Endocrine Cancers Program
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.
Endocrine Cancers Program Members
Clemens Bergwitz, MDEndocrinologyClemens W.H. Bergwitz, MD, is an endocrinologist at Yale Medicine who sees patients with primary hyperparathyroidism, general endocrine disorders, hyperthyroidism, thyroid nodules, adrenal disorder, hypophosphatemic disorders and hypogonadism. Dr. Bergwitz’s characterizes the endocrine system as the human body’s own data messaging system. “It sends information to regulate some of our body’s most critical functions,” he says. In addition to treating patients, Dr. Bergwitz conducts research on many of these conditions, and his lab has worked on projects that test various therapies for hereditary endocrine disorders. “I am really a physician-scientist. My patients inspire my research, which eventually leads back to the bedside,” he says. Dr. Bergwitz believes that patients should be the expert of their own illness. He strives to explain conditions and treatments in plain language so that patients not only understand their disorder, but also the biological mechanisms behind it. “I’m interested in providing my patients with the information they need to not only understand their condition, but to empower them to take good care of themselves,” he says.
Elizabeth H. Holt, MD, PhDEndocrinology, Internal MedicineElizabeth H. Holt, MD, PhD, treats patients with such endocrine conditions as adrenal disorders, pituitary disorders, osteoporosis and thyroid cancer. Dr. Holt is an associate professor of medicine (endocrinology) at Yale School of Medicine. Connecticut Magazine has included her in its annual list of the state’s Top Doctors.
Silvio Inzucchi, MDEndocrinology, Diabetes Medicine & ManagementSilvio E. Inzucchi, MD, director of the Yale Medicine Diabetes Center, treats patients who suffer from diabetes as well as pituitary and adrenal disorders. “Endocrinology is fascinating, and we are usually able to help patients improve their quality of life through multidisciplinary care and academic approaches to endocrine conditions,” he says. Dr. Inzucchi is a professor or medicine (endocrinology) at Yale School of Medicine and the clinical director of the section of endocrinology. In his research, Dr. Inzucchi, studies the cardiovascular effects of diabetes medications and glucose management in the hospital. Named a “top doctor” locally and nationally, Dr. Inzucchi has also received Yale’s David J. Leffell Prize for Clinical Excellence. The prize is given to individuals who demonstrate the highest level of clinical expertise, commitment to teaching and compassion for patients. He says he has developed an effective personal approach to treating patients, carefully honed over 30 years at Yale. It includes being on top of the latest advances, but also responding to each patient’s individual needs. “I like to try to draw people out in terms of who they are, what’s important to them, their life experiences and their family. Such an approach resonates with patients because they don’t want to be seen as a patient, they want to be treated as a person,” he says.
News from Endocrine Cancers Program
Endocrine Cancer Trials
- Thyroid and Other Endocrine Cancers
A Phase II Study Using Regorafenib as Second or Third Line Therapy in Metastatic Medullary Thyroid Cancer
- Ages18 years and older
- Colorectal Cancer, Stomach and Esophagus, Kidney Cancer, Head and Neck Cancers, Lung Cancer, Thyroid and Other Endocrine Cancers, Gynecological Cancers, Other Cancers, Bladder Cancer, Pancreatic Cancer, Prostate Cancer, Cancer, Breast Cancer
DART: Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors
- Ages18 years and older