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Thyroglobulin After Surgery

Celestec
Posts: 12
Joined: Sep 2010

Does anyone know how fast your thyroglobulin levels are supposed to drop after lymph node surgery?
I had surgery on december 21 to remove lymphnodes and a blood test on February 21 and my results said my levels were at 14 and the antibodies were under 20.
My doctor wants me to have RAI again but I'm waiting to hear back from the BRAF gene mutation results before I want to decide to do RAI. Could it be that my levels just haven't dropped enough yet after surgery? I think they were at 16 before surgery.

I had a TT and 40 lymphnodes removed on Nov 23 09 for papillary cancer and radioactive on December 28 09. I had more lymph nodes removed December 21st 2010.

Thank you,
Celeste

miladyx
Posts: 85
Joined: May 2009

did you have any sort of imaging to look for nodes, nodules, etc.? such as MRI, PET, CT?

Celestec
Posts: 12
Joined: Sep 2010

I had a neck ultrasound previous to surgery where they found and did a biopsy on two nodes which were removed in surgery this past December. My doctor now wants a full ct scan. I guess if the neck scan only showed two nodes maybe it is somewhere else? I just was hoping my tg levels just haven't fallen yet.

diane2h81's picture
diane2h81
Posts: 41
Joined: May 2010

I would think that the levels are as far down as they are going to go after surgery. I know after radiation it can take up to 6 months to drop but that is due to the radiation still working. The surgery is done and what was to be removed is removed. But again I am not in the medical field. I would do the radiation as your doctor is suggesting. You want that number to drop.

May I ask a question, did they use the same scar when they did the recent surgery? Or did they do a larger incision? I may be up for a second surgery for lymph node involvement, I have a whole body scan coming up at the end of the month and we will go from there.

Celestec
Posts: 12
Joined: Sep 2010

Thats what I thought too, I was just hoping for something different. I will get the RAI but only if I test negative for BRAF gene mutation. It seems people who test positive for the mutation are unresponsive to the RAI. Im supposed to get the genetic results back at the end of this week. Then I guess I'll make my decisions from there.

When I had my second surgery they made a separate incision on the side of my neck where the nodes were. My original TT scar is less then two inches long and is barely visible now. The second incision is a little over two inches and is still purplish but its directly in the crease of my neck so once it heals it won't be visible at all.

I wish you luck in your whole body scan!

sunnyaz
Posts: 582
Joined: Oct 2010

Hi Celeste,

My Thyroglobulin level was undetectable (below 0.9) after my third surgery (Neck Dissection of Lymph nodes on December 17, 2010). My thyroglobulin was tested a week after the surgery. I have the BRAF so I did the RAI for the second time just to be sure to kill anything microscopic that could grow and cause more cancer. My Oncologist/Endocrinologist/Surgeon didn't give me an option. My first dose was 83 mCi's and second was 178 mCi's (almost the max). That was on February 4th of this year. If you want my opinion, BRAF or not, I would do the RAI to kill anything microscopic.

Celestec
Posts: 12
Joined: Sep 2010

Thanks for the response!
So you have BRAF and the RAI still worked for you? I was under the impression you would have been resistant to it.
My tg level is at 14. Would you think that means its not microscopic and it could be else where in my body?
Sorry for all the questions. I'm mid-semester my Junior year and just got slammed with this news today. I just wish it would go away.

Glad to here your levels are so low now!

miladyx
Posts: 85
Joined: May 2009

i heard that braf may make thyroid cancer a little more aggresive (and more likely to be found in patients >40 years of age) but i have not heard that it makes RAI ineffective.

sunnyaz
Posts: 582
Joined: Oct 2010

Hi Celeste,

The B-RAF can make RAI less responsive however not in all cases. I was very strict with the LID to be sure that I would uptake. With a TG level of 14 there is a possibility that there is cancer present somewhere, but not in all cases. I would see about a CT or an MRI before RAI. If there is a tumor you will want to have it removed before the RAI. RAI won't kill tumors, only microscopic cells left behind after tumor removal.

B-RAF makes cancer more aggressive, harder to treat and faster growing. Age is not a factor, it's a genetic mutation that we are born with or without. About 43% of people have the B-RAF mutation gene and it's important to know if you have it so that you can be more aggressive with treatment.

I know this is hard but you will get through this. I was doing my Internship when I found out I had cancer in October of 2009. I had to put it on hold for two weeks while I had surgery. I was lucky to have an Internship with a doctor who was kind and willing to work with me. He let me come back two weeks after my surgery and finish out my education. There may be some things that you will need to put on hold, but try to realize that there may be a reason that is not within your realm of understanding at this point. Time and distance makes difficult times easier to understand. I could site some examples in my life where this has proven to be true, but I don't want to bore you. I am a very spiritual person and I believe that God has a reason for everything.

Be patient, pray often and focus on the positive things in your life. This too shall pass and you will be stronger and more knowledgeable because of it.

Blessings and prayers,
Julie-SunnyAZ

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