Mr Jonathan Bernstein areas of expertise:

Professional statement

Mr Jonathan Bernstein is a Consultant in Otolaryngology - Head and Neck Surgery specialising in head and neck surgery, thyroid surgery and ear, nose and throat conditions (ENT). From London originally, Jonathan qualified at Bristol University in 2002 and trained in Bristol, Manchester and Toronto. After completing UK training, Mr Bernstein undertook a three-year comprehensive fellowship programme in head and neck surgical oncology, reconstructive microsurgery and thyroid/ parathyroid surgery at the Department of Otolaryngology - Head & Neck Surgery, University of Toronto.

Mr Bernstein is Honorary Clinical Senior Lecturer at Imperial College London. He completed a two-year period of translational research and was granted a doctorate in cancer biology by the University of Manchester. He has undertaken research in clinical outcomes in thyroid cancer, surgical technology, head and neck cancer biomarkers, and functional MRI.

His surgical interests include salivary gland surgery (parotid/ submandibular), head and neck cancers (neck, mouth, throat), thyroid surgery and reconstructive techniques.

In your consultation with Mr Bernstein, he will discuss with you your opinion and preference, your health and medical history, and current best options for treatment.

Doctor's articles

Thyroid cancer: ask an expert

Credentials

GMC: ‍6051021

Professional experience

• Consultant Surgeon, Otolaryngology - Head & Neck Surgery, Imperial College Healthcare NHS Trust (present)
• Consultant Surgeon, Thyroid and Head & Neck Units, The Royal Marsden NHS Foundation Trust (present)
• Honorary Clinical Senior Lecturer, Imperial College London

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Sub-specialties

• Thyroid surgery
• Head and neck cancer
• Salivary gland lesions
• Neck lump
• Throat conditions
• ENT
• Thyroid cancer surgery
• Complex and reoperative thyroid cancer surgery
• Papillary thyroid carcinoma
• Medullary thyroid carcinoma
• Follicular thyroid carcinoma
• Ultrasound and biopsy
• Tonsillitis
• Branchial cyst
• Pharyngeal pouch / Zenker diverticulum
• Surgical oncology
• Dysphagia
• Hoarseness
• Parotid tumour
• Submandibular gland

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Teaching posts

• Honorary Clinical Senior Lecturer, Imperial College London

Education

• Advanced fellowship programme in head & neck surgical oncology, endocrine head & neck surgery, and reconstructive microsurgery, 3 years, University of Toronto (2013)
• Doctoral research degree in head and neck oncology, University of Manchester (2011)
• FRCS (Fellow of the Royal College of Surgeons of England) (2010)
• DOHNS (Diploma in Otolaryngology - Head & Neck Surgery), Royal College of Surgeons of England (2006)
• MRCS (Member of the Royal College of Surgeons of Enlgand, Royal College od Surgeons of England) (2005)
• MB ChB (Bachelor of Medicine, Bachelor of Surgery), University of Bristol (2002)

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Publications and conferences

• http://thyroidworldcongress.com/speaker/jonathan-bernstein/

Professional membership

• British Association of Endocrine and Thyroid Surgeons
• British Association of Head and Neck Oncology
• American Head and Neck Society
• The Royal College of Surgeons of England
• European Head and Neck Society

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Languages spoken

English

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15/01/2018

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Patient, knowledgeable, smiling doctor, who puts patients at ease with his impeccable bedside manners and infuses confidence with his skill and knowledge.

M. Verified Patient
14/11/2017

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Diseases, Medical Tests and Treatments

Head and neck cancer

What is head and neck cancer? Head and neck cancer can refer to a number of different types of tumours in various parts of the head and neck, i ...

Hoarseness

Hoarseness is when the voice becomes raspy and strained, and can be accompanied by a sore throat. It can follow an illness like viral laryngitis or ca ...

Neck lump

How common are neck lumps and are they serious? Neck lumps are extremely common and in the vast majority of cases are benign. They can be found any ...

Parotid gland surgery

What are the parotid glands? There are three main pairs of salivary glands that produce and release saliva into the mouth: the submandibular glands ...

Salivary gland surgery

The major salivary glands produce saliva in the mouth. There are three pairs: the submandibular gland, sublingual salivary glands and the parotid glands. Surgery of the parotid gland, also known as parotidectomy, is the operation to remove tumours that grow in the gland. It is estimated that over 70 percent of these tumours are benign (noncancerous) but any detection should be examined. The surgery performed depends on the type of tumour and its size and location. The most common are superficial parotidectomy or total parotidectomy, with conservation of the facial nerve, which also involves a lymph node dissection. The salivary glands may also suffer other diseases, the most common being: sialolithiasis, which is blockage of the salivary glands by the presence of calcium stones that prevent the output of saliva and cause inflammation of the gland; and sialadenitis, the infection of the salivary glands, which can be an effect of sialolithiasis, or be caused by a virus or bacteria...

Thyroid cancer

What is thyroid cancer? Thyroid cancer is a type of cancer which affects the thyroid gland, which releases thyroid hormones that help control the body’s metabolism. Thyroid cancer is relatively rare, and in most cases it is treatable. Thyroid cancer most commonly affects those above the age of 60, and those in their 30s. Thyroid cancer is also more commonly found in women than in men. What are the symptoms of thyroid cancer? Thyroid cancer symptoms include: Swollen glands A sore throat that doesn’t go away over time Trouble swallowing Hoarseness which occurs for no reason, and again does not go away over time A lump in the front of the neck (painless) Difficulty breathing Neck lumps are usually not cancerous, and they are often caused by less serious conditions such as an enlarged thyroid gland. However, if you have a lump in your neck, it’s important to have it checked, to be sure. What causes thyroid cancer? The cause of thyroid cancer is largely unknown, but there are certain factors which increase the risk of developing thyroid cancer. Those with a family history of thyroid cancer are at a higher risk, but it is important to remember that thyroid cancer is still rare, even if a family member has it. Exposure to radiation can be a risk factor for thyroid cancer, with it being more common in those who have undergone radiotherapy treatment, particularly during childhood. The risk of thyroid cancer is not generally higher in those who are regularly exposed to radiation through work, though in those who have survived atomic accidents or explosions, the risk is higher and thyroid cancer is more common. Thyroid cancer is also more common in those who are overweight, have diabetes, and those have had cancer before. How can it be prevented? Most cases of thyroid cancer are not preventable. However, as radiation is a known risk factor, medically it is not used in the treatment of less serious diseases. X-rays and imaging scans also increase exposure to radiation, so these types of test are only administered when absolutely necessary. What is the treatment for thyroid cancer? Treatment for thyroid cancer depends on how far along the cancer is (i.e if it has spread) and what type of cancer it is. Treatment is generally successful and there are various types administered, including external radiotherapy, chemotherapy targeting cancer cells, an iodine treatment which kills the cancer cells in the body, and surgery. Surgery removes all, or part, of the thyroid. After treatment is administered, and the cancer is removed, it is important to have further check-ups to make sure the cancer does not return. However, prognosis for thyroid cancer is good, and if it does return, it can be treated again successfully. ...

Dysphagia

Dysphagia, or discomfort when swallowing, refers to difficulty in swallowing or swallowing food, and is most common in elderly patients. In many cases it is a consequence of cerebrovascular accidents, Alzheimer's, Parkinson's or tracheotomies, diseases that cause problems in the tongue, the muscles of the throat and the oesophagus. Practical treatments focus on preventing food from getting stuck: exercises to strengthen the jaw muscles, sitting upright, waiting for three hours after eating in order to go to sleep, ingesting food in small amounts and accompanying it with plenty of liquid, and eating meals slowly. ...

Surgical oncology

What is surgical oncology? Surgical oncology is a branch of surgery focussing on the surgical management of tumours, in particular malignant (cancerous) tumours. While the term is frequently used, surgical oncology is not recognised as a specialty by the GMC (General Medical Council); rather, it is a term encompassing a number of disciplines across several specialties, for example, an otolaryngologist with a sub-specialty interest in the surgical treatment of head and neck cancer could be said to be a specialist in surgical oncology, as could a gynaecologic oncologist. Because of the varying natures and locations of different cancers, it is virtually impossible for one surgeon to specialise in surgery for every kind of tumour; however, surgeons of any specialty who are thoroughly involved in performing operations to treat cancer/tumours may consider themselves surgical oncologists. What conditions are treated under surgical oncology? Cells in just about every part of the body have the potential to mutate and become cancerous or form tumours. For this reason, surgical oncology covers a myriad of conditions. It is common for the surgeon to specialise in treating illnesses of the specific part of the body, with surgical oncology as a sub-specialty, as oppose to specialising in all types of cancer. Conditions that fall under the category of surgical oncology include: Breast cancer Colorectal cancer Head and neck cancer Melanoma Pancreatic cancer/tumours Sarcoma Other types of skin cancer Thyroid tumours What does surgical oncology involve? Surgical oncology essentially involves cutting the tumour or cancer out of the patient in a very delicate operation. Once the only option for curing a patient of cancer, the last century has seen the arrival of two sister branches of cancer care: medical oncology and radiation oncology. With many cancers, medication and radiation is not enough, and they are used in conjunction with surgery. Because of the advances in modern cancer care and cancer research, surgical oncology has also evolved, with the oncological surgeon now typically leading multi-disciplinary teams, collaborating with radiation oncologists, medical oncologists, radiologists, and others to counter the cancer in the most effective way possible. They must have a complete understanding of the biology and history of the disease. Surgical oncology as a specialty? While it is not currently recognised as a specialty in the UK (or in many other countries), there is some debate as to whether it should be. While some argue that no surgeon can truly specialise in every type of cancer, other propose that due to the expertise involved, and the importance of understanding the multi-disciplinary approach to treating cancer, there should be a specialist ‘surgical oncology’ accreditation. The European Society of Surgical Oncology is one such proponent of the latter, arguing that having such accreditation standardised would raise cancer care standards across Europe. Currently, there are a number of fellowships available for surgeons looking to get specialist training in surgical oncology. ...

Throat cancer / laryngeal cancer

Cancers of the throat and larynx are types of head and neck cancer. Depending on the location, the cancer can be classified as supraglottic tumour (above the glottis), glottic tumour or subglottic tumour (below the glottis). What is laryngeal cancer? The larynx, or voicebox, is an important part of the throat that helps us to speak and breathe. Laryngeal cancer comes in the form of malignant tumours that affects the cells of the larynx where the vocal cords are located. What are the symptoms of laryngeal cancer Symptoms of laryngeal cancer include: Hoarseness Neck lump Persistent sore throat Long-lasting cough Pain or difficulty when swallowing Breathlessness Wheezing Unexplained weight loss What is throat cancer? Throat cancer or oropharyngeal cancer tends to start behind the nose in the part of the throat that helps you swallow. What are the symptoms of throat cancer Symptoms of Oropharyngeal cancer include: Swelling or lump in the neck Sore throat Dysphagia Changes in your voice Earache Bad breath Unexplained weight loss What causes throat and laryngeal cancer? Smoking tobacco, drinking a lot of alcohol, an unhealthy diet, and exposure to harmful chemicals or substances like coal dust or asbestos increase the risk of laryngeal cancer. It also seems to run in families with a history of head and neck cancer. Throat/laryngeal cancer treatment Early detection of the disease is essential to increase the life expectancy of patients. The treatment is based on removing the tumour, while avoiding its spread to other parts of the body. Depending on the case, surgery may involve partial or total removal of the vocal cords, and treatment with radiotherapy and chemotherapy. ...

Thyroid disorders

What are thyroid disorders? The thyroid is an essential gland in the body which produces thyroid hormones. These hormones control and influence many bodily functions, such as body temperature, energy levels, and metabolism. Thyroid disorders occur for different reasons, but they have an effect on the body’s metabolic functions and produce adverse reactions. Thyroid disorders are relatively common and worldwide, they affect more women than men. What are the symptoms? There are many types of thyroid disorder, meaning there are also many different symptoms. Symptoms depend on the kind of thyroid disorder the patient has. Some more common thyroid problems include goitre, hyperthyroidism, hypothyroidism, thyroid nodules, and thyroiditis. Thyroid cancer is another condition affecting the thyroid. These conditions affect bodily functions and the metabolic system, so symptoms can include: Weight gain Menstrual changes Poor concentration Nervousness Feeling depressed Fatigue Feeling cold Hair loss Mood swings Low sex drive Symptoms vary depending on the type of thyroid disorder, and doctors will take a medical history and assess the symptoms displayed in order to correctly diagnose the type of thyroid condition affecting the patient. What causes thyroid disorders? Thyroid disorders can be caused in different ways, including related conditions such as autoimmune disease or inflammatory disorders, certain medication, radiation therapy (e.g for cancer), pregnancy, iodine deficiency, and congenital disease. There are various different causes and anyone can develop a thyroid condition. Some risk factors include: Being a woman over the age of sixty Having received radiation therapy in the neck or chest Being pregnant or having had a baby in the last 6 months Having an autoimmune disease Having a family history of thyroid disorder Having had thyroid surgery How can they be prevented? Thyroid disorders cannot really be prevented, but keeping the thyroid healthy is important and there are certain things you can do to reduce the risk. Cigarette smokers are more likely to develop thyroid eye complications related to Graves’ disease, and certain toxins in cigarettes can affect the thyroid, triggering thyroid disease. During X-rays, a special collar can be worn which covers the thyroid and reduces the chances of it being exposed to radiation. What is the treatment? There are various treatments of thyroid disorders, as there are multiple types of condition and each case must be considered individually. In order to correctly diagnose the thyroid condition, a doctor must first investigate and take a medical history, and measure thyroid hormone levels. A medical evaluation is essential in order to assess what kind of care is needed. Treatments include medication to lower, supplement or eliminate hormone production, and surgery to remove the thyroid gland, sometimes indicated in those with cancer, or particularly large goitres. ...

Thyroid gland surgery

What is thyroid gland surgery? Thyroid gland surgery is a treatment for a number of thyroid problems. The thyroid gland sits in the neck and secretes hormones that regulate the body’s metabolism. For conditions that affect the gland, thyroid gland surgery is the recommended treatment and all or part of the thyroid may be removed. The procedure is known as a thyroidectomy. Why would you do it? Thyroid problems are common. There are a number of conditions that can arise with the thyroid gland and many of them can be treated with medication. In some cases however, thyroid gland surgery is recommended to treat a range of conditions that affect the gland, including cancer, Grave’s disease, recurrent cysts or goitres (swelling due to an enlarged thyroid gland) that are problematic. What does it involve? The procedure usually involves removing all or a portion of the thyroid. A total thyroidectomy would involve removing the whole gland, whilst a lobectomy is the removal of half of the gland. Sometimes an isthmusectomy is performed to remove the central part of the gland. The portion of the thyroid that is to be removed will depend on the nature and extent of the condition. There are three main types of surgery. Conventional surgery involves making an incision in the neck through which all or the required portion of the thyroid is removed. Endoscopic thyroid surgery involves the use of video cameras inserted through small incisions to guide the surgeon performing the operation. In more recent times, a robotic thyroidectomy has been used, which allows the operation to be performed through incisions in the chest or armpit, avoiding incisions in the middle of the neck. In all cases, thyroid gland surgery will be carried out under a general anaesthetic. How to prepare for it As with any operation, a patient will be assessed for their suitability beforehand. Patients may also be required to stop eating for a period before surgery. Post-operative care In most cases, it is possible to leave the hospital in a few days. It is important to avoid putting strain on the neck for a few weeks following the operation. Neck pain and voice problems are not uncommon but usually resolve by themselves. In the case of a total thyroidectomy, where the whole thyroid gland is removed, the patient will need to take medication to compensate for the hormone usually produced by the gland itself. For a partial thyroidectomy, the remaining portion of the thyroid will often compensate for the entire gland over time and medication may not be needed. ...

Tonsillitis

What is tonsillitis? Tonsillitis is an inflammation of the tonsils that are located at the back of the throat. It is very common in children and adolescents, but adults can suffer from tonsillitis too. What are the symptoms of tonsillitis? If you have tonsillitis, your tonsils will be red and swollen. You will also have a combination of the following symptoms: A sore throat A fever (temperature of 38C or over) A headache Fatigue Nausea Difficulty swallowing Earache White pus-filled spots on the tonsils Swollen glands in the neck What causes tonsillitis? Tonsillitis is caused by a viruses or bacterial infection. Streptococcal tonsillitis is the most common cause. The tonsils are vulnerable to infection because they are one of the body’s first lines of defence in the immune system. Can tonsillitis be prevented? Tonsillitis can be prevented by practising good hygiene: Not sharing eating and drinking utensils. Avoiding contact with those infected. Washing hands frequently. How is tonsillitis treated? If your tonsillitis is caused by a virus, then at-home care is the only treatment for recovery. The following can be used to promote a quicker, more comfortable recovery: Throat lozenges Rest Staying hydrated Avoiding caffeine Gargling with salt water Using painkillers to manage discomfort If your tonsillitis is caused by a bacterial infection, then you will be prescribed a course of antibiotics. These must be taken as instructed, and the full course finished. People who suffer from tonsillitis frequently are advised to have the tonsils removed. If an abscess forms between the tonsils (this is called a quinsy), see a doctor, as this may need to be drained. ...

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Other information about Jonathan Bernstein

Publications in the National Institute of Health

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