2nd Thyroid Surgery

litman25

Just found out this week from biopsy and ultrasound I get to go for a 2nd surgery. I have been told it is risky because of possible nerve damage. Does anyone have and advice or feedback as to what I might encounter, it sounds like 2nd surgs are not that uncommon.

Rustifox

I'm sorry you are going through this, but you are right - many of us do have to go back for a second surgery.

I know how upsetting that can be - after my first surgery (lobectomy/partial thyroidectomy), when the pathology reports came back as malignant, I wasn't sure I wanted to go back for the second (completion thyroidectomy) one. I was scared, and even a bit angry that they hadn't taken the whole thyroid in the first one.

For me, though, the second surgery went very well, and in a way it was even a bit easier than the first one, because I knew what to expect the second time. If you look at my personal web page here, there is even a picture of my neck shortly after the second surgery.

Thyroid cancer is relatively rare, so many doctors feel confident that the lump(s) removed from just one lobe will be benign - so if they can, they like to leave a portion of the thyroid intact. That's why many of us ended up going back for another one.

If this is a situation where you had a complete thyroidectomy to start with, and they have found other areas that need treatment, surgery is still the very best option for you. Once any tissues have been 'debulked', the remaining cells become much more easily treated with radioactive iodine. In general, any tissues that are bigger/deeper than about 1cm are better to be surgically removed, as radioactive iodine has trouble sinking alot 'deeper' than 1cm.

If you do have any concerns about your surgeon's skill levels at all, please consider contacting the nearest Thyca group facilitator, to ask for a good surgeon's name in your area from other members - click on 'support' at this link:
http://www.thyca.org/
or also consider joining this group:
http://health.groups.yahoo.com/group/Thyca/

There are also some really good explanations on this page, that also may help address any concerns you may have:
http://www.mythyroid.com/
This page has some great info that may help, too:
http://www.thyroid-cancer.net/

Please do consider making sure that your surgeon does lots of thyroidectomies/thyroid cancer surgeries. As long as your surgeon is very skilled at this, the risks are similar to the first surgery, in the long run.

Risk factors are definitely less, though, if you have a very experienced thyroid cancer surgeon. It is delicate surgery at the best of time, so the doctor needs to be able to identify and protect special structures. If you are not totally confident in your current surgeon's skills, do consider getting a second opinion from a surgeon who does lots and lots of these operations. That will certainly help improve risk factors.

The best advice I received during the surgery stages of this was to try to take it one day at a time, one step at a time, and one treatment at a time. As the old adage goes, 'the best way to eat an elephant is one bite at a time'. When I stopped worrying about what was going to happen next month, 6 months from now, or a year down the line, it became much easier to handle.

All the best to you... I know this is frustrating and disconcerting, but in the long run, very complete surgery by a skilled thyroid surgeon is your best chance of having long term success at treating this cancer.

Take care, and be kind to yourself - as kind as you can be, through every step. All the very best to you.

stevens

I was told yesterday that I should have a second surgery as well. I had a 3 cm node that had been there at least 8 years, had many negative needle biopsys, had scans and ultrasounds. We finally said lets just take the nodule out. Much to my disappointment, it turned out to be questionable, so my surgeon performed a right hemithyroidectomy and a left subtotal thyroidectomy. The tests came back, Node- positive for Papillary Carcinoma, follicular variant. Right lobe- residual small Foci .2cm for the carcinoma. Margins of resection negative No evidence in left lobe.We are 5 1/2 weeks after surgery and not on any meds. my TSH levels are only 6. My doc gave 2 options Thyrogen to boost THS then ablation or give a smaller dose to "injure" the remaining thyroid tissue, then ablation. I went for a second opinion and he said another surgery to totally remove the thyroid.AAAGGGHHH! Can anyone out there relate or have any idea what this is all about, where I should go next?