young doctor with cancer... let's find answers together

genebing_md

Hi everyone! new to this - cancer and this forum 

Let me start by saying that just by initially browsing the topics from this forum that it's like reading into my own thoughts. I'm 30 years old, an internal medicine resident doctor and recently found that the thyroid tumor they took out of me was papillary cancer. I'm easily at stage 3 just by the size of the tumor. Thankfully, no signs of it being stage 4 (yet).

I had cancer. "Had" being the watchword since apparently my thyroid tumor was very perplexing and a few additional tests had to be done to confirm that it was cancer. The cancer is such an afterthought that I honestly do not know how to feel. It's such a powerful five-letter, two-syllable word "cancer" - enough to make people see me differently in a matter of that one second it takes for me to say it. I can almost catch the pity in people's breaths as they try to tell me that the worst is over and as far as the surgery went I'm basically cured (say for some radiation, of course).

"You have the best cancer possible." someone even said. Even though I am surrounded by my friends who are also doctors - I can feel that they are as scared as me but try to downplay it with research and statistics and shove acceptance more forcefully because they know that I know everything's gonna be alright (supposedly).

I do know that there is no un-accepting the fact that i had cancer. Yet there is this feeling that somehow i am forever changed. Textbooks tell me in black and white that 95% of the time I won't die of my cancer - I still had it though and have  to live with the fact that death has touched me at this young age where I am just about to graduate from residency and should be thinking about starting a career and a family and all those things people my age are supposed to be doing - maybe that's what needs accepting, working on that still.

I guess I'm writing this to the void to find release. i didn't think I'd have my turn to become the patient this early in the game. I'm the youngest and the only doctor in my family so talking to them basically leads to me comforting them (rather than the other way around) and of course, I put on a brave face because causing them to worry would not better anything . To end, i still love that i'm a doctor and optimistic about leading this double life as a cancer survivor.

I'm on break now after RAI so hit me up with whatever - questions, stories, violent reactions to long posts-  and will try to find answers or just extend a cold virtual hand (because I have the worst cold intolerance now) as best as I can.      

BestTypeOfCanoe

Hi friend. I too am 30. Just

Hi friend. I too am 30. Just had my thyroidectomy two months ago for PTC. I'll be doing RAI therapy pretty soon as well.

> I can feel that they are as scared as me but try to downplay it with research and statistics and shove acceptance more forcefully because they know that I know everything's gonna be alright (supposedly).

Can relate.

> have  to live with the fact that death has touched me at this young age ... and should be thinking about starting a career and a family and all those things people my age are supposed to be doing - maybe that's what needs accepting, working on that still.

Yep.

> talking to them basically leads to me comforting them (rather than the other way around) and of course, I put on a brave face because causing them to worry would not better anything .

Same.

> To end, i still love that i'm a[live] and optimistic about leading this double life as a cancer survivor.

I think about all the people I love in my life. And if I could choose it, I would rather me get the cancer than any of them any time. Perhaps it would be different if the outlook was bleaker, but I am happy that I can be a role model for those around me to tackle their battles. I feel like I have a life experience under my belt that will help me help others in the future. I suppose nothing is 100% bad, is it.

genebing_md

BestTypeOfCanoe said:

Hi friend. I too am 30. Just

Hi friend. I too am 30. Just had my thyroidectomy two months ago for PTC. I'll be doing RAI therapy pretty soon as well.

> I can feel that they are as scared as me but try to downplay it with research and statistics and shove acceptance more forcefully because they know that I know everything's gonna be alright (supposedly).

Can relate.

> have  to live with the fact that death has touched me at this young age ... and should be thinking about starting a career and a family and all those things people my age are supposed to be doing - maybe that's what needs accepting, working on that still.

Yep.

> talking to them basically leads to me comforting them (rather than the other way around) and of course, I put on a brave face because causing them to worry would not better anything .

Same.

> To end, i still love that i'm a[live] and optimistic about leading this double life as a cancer survivor.

I think about all the people I love in my life. And if I could choose it, I would rather me get the cancer than any of them any time. Perhaps it would be different if the outlook was bleaker, but I am happy that I can be a role model for those around me to tackle their battles. I feel like I have a life experience under my belt that will help me help others in the future. I suppose nothing is 100% bad, is it.

RAI in the horizon

High five! 

cannot even think about anyone getting cancer right now - might go nuts

RAI will be another experience altogether. The premise is there are microscopic thyroid tissue left after the surgery so you'd need radioactive iodine to bascially burn them out. the thing they don't tell you is you'd be a walking radiation source so 

1) you have to be isolated until you can flush out the radiation 

1a. people, nurses included, won't be able to visit as much and for very long so expect a lot of "me time" (BRING BOOKS, DECK OF CARDS)

1b. all your stuff stays in the room (trash, soiled clothes) -DON'T MAKE A MESS 

1c. DRINK LOTS OF WATER

2) low iodine diet is such a punishment for food 

- basically all the iodine needs to come from that radioactive pill they'll give you - i.e. you'll be surprised how hospital food could suck so much more 

- this for me was the real challenge of RAI

- at about your second day on RAI you'd need to add CITRUS FRUITS or SWEETS so you'll salivate and get rid of the iodine in your salivary glands 

3) bathe twice a day to clear more radioactive iodine 

4) once you're discharged you still have to stay away from people for a good 3 days - so still on house arrest, no malls or cinemas or the opera 

 

good luck friend! let me know how yours goes

It took me 3 1/2 days to get down from 100 mci to 0.5 mci  

BestTypeOfCanoe

RAI Dosage: Old vs. Young

How did you go about choosing your dosage? The impresison I get is it is very hand-wavy and a bit of a guess. Did you have any scans prior to RAI? I wonder if there are different risks for younger vs. older. On one hand I think it is good for a young person to get a high dosage because there's more time for it to come back and cause problems vs being older. On the other hand, giving a 65 year old Leukemia in 5 years at the age of 70 is a different story than giving a 35 year old Leukemia (although my perspective might change on that when I reach 65).

AFMother42

Total Thyroidectomy at 42

Hi all,

I think it is better if they catch it early like they did with you.  My cancer was completely everywhere in the thyroid - described as crusted through but not metastisized.  Everyone is different.  I know a woman who had her thyroid out in her 60s and she is 103.  We have to eat well, exercise and take good care of ourselves - don't miss medication daily. 

Best,

AF Mom

 

genebing_md

BestTypeOfCanoe said:

RAI Dosage: Old vs. Young

How did you go about choosing your dosage? The impresison I get is it is very hand-wavy and a bit of a guess. Did you have any scans prior to RAI? I wonder if there are different risks for younger vs. older. On one hand I think it is good for a young person to get a high dosage because there's more time for it to come back and cause problems vs being older. On the other hand, giving a 65 year old Leukemia in 5 years at the age of 70 is a different story than giving a 35 year old Leukemia (although my perspective might change on that when I reach 65).

when too much is enough

my doctor and i decided on 100mci due to the size and aggressiveness of my tumor - was stage 3 because of my 8x6cm 90 gram left lobe tumor and agressiveness was "high grade" because i had the follicular variant of papillary CA. 

no scans before RAI. just had to take a pregnancy test to make sure i wasn't bringing a young innocent life into this mess. (not like there was any doubt that i could be pregnant). young people fare better but live long enough to see side effects of the treatment. RAI would also call for women like me to not get pregnant for the next 6 months (although that doesn't stop people from trying )

genebing_md

AFMother42 said:

Total Thyroidectomy at 42

Hi all,

I think it is better if they catch it early like they did with you.  My cancer was completely everywhere in the thyroid - described as crusted through but not metastisized.  Everyone is different.  I know a woman who had her thyroid out in her 60s and she is 103.  We have to eat well, exercise and take good care of ourselves - don't miss medication daily. 

Best,

AF Mom

 

loud and clear

replacing thyroid hormone now. the waiting game back to feeling like my old self is long though. still, its enough to keep me motivated and on my meds. 

Micruss

From the other side of the bed rail...

Hi genebing, I'm so glad you posted. I've looked through this site the past 2 days, but for so many reasons, couldn't bring myself to post, until I read your words. I relate so completely to your comments but have been locked up internally with such a broad range of thoughts, feelings that I didn't know how to start.

I'm also a healthcare professional. I've worked in many settings, never wanted to be on "the other side of the bed rail"! Because of that I've spent my life practicing mental, emotional and physical habits all with the intentions to stay "out of the system". I'm an Occupational Therapist who went on to 4 years of traditional Oseopathic training. I understand anatomy structure, function & a wide range of approaches to help prevent issues or help a body heal when problems arise...yet, despite years of having done "everything possible" to build & manitain strong health here I am, still a bit in shock at what I've experienced over the past 6 months. I find myself looking in the mirror at a well healed scar across my low throat, wondering who is this, what just happened?

I deeply relate to your vantage point of being the pt. and even though I have a few years on you, I'm still filled with the sensation of death having introduced itself to me long before I expected. There are so many thoughts & emotions, yet so few words to adequately articulate my experience thus far. At this moment I'll just say, there were post surgical complications and the professionals involved lacked the appropriate skills to listen and take timely action. The surgeion inparticular was something, ("you just know too much") was his go to statement. That response added a significant amount of unneccesary mental, emotional & physical strain. I sincerely hope you have a team of true professionals who are able to listen deeply and with compassion as you move through this healing process.

I wish you all the best! And hope to communicate more with you along this path. 

upperwestside

Staging Thyroid Cancer

Staging for thyroid cancer is different than for other cancers, age is taken into account. Good news for the young doctor, you are stage I, not stage III. Look at this, scroll way down

https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/staging.html

My husband is aggressive stage III follicular variant of Papillary thyroid cancer...a cancer diagnosis is always life altering and terrifying. But after a few years we started to realize he is ok! At this point he just has to have his TSH tested perodically to make sure the Synthroid dose is ok. TG tested once a year as well as ultrasouinds of his neck.

This website is helpful:

http://www.thyca.org/pap-fol/

genebing_md

Micruss said:

From the other side of the bed rail...

Hi genebing, I'm so glad you posted. I've looked through this site the past 2 days, but for so many reasons, couldn't bring myself to post, until I read your words. I relate so completely to your comments but have been locked up internally with such a broad range of thoughts, feelings that I didn't know how to start.

I'm also a healthcare professional. I've worked in many settings, never wanted to be on "the other side of the bed rail"! Because of that I've spent my life practicing mental, emotional and physical habits all with the intentions to stay "out of the system". I'm an Occupational Therapist who went on to 4 years of traditional Oseopathic training. I understand anatomy structure, function & a wide range of approaches to help prevent issues or help a body heal when problems arise...yet, despite years of having done "everything possible" to build & manitain strong health here I am, still a bit in shock at what I've experienced over the past 6 months. I find myself looking in the mirror at a well healed scar across my low throat, wondering who is this, what just happened?

I deeply relate to your vantage point of being the pt. and even though I have a few years on you, I'm still filled with the sensation of death having introduced itself to me long before I expected. There are so many thoughts & emotions, yet so few words to adequately articulate my experience thus far. At this moment I'll just say, there were post surgical complications and the professionals involved lacked the appropriate skills to listen and take timely action. The surgeion inparticular was something, ("you just know too much") was his go to statement. That response added a significant amount of unneccesary mental, emotional & physical strain. I sincerely hope you have a team of true professionals who are able to listen deeply and with compassion as you move through this healing process.

I wish you all the best! And hope to communicate more with you along this path. 

the double agent life

hi micruss! the burden of knowledge lays heavy on us when we've become the patients ourselves. it's nice to find some validation that i am not alone in this. i actually think it makes us seem more relatable in a way. i recently went to screen patients in a surgical mission swhere i was able to handle patients going into thyroid surgery themselves; got to counsel them on what to expect and such. it was very rewarding. 

we tend to have too much thoughts running through our heads most of the time. so for me, it helps when i write it down; by writing me back, it helps me too hope everything goes well with you. keep me posted.

p.s. my scar remains to be pinkish and still stings even though its been months 

genebing_md

upperwestside said:

Staging Thyroid Cancer

Staging for thyroid cancer is different than for other cancers, age is taken into account. Good news for the young doctor, you are stage I, not stage III. Look at this, scroll way down

https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/staging.html

My husband is aggressive stage III follicular variant of Papillary thyroid cancer...a cancer diagnosis is always life altering and terrifying. But after a few years we started to realize he is ok! At this point he just has to have his TSH tested perodically to make sure the Synthroid dose is ok. TG tested once a year as well as ultrasouinds of his neck.

This website is helpful:

http://www.thyca.org/pap-fol/

east meets west

hi upperwestside! thanks for the clarification 

although it is true that academically i am stage 1 papillary thyroid cancer because of my age, asians especially filipinos like me tend to have bigger and more aggressive tumors (sucks to be me, i know). it basically follows my life story - just had a lump, repeated FNAB showed it was benign, it grew until it nearly popped out of my neck, had it removed then surprise! it was cancer.

so we here tend to  ignore the age clause and treat tumors like mine as stage 3 - as a means of "erring in the side of caution" and all. the basis for the age clause in the AJCC/TNM staging is also unkown.. they just studied a bunch of people and found that young individuals do not tend to die of their thyroid cancer and are more responsive to RAI- reasons on why this happens remain a mystery. 

i'm glad to hear your husband is ok lets hope his story becomes mine too 

CrisRN17

Greetings.:-)

hi there doc.:-) I am a fellow Kabayan.:-) i hope you are doing good. I was able to read your thread since I was seaeching for groups to minimize my anxiety. My ultrasound results confirmed that I have a thyroid nodule with benign criteria as described by the radiologist. Yet still my anxiety is at it's peak. I am praying for your fast recovery. Reading your story gives me the courage to further go into treatment. Godbless always.

genebing_md

CrisRN17 said:

Greetings.:-)

hi there doc.:-) I am a fellow Kabayan.:-) i hope you are doing good. I was able to read your thread since I was seaeching for groups to minimize my anxiety. My ultrasound results confirmed that I have a thyroid nodule with benign criteria as described by the radiologist. Yet still my anxiety is at it's peak. I am praying for your fast recovery. Reading your story gives me the courage to further go into treatment. Godbless always.

kabayan!

nice to hear from you! sometimes just the right amount of anxiety is key just because ultrasound features say benign does not let you completely off the hook
Please make it a point to follow up with your doctor