Neck and Groin Nodes

sammy528

Hello! A little background, I was diagnosed with papillary thyroid cancer in April or 2017. I had a total thyroidectomy as well as 6 lymph nodes removed for metastasic disease, followed by a dose of I-131 in May. Over the last 6 weeks I have developed some enlarged lymph nodes in the side of my neck, my collarbone and groin, these nodes are not painful at all, and are all located on the left side of my body. In addition to these I have also been experiencing extreme fatigue to the point I can barely keep my eyes open during the day or while driving home from work, a non-productive hacking cough, chest and left side pain, night sweats (that don't just happen at night) and chills. I've also noticed a change in my appetite, my three year old eats more than I do and I can't eat without feeling full almost immediately. 

I met with my surgeon who discussed with my radiation oncologist that this is probably not metastatic thyroid cancer but rather lymphoma. I am a little shocked and waiting on the results on some labs so we can move forward with imaging and other tests.

I am wondering how common this is? Would they mention more cancer if they aren't sure? Are two seperate cancers months apart a normal thing? I am so confused by my body at this point and just want to be healthy.   

 

 

Max Former Hodgkins Stage 3

Issues

Welcome to you Sammy.

I can speak only in generalities here.  I assume the lymph nodes removed with your thyroid tested positive for thyroid cancer.  That is fundamental.

If so, I would tend to guess opposite from your doctors (and it is only a guess) and say that the newly-enlarged nodes, if they are cancerous, contain metastatic thyroid cancer -- something you already had.  I say this because thyroid cancer virtually never morphs into Lymphoma.  Lymphoma commonly morphs into other strains of Lymphoma (there are over 60 recognized strains), and will at times morph into Leukemia.  But I have never heard of a thyroid-Lymphoma pathway.  It is conceivable that they emerged independently, but highly unlikely.

Having both types of cancer, and having them both emerge in the same body area unrelated is not impossible but is astronomically improbable. It does not pass the intuitive 'gut test' for me.

Yea, your surgeon and radiation oncologist would like to think that it is not thyroid cancer; that way, no negative reflection upon them.  But regardless of what they think it is, either way, you need a biopsy to determine what you do have, since it is not normal.  As a recent known cancer patient, they owe you timely and aggressive follow-ups: that means, at the moment, a  biopsy of these nodes.  Blood tests will NOT be conclusive, at least for Lymphoma. A CT or PET is necessary, but also NOT CONCLUSIVE. Only a biopsy will be definitive.

Your symptoms are characteristic of Lymphoma. I do not know the symptoms of thyroid cancer, but it, and the treatments you have received, could possibly be the cause of the fatigue.  Keep your oncologist and surgeon busy until this is resolved,

max

po18guy

Treatment carries the potential for secondary cancer

"If" it is lymphoma, my guess would be that the radioactivity affected a lymphocyte that was associated with inflammation in the area of your thyroid. From the Wiki:

"Due to its mode of beta decay, iodine-131 is notable for causing mutation and death in cells that it penetrates, and other cells up to several millimeters away. For this reason, high doses of the isotope are sometimes less dangerous than low doses, since they tend to kill thyroid tissues that would otherwise become cancerous as a result of the radiation."

So, the potential exists for I-131 to cause either thyroid cancer, or a secondary cancer, and there are certainly lymph nodes and lymphocytes flowing in the area. All it takes is a mutation in a single cell, and your immune system missing it, to develop lymphoma (or any cancer). As a result of several years of treatment, I devloped MDS, a bone marrow cancer. Her's hoping that it is not maglinant.

PBL

Concomitant cancers are possible...

... as shown in this case report from 2014 by a team from the Beirut, Lebanon Faculty of Medicine (http://www.sciedupress.com/journal/index.php/crim/article/viewFile/4897/3152). The title is: "Synchronous diagnosis of a hodgkin lymphoma and a papillary carcinoma of the thyroid".

Of, course, that does not necessarily bar the possibility of a cause-and-effect aspect in your particular medical history, considering the treatment already received. But it does suggest that mere chance, or perhaps a yet-unknown link between those two different cancers, can suffice.

Hope this helps.

PBL

yesyes2

Anything is possible.

It is very possible to have 2 cancers show at the same or close to a diagnosis of one cancers time.  I was diagnosed with NHL initially in January 2008.  I was treated and in remission when in July of that year a PET/CT picked up a breast cancer.  After treating the BC via surgery I had a recurrance of my NHL in JUly of 2009.  Along the way I met several people in support groups who were treated for one cancer when they were found to also have another form of unrelated cance.

Please keep us informed of what you find out.  I wish you the very best.