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PET scan question

CherylMike
Posts: 118
Joined: Oct 2009

I was diagnosed with papillary thyroid cancer almost 1 yr ago. I had a total TT and underwent I131 treatment. On September 23rd I had my year out scan. The scan came back clean but my bloodwork was elevated (4.7). I then had a mapping ultrasound, which also came back clean. (My endo ordered all of the follow up tests). I went to my ENT (who had done the orginal TT surgery) to have work done to make my left vocal cord work (it is paralzed). He asked what was going on with the cancer. I gave him the rundown and he ordered a PET scan, which I had yesterday. My question concerns the phone calls I received after I came home. The nurse called and said the radiologist was reading my scan and wanted to know if I had I131 or 123 treaments this month. I told him no, I had a year follow up scan with dose of I131 on Sept. 23rd. He called back to ask how large was the dose (3mc) and where I had it done. Should I be concerned?

CherylMike
Posts: 118
Joined: Oct 2009

I went and picked up the radiologist report. It showed uptake to my right vocal cord (which could possibly be because my left is paralyzed) and uptake to the left ovary. That is scary. Not sure what I should do next. It just sounds like a big needle in a sensitive place may be in order?????

alapah's picture
alapah
Posts: 259
Joined: Oct 2009

do you mean uptake of I-131 or the PET scan medium (that glucose injection solution)? i too have a paralyzed vocal cord and on PET scans my left vocal cord lights up - but they determined this was just picking up elevated activity due to the fact that the left vocal cord is working overtime to compensate for the frozen right one. That may well explain your cord lighting up. you may need something more on the ovary thing. i think that would be a really unusual place for thyca anyway. did they do a CT along with the PET scan?

CherylMike
Posts: 118
Joined: Oct 2009

was what the ovary and vocal cord showed. It did say that the vocal cord may be due to the fact that the other cord is paralyzed. They did a PET-CT. Did you have the injection behind the paralyzed cord? They did that to me when they removed my thyroid. My voice was perfect for 6 months and has steadily gone downhill. My ENT is going to inject the restilin (spelling may be wrong) again so that my voice will be strong. Have you had this done? Did your voice remain strong? I was told my body absorbed the restilin and that is why he needs to do the procedure again. Do you know of any other "fix" that is more long term? Do you know if the PET would show all types of tumor/cancer uptakes or only thyroid? My husband had this done for his head and neck cancer, but I forgot what they injected him with? Sorry for all the questions. I am a little bit nervous about this.

alapah's picture
alapah
Posts: 259
Joined: Oct 2009

PET scans highlight hyperactive cells, so they would light up any kind of cancer, not just thyca. Also, as we have observed ourselves, it also can highlight non-cancerous hyper active cells. it provides a good indicator of what may be going on but it can't tell the whole story (for example, what kind of cancer etc).

as far as the vocal cord paralysis goes, i am fortunate because mine ended up stuck near the medial position so i did not need any procedures. mine is kaput because the tumor had adhered to it so the surgeon had to sacrifice the nerve, much to his dismay. i had radiation to my neck as well as RAI, and before they did that run of radiation at Mayo they had me see a speech pathologist and ENT - i underwent a swallow test to see if i was aspirating (luckily, i don't). vocal cords are obviously important for voice but also for swallowing. from what i understand, the injections to plump up the paralyzed cord only last so long. there is another procedure, called thyroplasty, where they build up the front of the broken cord (maybe with your own tissue but possibly with a synthetic) and basically enlarge that broken cord so that its edge is near the medial position, making it easier for the working cord to reach and strike against. the downside in having it in the medial position is that it affects breathing a bit. here is a page that talks about these procedures: http://www.mayoclinic.org/voice-disorders/treatment.html

my voice came back pretty strong. i can't yell and i have to swallow in a certain way but it's all very liveable.
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