Expert Voices: Florida physician shares innovations in thyroid cancer care

Physicians have always been at the heart of HCA Healthcare — two of our three founders were physicians. Today, that legacy continues through a network of more than 44,000 active and affiliated physicians whose clinical expertise shapes how care is delivered across our system. Through our blog series, HCA Healthcare Expert Voices, we spotlight exemplary physicians who are advancing the practice of medicine — bringing deep clinical insight, leading-edge research and innovative care strategies to some of the most complex and critical patient needs.

Dr. Rashmi Roy, Thyroid Surgeon
Hospital for Endocrine Surgery, a part of HCA Florida South Tampa Hospital (Tampa, Florida)

The thyroid plays a critical role in regulating the body’s metabolism and overall health — but when something goes wrong, it isn’t always immediately apparent. In fact, thyroid cancer — one of the fastest growing cancers in women — often develops silently and without symptoms or abnormal lab results.

The clinical reality underscores the need for a more proactive, specialized approach to detection and treatment. At the Hospital for Endocrine Surgery, a part of HCA Florida Healthcare, Dr. Rashmi Roy and her colleagues are advancing a model of care designed to identify disease earlier and treat it with greater precision.

With outcomes that significantly outperform national benchmarks, their work reflects a broader shift toward coordinated, high-expertise care that improves both patient experience and clinical results.

“The first thing I tell patients when they’re diagnosed with papillary thyroid cancer is don’t panic,” Dr. Roy shared. “You have your diagnosis, you’re going to get an expert evaluation and operation, and your surgery is going to be curative.”

“Our surgery outcomes here at the Hospital for Endocrine Surgery for well-differentiated thyroid cancers are excellent, with a very low risk of recurrence.” Dr. Roy said. “This is because of the expertise of our surgeons and the techniques we use.”

That confidence is grounded not only in experience, but in a care model intentionally designed to reduce delays and eliminate fragmentation. From the moment a patient fills out a form on the hospital’s website, they are quickly connected with a surgeon   often within 48 hours — to review their case and discuss next steps.

On the day of their visit to the hospital, patients may undergo a high-resolution ultrasound biopsy with rapid bedside pathology results and, when appropriate, surgery — and if indicated, all within a single, coordinated episode of care. By integrating diagnostics and treatment, this approach accelerates time to intervention while reducing the uncertainty and anxiety that often accompany a cancer diagnosis.

High-volume specialization is central to this model. The Hospital for Endocrine Surgery is staffed by a team of highly specialized thyroid surgeons who collectively perform over 2,000 thyroid operations each year, supported by dedicated nurses, anesthesiologists and other care team members. Every surgery is performed by two expert thyroid surgeons — an approach designed to enhance precision and minimize complications in an anatomically complex area.

“The thyroid is all about real estate,” Dr. Roy explained, referencing its proximity to the vocal cord nerves, windpipe, esophagus and parathyroid glands — structures that require expert-level experience to protect.

Beyond the operating room, Dr. Roy is helping expand access to earlier detection of thyroid cancer through community-based screening initiatives. After identifying a need during a local wellness event, she launched a free thyroid cancer screening program across the Tampa Bay area, and will soon be taking it to Austin, Texas in April 2026..

Since 2022, more than 600 women have been screened — leading to over a dozen thyroid cancer diagnoses that may not have been identified until later stages. By bringing portable ultrasound technology directly into the community, her team helps remove barriers to care and identify disease earlier, when it’s most treatable. Dr. Roy’s work was recently published in a national peer-reviewed journal emphasizing the need for screening thyroid ultrasounds.

“Early detection, just like any cancer, means an early cure,” she emphasizes.

What conditions and disorders affect the thyroid?

Dr. Roy: The thyroid is kind of like the thermostat for the body, producing the key hormones that play a central role in regulating your body’s metabolism and temperature tolerance. While it may seem like just a small, butterfly-shaped gland in the front of your neck, it has wide-reaching effects throughout your entire body and is what keeps everything in order. Because thyroid hormones affect nearly every cell in your body, even small imbalances can make you feel “off.” 

When we talk about thyroid conditions, it’s important to distinguish the two main categories: thyroid function disorders and thyroid cancer. A common misconception is that if someone has thyroid cancer, their thyroid hormone levels must be abnormal. In reality, many people with thyroid cancer have completely normal thyroid function. That’s why it’s important to differentiate between hormone function disorders and nodular or cancerous changes to the gland.

Thyroid function disorders

Thyroid function disorders relate to how well the thyroid produces hormones – specifically T3 (triiodothyronine) and T4 (thyroxine) — and how those hormones affect the body.

• Hypothyroidism occurs when the thyroid function is low and does not produce enough hormones, slowing the body’s metabolism. It affects nearly 5 out of 100 Americans ages 12 years and older, although many cases are mild. Symptoms may include fatigue, weight gain, trouble tolerating cold, dry skin, hair thinning, heavy or irregular menstrual periods or fertility problems, slowed heart rate or depression. The most common cause is Hashimoto’s thyroiditis, an autoimmune disorder.
• Hyperthyroidism is the opposite as the thyroid is producing too many thyroid hormones, accelerating the body’s systems. It affects about 1 out of 100 Americans ages 12 years and older. Symptoms can vary from person to person, but may include heart palpitations, tremors, insomnia, sweating or trouble tolerating heat and weight loss. The most common cause is called Graves’ disease, another autoimmune condition.

Thyroid cancer

Thyroid cancer involves abnormal cell growth within the thyroid gland rather than a hormone production issue. It can be difficult to detect early because it often presents without symptoms in its early stages. As the cancer progresses, it may form a nodule — a small lump that can sometimes be felt or detected during imaging, such as an ultrasound, CT or MRI scans. Thyroid nodules are common, especially in older adults, and the majority are benign or non-cancerous. However, a small percentage are malignant or cancerous, meaning they can spread to lymph nodes or even invade nearby tissues. Importantly, many individuals with thyroid cancer still have normal thyroid hormone levels and no symptoms of hypothyroidism or hyperthyroidism.

What are the different types of thyroid cancer?

Dr. Roy: There are several types of thyroid cancer, but most fall into three main categories: differentiated (papillary, follicular and oncocytic), medullary and anaplastic. The majority of thyroid cancers are differentiated, meaning the cancer cells still look somewhat like normal thyroid cells in the lab.

• Papillary thyroid cancer is the most common type, accounting for about 80% of cases. It typically grows slowly, usually develops in just one lobe of the thyroid gland and sometimes spreads to the lymph nodes in the neck.
• Follicular thyroid cancer is the next most common type as it makes up about 10% of cases. This type of thyroid cancer does not usually spread to the lymph nodes but can have the potential to spread to other areas of the body like the lungs or bones.
• Oncocytic carcinoma of the thyroid (Hürthle cell cancer) is less common and arises from oncocytes, a type of follicular cells in the thyroid gland and also has the potential to spread to lung and bone.    
• Medullary thyroid cancer develops from the C cells of the thyroid gland, which normally produce calcitonin – a hormone that helps control the amount of calcium in blood. This type of cancer can spread to the lymph nodes, lungs or liver sometimes before a thyroid nodule is even discovered. 
• Anaplastic thyroid cancer is a rare but aggressive form that rapidly grows and spreads quickly into the neck and other parts of the body. It is the most fatal cancer known to mankind.

How do you screen for thyroid cancer?  

Dr. Roy: Thyroid cancer is often found incidentally because patients don’t have symptoms and have normal thyroid labs. In some cases, patients may notice a lump or bump in the lower front of the neck where your thyroid is, near the collarbone and beside the windpipe — if you could imagine a pea or grape underneath your skin. Other possible signs include swollen lymph nodes in the neck, frequent throat clearing, a persistent cough when you’re not sick or difficulty swallowing or a sensation of tightness or pressure in the neck.

If you notice these symptoms, schedule an appointment with a healthcare provider who will review your medical history, risk factors and perform a physical exam. During the exam, they will carefully feel the thyroid gland and surrounding lymph nodes to check for firmness, enlargement or nodules.

If a nodule or abnormality is found, an ultrasound is typically the next step. Imaging helps determine the size and characteristics of a nodule and whether it looks suspicious. Depending on those findings, further testing may be recommended to determine whether the cells are benign or cancerous. If cancer is confirmed, or if the nodule is large, growing or causing symptoms, your doctor will discuss the surgical options you have available.

What are the main thyroid cancer treatment options?

Dr. Roy: Surgery remains the primary and most effective treatment for thyroid cancer. Our goal is to cure a patient’s cancer with only one operation and with the most minimal operation necessary.

In some cases, removing only half of the thyroid gland is sufficient. For more advanced or aggressive cancers, the entire thyroid gland and nearby lymph nodes may need to be removed. The surgical approach depends on the type of cancer, its size and whether it has spread.

What does recovery from thyroid surgery look like?

Dr. Roy: Recovery is typically quicker than many patients expect. I tell my patients, I expect you to be up, walking, talking, eating and caring for yourself the same day as surgery. There are no dietary restrictions and no bed rest required — in fact, I want my patients up and walking around.

At the Hospital for Endocrine Surgery, we pair leading-edge techniques including minimally invasive and robotic-assisted approaches when appropriate, with HCA Healthcare’s enhanced surgical recovery protocols designed to optimize outcomes and accelerate healing. Early mobility is an important component of enhanced surgical recovery.

The most common discomfort after surgery is a sore throat, which is usually caused by the breathing tube used during anesthesia rather than the surgery itself. This discomfort typically lasts a few days. By about one week after surgery, most patients feel roughly 90% back to normal.

The main restriction is avoiding heavy lifting, strenuous activity and swimming for about three weeks to allow proper healing. I tell my patients to take about a week off from work, though some feel ready to return sooner depending on their job. Overall, recovery is generally smooth, and most patients resume their regular routines quickly.

What should women know about early detection of thyroid cancer? 

Dr. Roy: Thyroid cancer is one of the fastest rising cancers in women, and there’s no way to detect it unless you’re looking for it.

One of the most common questions I hear is, “Dr. Roy, how is it possible that I have thyroid cancer when my thyroid labs have always been normal?” Many patients assume that abnormal thyroid blood work would be the first sign of a problem. But thyroid cancer typically does not affect thyroid hormone levels, which means your labs can be completely normal even if cancer is present. I encourage women to be proactive and familiar with their bodies. Just like you do self-breast exams, do your own neck exam. When you’re putting on lotion or showering, gently feel the lower front of your neck and the sides of your neck to notice any new lumps, bumps or areas of fullness. If you detect something unusual, it’s important to follow up with a healthcare provider.

What innovations in thyroid care are most exciting right now?

Dr. Roy: We’re seeing significant advancements in both surgical and non-surgical approaches.

One of the most exciting advancements we offer at the Hospital for Endocrine Surgery is a robotic approach to thyroid surgery for patients who fit the criteria. The robotic approach allows us to remove cancer without making a visible incision on the neck. Instead, the small incision is hidden discreetly under the arm. That means that certain patients who are candidates for robotic surgery can be cured of their thyroid cancer without a noticeable neck scar. We are one of the few hospitals in the country offering robotic thyroid surgery and the only hospital currently performing single-port robotic thyroid surgery, which uses an even smaller incision under the arm.

We also offer radiofrequency ablation (RFA), a nonsurgical treatment for smaller benign thyroid nodules. While RFA is not used to treat thyroid cancer, it is an excellent option for patients with non-cancerous nodules that are causing symptoms. This in-office procedure uses a heat probe to shrink nodules, allowing some patients to avoid surgery altogether.

We’re able to deliver better outcomes by stressing earlier detection, advancing precision, strengthening coordination and making recovery as seamless as possible for patients — while continuously improving and sharing learnings across the broader healthcare community.