Oct 26, 2010 - 5:25 pm
In August 2010 underwent partial thyroid removal for suspected Hurthle cell node. Post surgery pathology report from the University of Iowa Hosps. and Clinics came back positive for Hurthle cell carcinoma. The chances of that diagnosis were 1 in 5 per the thyroid doctor/surgeon. Nodule was fully ecapsulated, no sign of invading the capsule, but widely invasive of vascular system at more than 4 points. No signs of any cancer outside the capsule at time of surgery. Size of tumor- 1.5cm at widest point. Age of patient at time of diagnosis and initial thyroid surgery 56, male. No patient symptoms, node was found by doctor during a routine physical.
Based on path report, they removed the rest of the thyroid September 13, 2010. No problems. Surgeon later told me there was a one mm speck on the remaining piece of thyroid they removed and it wasn’t examined since they already know the one mm speck is a cancerous spec or spot. Anyway, thyroid completely gone , no problems.
I-131 ablation pill was administered one month later on Oct 13, 2010. No problems. Full body scan one week later on Oct 20, 2010. Endoctrinologist says scan comes back showing I-131 absorbsion uptake at the front of the neck where the thyroid was.
Endoctrinologist says it’s suspicious, says the Hurthle cell cancer may have spread to the lymph nodes there. My endoctrinologist says he will show the body scan to another doctor, consult with him on the scan results and then call me. Endoctrininologist calls me within 24 hours and tells me the lymph nodes show Hurthle cell cancer cells. Chances of that happening per the doctor were 1 in 10.
Now taking thyroid pills and feel back to my old self.
I asked the endoctrinologist whether it would be best to immediately cut out the infected lymph nodes. Endoctrinologist then says the I-131 dose I got may kill the cancer in the lymph nodes as well as ablate any microscopic thyroid tissue left after the surgeries. He says we’ll have to wait and see. He plans another dose of I-131 in 4 months (that’s about February 2011) and then another scan to see if everything was killed off or if it’s still there in the lymph nodes or worse, has spread.
He also asked if I wanted to get a second opinion. I was thinking just cut out the lymph nodes now and be done with it and hope for the best. My understanding is that I-131 rarely kills Hurthle cancer cells. Only works about 1 time in 10.
So far I don't feel so lucky. Any comments or thoughts? and can anyone recommend someone or someplace good for a second opinion on all of this? I'd like to find my own source rather than have my endo refer me to a colleague of his. I'm just more comfortable that way. I called Mayo but they can’t see me until late December 2010. I'm thinking of going to the cancer center at the University of Iowa Hospitals and Clinics. Anywhere else in the Midwest to consider?