.
But there is a small subgroupof patients that has just
recently been focused on andfound that some patients those
10% patients where surgery isbeneficial for you, which is not
the case if your hypothyroidismis for some other reason, how
would surgery benefit somebody?
Michele Folan (08:00):
with Hashimoto's.
Rashmi Roy, MD (08:01):
Yeah, so it's a great question.
So there was a great study thatcame out of Norway and Sweden
now, maybe about seven years ago, where they looked at these
particular patients, and thesubgroup of patients that
benefit are patients that are onthyroid medication or they've
tried lifestyle changes.
So the best diet forHashimoto's is a gluten-free
(08:22):
diet.
So they've done lifestylemodifications.
They've done a thyroid hormonesreplacement and exercise.
You know, living the healthiestlife you can and you still feel
awful.
So these are patients that haveessentially failed medical
management.
Or there's a group ofHashimoto's patients where their
thyroid function is normal andwe can't put you on medication
(08:44):
because if we put you onmedication now you're going to
be hyperthyroid.
So again, you've failed medicalmanagement.
So those patients once youremove the offending organ
that's producing theseantibodies, then you now have a
chance for the thyroid hormoneto work because it's not
fighting against the organ.
Michele Folan (09:02):
Okay, and then my other question would be how
young do people get Hashimoto's?
Rashmi Roy, MD (09:09):
So usually it's midlife, 30s to 50s, but there
are patients that can get itearlier, but it's usually 30s to
50 years old where you getdiagnosed with it, all right.
Michele Folan (09:20):
And then, why do thyroid nodules form?
Are they always a cause?
Rashmi Roy, MD (09:25):
for concern.
So we don't know why thyroidnodules form, but it's super
common.
As we get older we're morelikely to find thyroid nodules.
You know, to put everyone kindof at ease a little bit, 95% of
thyroid nodules are actuallybenign.
So just because you have athyroid nodule you don't panic.
So they're not always a causefor concern.
(09:46):
But certain characteristics onan ultrasound make it suspicious
.
And if you have thosesuspicious characteristics then
your next step would be a needlebiopsy of that nodule to see if
it's something to be concernedabout or that needs further
intervention.
Michele Folan (10:02):
What is the family heredity connection with
thyroid disease?
Rashmi Roy, MD (10:08):
So you know, patients that have autoimmune
diseases in their family aremore likely to get a Hashimoto's
disease or Graves disease.
So Graves disease is kind ofthe opposite of Hashimoto's.
It causes hyperthyroidism.
So if autoimmune disease isrunning your family you're more
prone to getting those types.
If goiters run in your family,so enlarged nodules, then you're
(10:28):
more prone to get it.
Thyroid cancers there's onlyone genetic thyroid cancer that
you can actually test for with agenetic mutation.
That's a thyroid cancer calledmedullary thyroid cancer.
It's rare.
The most common thyroid cancer,which is papillary thyroid
cancer, there's no geneticmutation that you can get tested
for.
It's rare that it really runsthrough generations of your
(10:51):
families, but it can happen.
So you just need to be aware ofyou know what is your family
thyroid history.
Michele Folan (11:00):
All right, you brought up goiter.
I have to ask what the heck isgoiter and what would your
symptoms be, and why would it beproblematic for someone so?
Rashmi Roy, MD (11:10):
a goiter is essentially an enlarged thyroid.
So you can have a goiter fordifferent reasons.
Hashimoto's you can get what'scalled a Hashimoto's goiter
because the inflammation justmakes it so big.
But most commonly it's causedby large nodules.
So symptoms of a multinodulargoiter mainly are what we call
(11:30):
compressive symptoms, where youhave trouble swallowing.
So if you're eating, you know,bread or meat, you kind of have
an increased effort to swallow.
When you lay down, you kind ofyou have tightness in your neck,
or sometimes with women theyfeel like their necklace is
getting tighter.
So it's a kind of a feeling oftightness in your neck and you
(11:52):
can get something where I callit you're clearing your throat a
lot but you're not sick andthat's the irritation of the
thyroid on your trachea or yourwindpipe.
Michele Folan (12:11):
So compressive symptoms are the most common
side of a goiter.
Ooh, okay, now that'sinteresting because I know
people that have had that happenand I don't think that they say
allergies or GERD.
You know for the constantclearing of the throat, but I
had not heard goiter.
And I didn't mean to laughabout goiter, but it's one of
those things you know, you hear,but it's like, oh, I don't know
what that is.
Yeah, okay, we're going to takea quick break and when we come
back, I want to talk aboutthyroid cancer specifically.
(12:36):
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(13:20):
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All right, we are back.
I want to dig into thyroidcancer, because I know that
often there are no signs thatshow up in blood work.
Why is that, yeah, so that'sthe most common misconception.
Rashmi Roy, MD (13:37):
When patients come into my office they say Dr
Roy, how is this possible that Ihave thyroid cancer when my
thyroid function is completelynormal?
And it's true.
So there is no tumor marker forpapillary thyroid cancer, the
most common thyroid cancer?
There's something calledthyroglobulin, which is a tumor
marker for papillary thyroidcancer, but that is only after
(13:58):
your thyroid has been removed.
So that is a marker for tumorrecurrence if it comes back.
But with your thyroid in placeyou have thyroglobulin.
So there's just no way to testfor it.
And having thyroid cancer, youcould have a full neck of
thyroid cancer and havecompletely normal thyroid
function.
(14:18):
So there's just no blood testto check to see if you have
thyroid cancer.
Michele Folan (14:25):
So you had mentioned before that we're
seeing more thyroid cancer.
Are we to say we're recognizingit more quickly, or the fact
that there may be someenvironmental or lifestyle
factors involved here?
Rashmi Roy, MD (14:38):
Yeah, I think it's a great question.
I think the answer is both.
I think we're finding it morebecause of all the scans that
we're doing.
I think people are more awareof it and there's something
going on that we don't know yetin the environment that's
causing it, and I think there'salso an estrogen link.
There has not been a scientificcausative link that's been
(14:59):
detected yet, but there's got tobe, because if it's three times
more common in women than men,then there has to be, in my mind
, an estrogen component.
Michele Folan (15:08):
Would you suspect a decline in estrogen is
prompting a surgeon diagnosis.
No, I think more estrogen wouldbe causing Okay Interesting.
Is there a way that I canself-diagnose if I have
suspicion that something's goingon?
Rashmi Roy, MD (15:26):
Yeah, so you know, I think that the best
thing that women can do isreally two things.
Number one be aware of yourbody.
Just like we know to do selfbreast exams, you can do your
own self neck check and reallyall that is is taking your
fingers circular motions on yourneck, in the middle of your
(15:46):
neck to the sides of your neck.
You know circular motionsaround your on your neck, in the
middle of your neck to thesides of your neck.
Just feel for any lumps andbumps, feel what your neck feels
like on a normal basis and then, if you detect an abnormality,
then you go further.
So I think that's the firstthing is being aware of your
body and doing a neck check, andthe second is ask your primary
care doctor for a thyroidultrasound.
(16:07):
If you've never had one, thenget one to see what a baseline,
what your thyroid looks like atbaseline.
Michele Folan (16:13):
Oh, could you have thyroid cancer and not feel
anything, though?
Rashmi Roy, MD (16:17):
Absolutely, and so, and that's another reason
why I think you know being anadvocate for yourself to doing
these things is so important,because I would say 90% of my
patients that come in have nosymptoms, so they can't see it.
On blood work they have nosymptoms and then it was just
found.
Michele Folan (16:35):
Incidentally, you know this kind of reminds me of
osteoporosis.
I mean, we're not.
A lot of women are notproactively getting DEXA scans
and they don't know they haveosteoporosis until they have a
fracture.
Right, you're right.
Until it's a little too late,yeah, and we're not typically
really recommending a DEXA scanuntil people are 65.
Well, that's, you know.
(16:56):
The horse is way out of thebarn by then.
So you know, it's just.
This is great awareness.
If you catch thyroid cancerearly, can it be cured?
Absolutely.
Rashmi Roy, MD (17:05):
So thyroid cancer in general has an
excellent prognosis and can becured.
You know, even if it has spreadto lymph nodes in your neck it
can still be cured with surgery,possibly postoperative
radioactive iodine treatment ifneeded.
But the key is early detectionis early cure and hopefully less
surgery and maybe not evenneeding thyroid hormone
(17:27):
replacement afterwards.
So that's the key, just likewith any other cancer.
Michele Folan (17:32):
Yeah, that was going to be my next question.
So what does treatmenttypically look?
Rashmi Roy, MD (17:35):
like yeah, so treatment is surgery.
Surgery is the only option fordefinitive cure for thyroid
cancer and then, if it's moreadvanced and there's extensive
lymph node involvement, then aradioactive iodine pill.
So you know, most patients.
There's no chemotherapy orradiation that's needed, it's
just a one-time, one-dose pillof a radioactive iodine that
(18:00):
patients may need to take.
Michele Folan (18:02):
What other cancers would you be able to use
a radioactive iodine?
Rashmi Roy, MD (18:10):
would you be able to use a radioactive iodine
.
So this is that's.
What's so perfect about theradioactive iodine pill is that
it's only goes to thyroid cellsin the body.
Oh, wow, Okay.
That's why science is very cool.
Michele Folan (18:19):
I told you you're going to teach me something.
Today.
I'm like I'm asking you waymore questions than I thought I
would because I'm like okay,this is okay, I get it.
Okay, this is really good.
You started a thyroidultrasound screening program in
Florida.
What did you discover throughthis process and what makes it?
Rashmi Roy, MD (18:40):
unique, yeah, so I started this in 2022, kind of
out of nowhere, really and thenthe results kept me going and
now it's my passion, so I so,basically, it's a free
ultrasound screening program andit's mobile.
So if a if there's a group ofpeople or a company that wants
(19:02):
to be screened, I take my team,I take my mobile ultrasounds and
I go and I screen women forfree, let them know what they
have, let them know what theirnext steps are, and we have
diagnosed and cured many womenin the Tampa area that had no
idea that they had it, and sothat's been really, you know,
(19:23):
just gratifying for me to knowwhat an impact that this program
has had.
But what's even more so is thedata that's been collected.
And so this program has amalignancy detection rate of
2.4%, which may not seem high ifyou don't know much about
detection rates, but mammogramsand pap smears, which are
(19:46):
standard of care screeningdevices, have a less than 1%
malignancy detection rate, andit's standard.
So my program has a 2.4%malignancy detective rate and no
one gets thyroid ultrasoundsWow.
So my goal is to try to have itbe protocol that women over 30
(20:08):
get a thyroid ultrasound done.
It's non-invasive, it takes twoseconds.
You know why not All right?
Michele Folan (20:15):
I need to ask this what's the mortality rate
of thyroid cancer?
Rashmi Roy, MD (20:21):
So it's not high , it's not, you know so, this
standard.
So papillary thyroid cancer,you know you have a 98 to 99%
five-year survival rate and theyonly go to five years because
once you've hit five yearsyou're going, you're surviving,
so it's not changing yourlifespan.
But there are more aggressivethyroid cancers that again could
(20:42):
be detected with ultrasounds.
There's medullary thyroidcancers, follicular thyroid
cancers and then thyroid cancerthat is the emergency and is the
most fatal is something calledanaplastic thyroid cancer.
And how common is that?
Very rare, but if you have ityou have less than six months to
live.
Oh gosh.
Michele Folan (21:03):
You're working to get this program data in front
of the American ThyroidAssociation and I know you have
some goals for women'spreventive care.
What kind of roadblocks are yourunning into?
Rashmi Roy, MD (21:16):
So you know I'm going against the grain.
So you know, thyroid screeningis not something that people
want to do because of the chanceof overdiagnosis, and so if you
find a nodule, the fear is thatpatients will get more tests
and really overwhelm thehealthcare community.
(21:38):
And there are some thyroidcancers that some patients may
want to observe, and that's fine.
I'm not saying that everythyroid cancer needs to be
treated.
If it's small and you want toobserve it, then that's
completely up to you, but Ithink you should at least know
about it.
And so the roadblock is thatI'm going against the grain and
people don't want to do thescreenings.
(21:59):
But I think that it is, youknow, going above and beyond for
self-awareness.
Michele Folan (22:06):
Yeah, I mean, and I see this becoming a cost
issue.
You know overall, you know it's, you know we, we, we get our
mammograms every year, we'rewe're supposed to get a DEXA
scan, huh, yeah, and there's theadditional blood work that
we're getting and it's like onemore thing to add on to the list
(22:27):
.
And I can see insurancecompanies going to Chang, to
Chang, to Chang.
But on the flip side of that,by being more preventive, which
I hope we're moving in, maybenot needing thyroid hormone
replacement, not needing theradioactive iodine treatment.
Rashmi Roy, MD (23:02):
So there's definitely pros to finding it
earlier, you know, than lettingit progress.
Michele Folan (23:08):
So, as a surgeon who has seen thousands of cases,
what message do you most wantwomen to hear about their
thyroid health?
Rashmi Roy, MD (23:18):
So I just exactly what we're talking about
is preventative care is doingyour neck check?
I'm actually launching acampaign and it's hashtag neck
check.
Where I have on my YouTubechannel, I have a video of how
you do your neck check and we'retrying to spread the word.
So do a video, spread my video,take a picture of yourself and
(23:42):
say hashtag neck check, so thatwe just spread awareness to all
the women that we know in ourlives about thyroid cancer.
Michele Folan (23:49):
Well, and I know, even doing your own self breast
exam is sometimes a push.
So we really need to get theword out there that you can
really do yourself a lot of goodby checking this on your own.
I mean, it's, it's so simple.
It's right here, it's not right.
Rashmi Roy, MD (24:09):
And get an ultrasound.
You know, ask your doctor foran ultrasound, it's easy.
Um so those neck checks andultrasounds.
Michele Folan (24:16):
You mentioned your YouTube channel and it's
called the Goiter guru, which isso cute.
What inspired you to launchthat platform?
Rashmi Roy, MD (24:24):
Yeah, so I, you know, I did it all for fun.
At first I just started doingall these big goiters.
So all these goiters that otherpeople weren't able to do or
wouldn't even attempt, I it just.
It just kind of naturallyhappened and I said you know
what?
This is a fun video, this is afun thing to show patients.
And so it just it just kind ofnaturally happened and I said
you know what?
This is a fun video, this is afun thing to show patients.
Um, and so it just grew Um.
So now I have almost 40,000followers, um, on my channel and
(24:48):
I do these big goiters that godown into the chest where other
surgeons say they have to crackyour chest open.
And I use you know I'll be ableto take it out of just your
neck.
Who wants their chest crackedopen?
Right, obviously.
So then I use it as just kindof something fun and then I use
it as an educational channel.
So not only do I show goiterguru videos about these huge
(25:11):
goiters, but I talk aboutHashimoto's, I talk about
thyroid cancer, I talk aboutwhat you should do if you have a
thyroid nodule.
So it's now become more of aneducational thing as well as fun
.
I talk about myths.
You know what are your, whatare thyroid myths, and then I
have this whole segment on, youknow, busting myths and things
like that.
So it's fun and educational,you know.
Michele Folan (25:33):
I don't know if people realize how common
hypothyroidism and Hashimoto'sare.
I mean there are full-on groupson Instagram and other places.
We don't talk about it thatmuch, but I mean people that
have it are very involved inthat community.
Rashmi Roy, MD (25:52):
Well, they struggle.
When patients come into myoffice with Hashimoto's, I don't
even really have to ask them.
All I say is tell me how you'refeeling, that's it, and it is
the same textbook answers andmost patients break down crying.
I haven't even met thesepatients and they're just you
know, they just are so emotionalabout it because it really is a
(26:15):
devastating disease.
If you can't get it undercontrol, what's the most common
thing.
They complain about Just feelinglike they're on a roller
coaster, that they one day, theyyou know they really high,
highs and really high, lows andreally low, lows, and then just
their life's been taken awayfrom them.
They used to be this activeperson and they just they're
(26:38):
doing life but they're notenjoying life.
They feel like they're missingout on things with their kids.
Some people have to quit theirjobs when it's so severe, so
just their quality of life isawful.
Michele Folan (26:51):
Do you have a patient success story you can
share?
So there's so many I bet, I bet, and I didn't tell you I was
going to ask you that, but Ijust thought I was like oh, you
know what, I'm sure she's gotone that stands out.
Rashmi Roy, MD (27:06):
Yeah.
So I guess there's differenttypes thyroid cancer success
stories, goiter success stories,hashimoto's success stories.
I actually say some of my mostgrateful patients are my
Hashimoto's patients becausethey do get their quality of
life back and so scientificallyyou know they patients shouldn't
(27:29):
get their feel, start feelingbetter.
For three months.
We had a patient actually hewas a well-known surgeon and he
had he had, he had suchdevastating Hashimoto's that it
affected his neurological stateso much he had to quit his job
and he was almost comatose.
(27:49):
Now this is severe, severe case.
We took out his thyroid and Itell you that the next day he
was communicated with his wife,where he was not able to speak
to his wife.
That's how bad his Hashimoto'swas and it's something that I
can't scientifically explainbecause it takes three months
for the antibodies to leave yoursystem.
(28:10):
But I mean, talk about gettingyour life back.
He wasn't able to reallycommunicate anymore, let alone,
you know, function as a surgeon.
So yeah, I mean, the thyroid isa small but mighty gland that
can really affect everything inyour body.
Michele Folan (28:26):
Amazing.
Wow, see, I told you you weregoing to teach me so much today.
I ask all of my guests this,but in particular, I'd love to
ask doctors this, I thinkbecause it sets a great example
for my listeners.
But what's one of your personalnon-negotiables when it comes
(28:47):
to your own health, as a busysurgeon and advocate for health?
Rashmi Roy, MD (28:51):
Yeah.
So I think it's a greatquestion because it goes in line
with everything we're talkingabout and for me, you know I'm
not the greatest at drinking youknow so much water in a day
because I'm in the operatingroom all day, so I'm not the
greatest at getting you knowcertain amount of exercise all
the time because of how busy Iam.
But for me it is keeping upwith your preventative
(29:13):
screenings.
So all the preventativescreenings that we're supposed
to do mammograms, colonoscopiesfor men, you know your PSAs,
things like that that is anon-negotiable for me is to keep
up with that.
Michele Folan (29:26):
So you are good at that, because I often think
that doctors are sometimes theworst patients.
Rashmi Roy, MD (29:32):
We are, and I'll tell you that I didn't have a
primary care doctor foreverbecause I can just order my own
labs and I can just you know.
But the preventative screening,I think, is for me, that's what
I is at the top of my priority.
Michele Folan (29:46):
You know, my dad was a urologist and he finally
had to get some urologicprocedure done, and he was a
little older, it was a TUR,maybe I forget.
But anyway, long story short,as he's there in the hospital
recovering, I said how'd it go?
And he goes.
Well, I'll tell you one thingI'm going to tell all my
(30:06):
patients they should do this.
He goes.
I don't know why I waited solong, but the old saying, the
cobbler's children has no shoes.
It's like the doctor's alwaystelling the patients to go and
do these things, but theythemselves, yeah, I know it's a
real thing.
So anyway, yeah, yeah, for sure.
(30:27):
Dr Rajmi Roy, can you pleasetell our listeners where they
can find you and follow yourwork?
Rashmi Roy, MD (30:32):
Absolutely, so.
I operate exclusively at thehospital for endocrine surgery.
So the hospital for endocrinesurgery is a hospital that is
one of its kind in the country.
It is the only specialtyhospital where that's all that
we do.
So we are in Tampa, Florida, soyou can find me at the hospital
for endocrine surgery,specifically the Clayman Thyroid
(30:53):
Center, and you can find me atmy YouTube channel, Goiter Guru
on YouTube, and get moreinformation about thyroid
nodules and thyroid cancer atour website, which is
thyroidcancercom.
Michele Folan (31:05):
You know, being this dedicated center, do you
get a lot of patients from othercountries, other states, yeah,
so actually 55% of our patientsare out of state, Wow, yeah.
Rashmi Roy, MD (31:19):
And so what's so special about our hospital is,
and especially the thyroidcenter, is I can diagnose you
and operate and cure you in asingle day.
So if you think about that,think about going to schedule an
ultrasound, okay.
So now it's taken three weeksto get the ultrasound.
Now you need a biopsy that'sthree weeks.
Now you need to meet a surgeonthat's three.
(31:40):
Ultrasound Now you need abiopsy that's three weeks.
Now you need to meet a surgeon.
That's three weeks.
Now you need to get the surgery.
That's another three weeks, andthat's, you know, being
optimistic.
So basically, what happens isthe patient fills out a form, an
online form, atthyroidcancercom.
They get a personal call from asurgeon.
If you're out of state, you'llactually get the phone call from
me.
If you're in the state ofFlorida, one of our other
surgeons will call you and Iwill tell you exactly what you
(32:02):
have, what you need, and thenyou come in.
We do our own ultrasound in themorning.
Whatever else we need to do abiopsy, a CAT scan, whatever
your surgery is that afternoon,and if it's just half your
thyroid, you're in the hotel thesame day.
So it's a pretty remarkableplace where we're able to do all
of that.
That's incredible, and that'swhy it's so special that you
(32:23):
know the hospital for endocrinesurgery.
Michele Folan (32:25):
That is so neat.
I wonder if that'll be a modelthat we'll start to see more of.
Rashmi Roy, MD (32:31):
That's what we're.
You know, we thought we wouldbe a model and it's hard to
replicate, but it's also easy toreplicate if you use us as the
model.
Michele Folan (32:41):
Yeah, fascinating , Dr Rashmi Roy, thank you so
much for being here today.
Oh, thank you for having me.
It was a pleasure.
Thank you for listening.
Please rate and review thepodcast where you listen and, if
you'd like to join the Askingfor a Friend community, click on
the link in the show notes tosign up for my weekly newsletter
, where I share midlife wellnessand fitness tips, insights, my
(33:05):
favorite finds and recipes.
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