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Thyroid Remanent

aluap
Posts: 1
Joined: Mar 2005

I would so appreciate any feed-back from anyone out there!!! In Jan. of 1991 I had the left lobe of my thyroid removed because of a goiter. The Surgeon told me it looked like a benign situation when he opened me up. When I went for my follow-up visit he said they found a pathologist's finding of incidental papillary cancer. He said I needed no further treatment, adn that I should do follow-up with an Endocrinologist which I did for the past 14 years. Last April my Endo said he felt something cobbly and firm on the right side. I went through a couple of biopsies and in the end one came back with fragments of cancer cells found. I opted to have surgery to remove the left lobe or a total thyroidectomy. I had it done in NY last October 2004. I asked the Surgeon if I could wait till after the Holiday's to go off my medicine to have a low dose of radioactive Iodine to clean up any residual cells. By the way, the right side had a tumor with papillary cancer that had gone into the thyroid gland. But the Surgeon felt confident that it was all removed. After 5 weeks of being off my medication in Jan. my TSH levels went down instead of up (which usually happens, I guess) and the Dr. couldn't tell me why that was. So they opted to give me thyrogen injections last week. Then a tracer dose of RAI and they did a total body scan, as well as another scan of my thyroid. Last Friday my Endo called me and said they found a remanent piece of thyroid 18% on the left side, bu the good news was there was no spread of cancer anywhere. He suggested once again having surgery that I told him I refused to have!!! He said option B would be to take me off my medication again, go on a low iodine diet, and perhaps have 3 injections of the thyrogen as well. The original Surgeon who removed the left side feels it would be high risk to cut myneck again for the 3rd time. Does any one out there no anything about using thyrogen to have ablations? Do I have any options other than surgery here? Would very much appreciate feed-back. My e-mail address is pauladimitra@aol.com

Rustifox's picture
Rustifox
Posts: 131
Joined: Mar 2005

Hi, Paula,
18% is quite alot of tissue, from what I understand. Ablation works best on a cellular level. If they were to use a low dose (and it would need to be low, to prevent radiation thyroiditis, with that much tissue - high dose would likely be very, very painful with that much tissue left behind), it is quite likely you would still have alot of tissue left six months down the line. It takes about 6 months for ablation to work - the radioactive iodine continues to try to eliminate the tissues, a few cells at a time. Honestly, if tissue can be removed surgically, it should be. That is the safest, and best way of resolving the growth - which could be benign or malignant, but is a risk factor, one way or another. Have you had a thyroglobulin blood test done (and thyroglobulin antibodies)? Do you know what the result/numbers were?

While I know we hate to have a second, third, or any more surgeries, that would be the safest and likely least painful/most effective way to deal with all that extra tissue. You definitely need a thyroid cancer surgeon, though. I'd likely seek a second opinon from another surgeon, one who has alot of experience with thyroid cancer and specifically thyroid surgeries. If it was me, I'd definitely do the surgery. It will give the ablation the best opportunity to work after the fact, too - it is too hard to try to ablate too much tissue, and often has limited success.

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