The Endocrine Program at Smilow Cancer Hospital is one of the largest multidisciplinary endocrine programs in the country. We evaluate, diagnose, and care for patients with both cancerous and benign tumors of the thyroid, parathyroid, adrenal glands, pituitary gland, hypothalamus, and pancreas.
As part of the only endocrine surgery program in Connecticut, our highly trained surgeons collaborate with specialists both at Yale and other institutions in order to provide the most comprehensive, leading-edge surgical treatment available to all of our patients. Our emphasis is on the safest and most minimally invasive surgery with the least amount of discomfort, scarring, and the fastest recovery time for every patient.
The Endocrine Program is experienced in treating rare cancers, such as parathyroid carcinoma, advanced thyroid cancer, adrenal cancer, and pheochromocytoma/paragangliomas, which benefit from this multidisciplinary approach and specialized expertise.
Specialized surgical expertise is essential for the management of all endocrine tumors. Some of the latest and most innovative procedures offered by our program include:
Minimally Invasive Parathyroidectomy: The 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. This is performed with a focused approach, often using a gentle local anesthesia technique. This enables the patient to vocalize during surgery, ensuring the vocal cords are protected.
Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): A minimally invasive technique for removal of the thyroid that leaves no visible scarring. Yale was one of the first centers in the world 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.
We offer several specialized approaches to enhance care in conjunction with surgery. These include:
A parathyroid four-dimensional (4-D) CT Scan, an advanced imaging technique used to localize parathyroid tumors before surgery is performed
Rapid PTH (parathyroid hormone) assays, which allow for real-time testing while patients are still in the operating room. Rapid PTH-assays are essential in determining if a tumor has been completely removed, or if further exploration is needed before concluding surgery. 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.
While surgery is the most common and important treatment for endocrine tumors, traditional external beam radiation therapy and chemotherapy are occasionally required. Radioiodine therapy is another safe, nonsurgical treatment offered by our program to treat thyroid cancer, and uses radioactive iodine destroy cancer cells. Following treatment, hormone therapy treatment may be administered to slow the growth of any remaining tumor cells and lower the chance of a recurrence.
In collaboration with the Smilow Cancer Hospital Cancer Genetics and Prevention Program, patients are screened and evaluated for hereditary endocrine tumor disease. Clinical trials testing new therapies and treatment options are also offered to patients with medullary or anaplastic thyroid cancer.