Follicular Cancer???

[amaryllis2]

  Hello, I am a 64y/o female.  In 1944 at age 2 I had radiation therapy (RT) for

[Mark Lupo, M.D.]

Confirm the size of this -- '2mm' is very small, perhaps you meant 2cm.  In that case would have the slides sent to a University pathologist (I use Univ Florida) from the 2 FNAs and see what she has to say -- if it is truly a follicular lesion, then sugery is typically recommended.

[ChitChatNine]

I was wondering the same thing bcz I have a 2mm nodule in the side of my thyroid left intact (1/2 thyroidectomy) and they told me they couldn't do an FNA on something so small!

Cheryl

[utahmomma]

"Downwinder" refers to a large group of people in Southern Utah, Northern Arizona, and Southern Nevada who were exposed to high levels of nuclear fallout from above-ground nuclear testing in the Nevada desert in the 50s and 60s.  I was born in '66 so I "don't count" but I grew up in Northern Utah and grew up drinking well water.  So did all my sisters and there are 4 of us with cancer (I'm the oldest at 40), and one with precancer.  Supposedly papillary carcinoma is not hereditary.  Hmmm.

*IF* you do ever decide on surgery please know that it is one of the easiest surgeries that many of us have had.  I've had eight surgeries - two for thyroid - and the thyroid had the least amount of pain and fastest recovery.

Go onto the patient-to-patient forum, you will find many others with similar experiences and a lot of us thyroid cancer survivors.

[amaryllis2]

Hi utahmomma,

Thanks for the explanation.  With you & your 3 sisters all having thyroid cancer, I would suspect it was from the nuclear testing.

I did have my left lobe removed in 1969 due to a growing nodule.  There was no ultrasound or FNA to ID what it was back in those days.  The head & neck surgeon I was going to was following the nodule over a 12 month period.  It was getting smaller and then what was to be the last of 4 assessments over that 12 month period, it grew.  I had the surgery and like you said It was not that bad.  All I remember was having a terrible headache the evening I had the surgery, no pain just a headache.

The only thing I worry about is if I have surgery to remove the rest of my thyroid, what will happen to my parathyroids.  The doctor who monitored my thyroid from 1974 until he retired in 1994, had told me that it would be very tricky surgery because I would only have 2 parathyroinds left and they would have to watch very carefully not to remove or damage them in a susequent operation.

I'll have to take your suggestion & go over to the patient-to patient forum.  I have a more questions & concerns.

[amaryllis2]

utahmomma & ChitChatNIne,

Thank you both for sharing your experience and information.  

utahmomma, what is a "downwinder"?

ChitChatNIne, if I get 2 out of 3, I think I'll get a second opinion.  Or, I'll go back to the ENT.  He initially gave me 3 choices: 1.  Have the thyroid removed.  2.  Have the FNA.  3.  Watch it.  I didn't want to jump in and have it removed and I didn't want to watch it.  So I chose the FNA thinking it would be difinitive.

[utahmomma]

I am so sorry you are going through all of this!

First of all, I'm *NOT* a doctor, just a thyroid cancer survivor with a *huge* history of family cancer (3 sisters with papillary carcinoma, one "pre-cancerous", teenager daughter "pre-cancerous")

There is a lot of research linking radiation therapy pre mid-60s to thyroid cancer.  A nodule that has grown as much as yours has is also a concern, as are the results of your FNA.  While thyroid cancer is not as aggressive as ovarian cancer.

I just have my experience to share.  My suspicious nodule was small (5mm) but I had a bad feeling about it.  At the time I had no family history of thyroid cancer, I had not been exposed to radiation as a child, and although I live in Utah I was technically too young to be a "downwinder."  However the fact it was a complex nodule with irregular margins was enough to get me to a surgeon.  I had 1/2 removed and papillary carcinoma was discovered after I was taken into recovery.  Within 12 months all four of my sisters had also had their thyroids checked then removed:  three with papillary carcinoma (one was Stage II), the other was precancerous and my daughter also had her thyroid removed (one large nodule was pressing on her jugular) and it was precancerous.

We all learned how important it is to follow your "gut instinct" when it comes to your health.

I hope that you find answers soon and I wish you well on your recovery.

[ChitChatNine]

Based on an FNA of a nodule that was "atypical for follicular cells" I had 1/2 thyroidectomy done just a month ago (1/07).  Both of the nodules on that side were benign upon prelim and final biopsy, BUT they found two small areas of Papillary Carcinoma elsewhere in the gland.

I would definitely have the FNA but I wouldn't necessarily put all my eggs in one basket based on the 2 out of 3 FNA theory .. that is my personal opinion.  I would also closely look @ the ultrasound characteristics wtihin these next few months very carefully.

I agree with above post you must follow your instincts.  I just knew something was not right and I even posted it 2X before my surgery predicting something "small" would be found and it was so true and I am so so glad I had my partial thyroidectomy.

Now they will watch the other side like a hawk as I have a 2mm nodule there, too .... I'm not thrilled by all this but I always have the option to rid the other side at anytime.  I will run (not walk) to have the other side out if it even shows hints of something not right and wouldn't base my decision 100% on a biopsy.

C~

[utahmomma]

Oops, sorry about the ovarian cancer reference. I mixed my posts.

[amaryllis2]

I forgot to explain that after the MRI my family doctor referred me to an ENT surgeon.  The ENT had an ultrasound done 8 months after the MRI.  The nodule had grown 1 cm during that interval.  It was now 1.2 cm.  He said based on my history it was best to have a FNA biopsy.  He referred me to the ENDO.