OL
—
CC
individual and arrangements be made for one copy to be retained by the
Government of Micronesia so that it can be referred to at any time as
I recommend
required by doctors or a person of similar qualifications.
also that more highly trained health aids be stationed on the islands and
have doctors visit the island 3-4 times a year for examination and consultation, and that both the doctors and health aids cooperate in maintaining
the health of the residents.
2.
a.
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I shall limit my report to thyroid diseases.
Surgical Treatment:
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of laboratory test results with the doctor*s opinion is prepared for each
appropriate.
The operations for thyroid cancer that have been conducted are
It is usually the case with adenomatous goiter that operation
is performed only after the tumor becomes enlarged causing disturbances.
Therefore, for small adenomatous goiters as seen in many of the exposed,
total thyroidectomy or similar operations are not required.
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Therefore, it is safer to perform such operations on cases with even the
Slightest suspicion.
(2)
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From the biopsy specimens prepared from surgical material,
I received the impression that some parts showed severe cell abnormality.
Considerations must be given to the possibility of such areas developing
into cancer in the future. From the standpoint of preventing radiation
induced cancer from occurring, it is safer to perform such operations.
Medical Treatment:
(1) Treatment with Synthyroid after operation of the thyroid
is considered as having been properly administered in view of the fact that
the patients failed to show symptoms considered as due to hypothyroidism.
Administration of Synthyroid for prevention of thyroid
diseases is also considered as being properly handled, though some patients
were found not to be taking the medicine as instructed by the doctor.
This
is considered due to the reason stated in l-c, and the necessity for a means
to more effectively utilize the results of examinations as stated in 1-d
was keenly felt.
b.
The above stated opinions are presented on the basis of my
knowledge, experience and reference from medical literature.
3.
Additional Comments
Item 1.
This is beyond the realm of my speciality
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Under the present system where one examination is made
per year, it is not possible to make detailed follow-up observations.
(2)
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209
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It is enough
to closely follow the course and perform an operation only when cancer is
strongly suspected. However, for the following reasons, the treatment
given in the past is considered to have been inevitable.