The London Thyroid Clinic is dedicated to the accurate diagnosis and successful treatment of thyroid disorders. It is run along the guidelines produced by the British Association of Endocrine Surgeons. The objective of the clinic is to provide an integrated service staffed by a dedicated multidisciplinary team specialising in the assessment, diagnosis and treatment of benign and malignant thyroid disorders.
The London Thyroid Clinic is able to call upon an expert team of surgeons, radiologists, nuclear medicine consultants, cytologists, pathologists, endocrine physicians and oncologists, as well as specialist nurses in order to assure a first class service.
New patients are seen regularly with on site ultrasound scanning, general radiology and cytology.
UK specialist in thyroid surgery
Mr S K Marsh, Surgical Director and Consultant Surgeon
Simon Marsh MA MD FRCS Eng FRCS (Gen Surg) trained at Trinity College, Cambridge and The Clinical School, Addenbrooke’s Hospital. He is one of the few students to have been awarded the William Harvey Studentship in consecutive years. He qualified in 1987, having been awarded a BA in 1985. In 1992 he was made a Fellow of the Royal College of Surgeons in England and granted an MA from Cambridge.
In 1996, he was awarded an MD by the University of Cambridge and received the Intercollegiate Fellowship in General Surgery. In 1999, having been appointed a Consultant Surgeon in Colchester, he joined 108 Harley Street.
He is a member of the British Association of Surgical Oncology, The British Association of Endocrine Surgeons and the Thyroid Cancer Forum UK.
Assessment of thyroid problems
The activity of the thyroid gland is assessed by taking a history and performing an examination, as well as doing some blood tests.
History and examination
All patients will have their medical history taken and will be examined. Particular attention will be paid to the thyroid gland in the neck.
Thyroid function blood tests will be required to measure the activity of the gland and the blood will also be checked to make sure that the body has not produced any antibodies to the thyroid (autoimmune disease).
Ultrasound scans can assess the thyroid gland for its overall size as well as the presence of any lumps. Ultrasound can also be used to help obtain a needle sample (cytology) from a small lump that is difficult to feel.
All thyroid lumps, and in many cases where the thyroid is enlarged, will have a needle sample taken. A fine needle is inserted into the gland and a cell sample is obtained that can be examined under a microscope.
This scan involves a tiny amount of radioactive material that is taken up by the thyroid gland to give a picture of how well it is working/ It may show areas that are underactive or overactive, and along with the ultrasound scan, it helps to guide the correct treatment.
Occasionally other tests will be needed. A chest x-ray can sometimes show if a large gland is affecting the windpipe and a CT or MRI scan can help to show more exactly the extent of any thyroid swelling.
Operations on the thyroid gland
All patients will have their operation discussed with them before surgery and will be given a written information sheet, so that surgery is always based on informed consent. A patient will not be asked to consent to proceed to further or alternative measures.
A thyroidectomy is removal of all (total thyroidectomy) or part (usually a thyroid lobectomy) of the thyroid gland. This may be required because the whole gland is enlarged (a goitre), or the gland is overactive, or there may be a nodule (a lump) on one side of the gland that needs to be removed to find out the cause of the lump.
If the entire gland is removed you will have to be on thyroxine tablets afterwards for the rest of your life. The correct dose varies for different people and can be monitored by a simple blood test. This does not affect your ability to lead a normal, active life.
If only part of the gland is removed most people will not need to take any tablets.
Occasionally the parathyroid gland is removed or damaged during thyroid surgery. In many cases where the whole gland is removed, the parathyroid glands tend to “shut down” for a few weeks. In these cases you will normally be put on calcium tablets for around a month to allow the parathyroid glands to recover. Very rarely the parathyroid glands do not recover and you may be on calcium tablets, as well as thyroxine, for the rest of your life.
After the operation your neck will feel stiff and you will have a sore throat. This is due to having a tube in your windpipe during the operation and the fact that the thyroid gland sits near to the voice box. Because of this you will find that you are a bit hoarse to begin with but this will quickly improve. If the recurrent laryngeal nerves have been bruised, the hoarseness will last longer, but will almost always recover on its own.
The scar heals quite quickly. Although it is often fairly red and can be quite thick initially, over a period of several months it settles down and becomes paler and thinner.
Some patients who have surgery for thyroid cancer may need further treatment. This is decided when all the results of the specimens taken at operation have been fully analysed. In some cases this will involve treatment with radioactive iodine under the care of one of their expert Consultant Oncologists, who will discuss the treatment fully before it starts.
Payment and costs
A written estimate of the surgeon’s fees is provided before the operation. Patients who are insured are advised to contact their insurers prior to admission to check their cover for hospital and medical fees.
Procedures performed in the treatment rooms are subject to a hospital charge as well as the consultant’s fees. These charges have been agreed with all the major UK medical insurance companies and does not affect the out-patient allowance.
Inclusive packages for uninsured patients are available on request. The inclusive package fee covers the cost of surgery, anaesthesia and hospitalisation. Payment is required in advance of the operation.
The London Thyroid Clinic
108 Harley St
London W1G 7ET
Tel: +44 (0)20 7563 1234
Fax: +44 (0)20 7563 1212
Web: Visit the London Thyroid Clinic website
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