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I have an appointment to see thyroid surgeon for evaluation

hopeful girl 1
Posts: 454
Joined: May 2010

Friends,

I have made a couple of posts on this board recently.
I have completed treatment for my uterine cancer on Nov 2nd-which was my last chemo.
I had the treatment program of 6 chemos and 25 radiations, in addition the the surgery.

Now I have the issue of thryoid nodules to check on, that were found as an incidental on a ct back in June during my treatment.

I had a thryoid ultrasound in December which showed a "predominant in size" thyroid--what does that mean? Does that mean thyroid is larger than what is considered normal? Also I have multiple nodules, 2 of the largest are predominantly solid, and one was cystic. I am not sure how many total nodules there are. It showed that the lymph nodes adjacent to the thryoid were NOT enlarged. Is it a bad sign that the two are predominantly solid? I read online that nodules that are part solid and part not, are more likely to be cancerous???
Although I read so much that only 10% or so of all nodules for thyroid are cancerous.

I also had the bloodwork done for thryoid which I was told by my gyno-oncologist's nurse came back normal. That one part of the test which is the cancer marker test, was not back yet-they send that offsite. And my oncologist's nurse said she doesn't know how to read that one, so I don't think she will call me when it comes back anyway. They are referring me to the thyroid surgeon for evaluation.

My appointment is 1/13/10. What should I expect from this appointment do you think? Can they tell much by the tests I had so far? Will they know a lot by touching/feeling the area? I would imagine they will order a fine needle biopsy and or scan right?

Also, if by chance it turns out not to be cancerous, what would be the reasons for a thyroidectomy or the radioactive cocktail to kill off thryoid? Is it so it doesn't keep getting larger? Are there cases where the doc will just continue to monitor you every few months rather than surgery if not cancer?

I look forward to your further feedback.

Cindy

nasher
Posts: 507
Joined: Apr 2010

well lets see if i can try to answer some of your questions

it sounds like you have an enlarged thyroid or thyroid node.

yes a large amount of enlarged thyroid nodes are non cancerous time to quote from sites..
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http://www.mythyroid.com/thyroidnodules.html

Nodules may be solid or filled with fluid (cystic). Thyroid cysts are less likely to be malignant, although cystic nodules with significant solid components (referred to as complex nodules) should be evaluated as solid nodules. Generally, the larger the nodule, the greater possibility that thyroid cancer may be present. Nevertheless, more than 90% of solid thyroid nodules are usually benign. Nodules may occur as single isolated occurrences (single or solitary nodules), or several nodules may be present (a multinodular gland). Having more than one nodule in the thyroid does not imply a more worrisome problem.
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Blood tests http://thyroid.about.com/library/howto/htthyroid-test.htm
# Find out your thyroid test results from your doctor's office.
# If you can, get a hard copy printout for your own review and home medical files.
# If "normal" or "reference" ranges are not indicated on the lab results, ask your doctor's office to tell you what these ranges are.
# Note the level of your Thyroid Stimulating Hormone (TSH). At most labs in the U.S., up until late 2002, the normal range is from around 0.5 to 5.5. That range changed to .3 to 3 as of early 2003.
# If the TSH level is below normal, your doctor may determine that you are hyperthyroid (overactive thyroid.)
# If the TSH level is above normal, your doctor may determine that you are hypothyroid (underactive thyroid.)
# If your doctor ran a test called Total T4 or Total Thyroxine, normal range is approximately 4.5 to 12.5. If you had a low reading, and a high TSH, your doctor might consider that indicative of hypothyroidism.
# If your doctor ran a test called Total T4 or Total Thyroxine, normal range is approximately 4.5 to 12.5. If you had a low reading, and a low TSH, your doctor might look into a pituitary problem.
# If your doctor ran a test called Free T4, or Free Thyroxine, normal range is approximately 0.7 to 2.0. If your result was less than 0.7, your doctor might consider that indicative of hypothyroidism.
# If your doctor ran a test called Total T3, normal range is approximately 80 to 220. If your result was less than 80, your doctor might consider that indicative of hypothyroidism.
# If your doctor ran a test called Free T3, normal range is approximately 2.3 to 4.2. If your result was less than 2.3, your doctor might consider that indicative of hypothyroidism.
# If your test results come back "normal" but you have many of the symptoms or risk factors for thyroid disease, make sure you ask for an antibodies test. Some doctors believe in treating thyroid symptoms in the presence of elevated antibodies and normal TSH levels.
# If your test results come back "normal" but you have many of the symptoms or risk factors for thyroid disease, consider going to a reputable holistic M.D. or alternative physician for further interpretation and diagnosis.
---

is the thyroid bothering you.. when i had mine removed one of the nodes was 7+cm (think pool ball) and was making it harder to breath.

yes they will probably do a fine needle biopsy
it will either come back clean, positive for cancer, or inconclusive
but they will be able to tell what type of thyroid cells they are.

mine showed up inconclusive and it turned out when they removed 1/2 my thyroid that i had 2 different types of thyroid cancer. so they removed the rest of it.

in my case if it wasn't making it harder to breath they would have waited a few months and watched it.

they can either remove 1/2 the thyroid or the entire thyroid with either surgery it is probably that you will be on thyroid replacement for the rest of your life 1 small pill a day.

if it is inoperable they may use Radioactive iodine to shrink it to make it easier to operate.

if they find out it is cancerous get it removed and do the Radioactive iodine treatment. (from what i know its a breeze compared to chemo)

my year experience is listed in a forum below http://csn.cancer.org/node/204377

I recommend www.thyca.org they have a real good listing of everything.

if they leave it, and its non cancerous it will probably go back to normal size in a few months.

thyroid cancer has a normal life expectancy cause you can be on thyroid replacement pills for the rest of your life with minimal problems and lead a normal life

please ask questions we will try to give you answers. If you don't understand what the doc says get a printout of it ask them to explain it and then ask us we might have some good questions to ask your doctor.

good luck and keep us informed please

Craig

sunnyaz
Posts: 582
Joined: Oct 2010

I concur with everything Craig said as usual. Just one thing to add from my own experience is that my TSH (Thyroid Stimulating Hormone) including T3 and T4 (T4 is converted to TSH in your body) were within normal ranges even though I had cancer. That's why my PCP said that there was no reason to worry or send me for Biopsy or Ultrasound. But, I kept having symptoms of Hypothyroidism, so I insisted on further testing after much research on the internet. I thought I was going crazy but it turns out that I was right, it was Papillary Carcinoma.

I can't express enough that we have to be our own advocates. Like Craig said, get the reports and ask us if you don't understand them and can't get straight answers from your doctor. The tumor marker test is called "Thyroglobulin" and it should be undetectable.

I wish you the best at your appointment and pray for the best possible outcome. Remember that 90% of nodules are non-cancerous, so your odds are pretty good. If they do a biopsy and it comes back positive for cancer, just know that you have friends here to help you through this. Believe me; you will get through this too. This is a walk in the park compared to Uterine Cancer.
God Bless,
Julie-SunnyAZ

hopeful girl 1
Posts: 454
Joined: May 2010

One question I have for both of you is....

If a fna were to show non cancer, but thyroid is enlarged, would they probably still watch and see? I really don't like the thought of more surgery after my two marjor surgeries last year for the uterine cancer. I had my complee hysterectomy end of March and they had to open me back up one week later to the date, as there turned out to be a bladder tear-and they repaired that.

Since I had chemo and radiation from May-Nov 2010 I feel my body is still building back up at this point-and don't want to think I may need another surgery right now.

I did go thru a lot last year, but I know there are many out there who have gone thru' far more than I did, so I feel fortunate. It is enough to worry about hoping that the uterine cancer will not return, I was 3C (aggressive grade), and now I am worrying about my thyroid.

I try to keep the faith that it will all work out.

Thank you both for your kindness and feedback.

Thank you,
Cindy

nasher
Posts: 507
Joined: Apr 2010

yes they will probably do the wait and see unless you push them into surgery

myself i had 4 surgeries last year and radiation therapy and this year (probably feb) i am going into another surgery.. i have tons of medical appointments but i want everything fixed.

if you wish they are wanting to do the surgery and you want to wait i am sure they will put it off. (unless FNA shows cancer).

if you are through with your chemo and dont expect another round and you feel like waiting a month or two that probably wont hurt.

heck for me Dec 5 they found the growth.. they didnt get a FNA till mid January and they didnt do the surgery till 22 Feb. then they found there was cancer in the 1/2 they took out and it was another week from when the found cancer till they removed the rest of my thyroid.

If it appears non cancerous by FNA and it is not bugging you much it probably wont hurt to wait a month or so but realize if you want it out it still may take a month or more just to get everything scheduled.

Again for myself I am trying to get things done as quick as posible so i can get on with life but i keep getting delays on surgeries and the like.

22 Feb 2010 right side thyroidectomy
09 Mar 2010 Thyroidectomy completion
02 Apr 2010 Stapendectomy right ear
05 May 2010 Radioactive Iodine treatment
18 Aug 2010 Stapendectomy Left ear
and its looking like it will be febuary or march before they will get around to fixing the problem they made on my left ear stapendectomy.

they scheduled my surgeries as close as they were willing to for me they wanted me to be healed from the last surgery before the next one.

Remember YOU need to be in charge of your health care so if you are not ready you tell you want to wait till ... if you want it now you need to push them.

please keep us up to date and ask as many questions as you want to

Craig

swt_reyes
Posts: 28
Joined: Nov 2010

I just went through the very exact same thing you are going through! I had one very large “Cold” mass tissue nodule and several very small nodules. We decided not to do a biopsy because I was having problems breathing and the nodules were only going to continue to grow, causing my airways to eventually shut off completely. Most of the signs I had also pointed to cancerous; cold mass tissues, they say a more likely to be cancerous. I had a total thyroidectomy (TT) as you will see people refer to it as that on this site, on Jan 3rd just 1 week ago today. I was so scared I was going out of my mind. I knew about all these things for about 4 or 5 months prior to the actual surgery, so I had a lot of time to research, ponder and worry myself to death. I done most of my research through the National Cancer Society website because I wanted to be positive I was reading legitimate sources! I got my results back just the other day and I am Cancer Free! So you see dear, no matter what the odds point to, you really never know until you know for sure. Just trust in your Doc, and if you don’t find another one that you do. Let them guide you and I am sure they will take great care of you. I know it is hard but you will make it through I am sure of that!

To be honest with you I was freaking out so bad I went to my general Doc about a month b4 the surgery complaining and winning around scared and all. She decided it would be in my best interest to start Prozac once a day and xanax twice a day to help me relax and focus on schooling; I am in college and it was really affecting my concentration with all the worries and also having 3 children and a husband to deal with (might as well say 4 children if ya count him, lol). It really helped me and I am still on the medz as long as I need them. Maybe this might be something that you might want to talk to your Doc about and maybe not I just thought I’d share my experience with you. I hope all goes well with you!

Sincerely,
~Christy~

hopeful girl 1
Posts: 454
Joined: May 2010

Christy,

Thank you for your post.

I am really scared. I am already taking some anxiety meds-I tried to taper them down, but once I found out I need more looked at with thyroid I went back to taking them.

I am hoping that I do not need surgery, and that this is not cancer.

I just completed a year of surgery, chemo and radiation in 2010 for uterine cancer 3C, which was an aggressive cancer.

I have enough worries of that possibly returning, and now this thryoid issue.
I am also scared if could be spreading in my neck etc. As you mentioned I am just researching and reading and imagining the worst possible scenarios.

Tomorrow I go for my evaulation-I am guessing he will want to order a fine needle biopsy and or the scan. To date I have had he ct in June, which showed the nodules, a thyroid ultrasound in December, and thyroid blood work in December as well. So he will look at those records, examine me and determine his findings and next steps.

What bothers me is this was supposed to be my time to relax and enjoy. I finished my last chemo in Novemvber for uterine cancer, and my follow up for uterine cancer is in February. Instead, I am spending the interim worried about the thyroid, and possibly looking at more cancer or treatment or surgery ahead.

My blood counts are still coming up from my last chemo.

Wish me luck tomorrow.

Cindy

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