Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Treatment for Papillary Thyroid Cancer
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Treatment for Papillary Thyroid Cancer

I  just had a TT 2 1/2 weeks ago.  I was Dx with Hashi 13 years ago, enlarged gland was causing compressive issues.  MD informed me that Thyroid appeared to be burnt out with numerous nodules related to the Hashi.  There was a 1 cm papillary carcinoma identified that did not appear to have spread to the lymph nodes.  The surgeon says that we need to decide if RAI treatment should be done or not.  She said that if it was less than 1 cm they do not normally choose RAI, but since mine was right at 1 cm it should be considered.  Do you have any suggestions about the bennifits of RAI treatment for small tumors of 1cm? If I choose not to have the RAI, what could be the outcome later?  Could the cancer come back in the remaining thyroid tissue even though most of it was removed?  I also, have Sjogren's Syndrome and have read that sometimes RAI can cause issues with the paratid glands.  Do you have any experience with Sjogrens?  Will this condition worsen if they do RAI?
If I choose to have the RAI, is there an alternative to going off Synthroid prior to procedure?    Read on line a few people have mentioned Thyrogen shots?  Any suggestions?
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A 1cm single focus classic PTC without extension of lymph node involvement does not usually require I-131 according to current (2009) ATA guidelines.
Monitor with serial ultrasound and thyroglobulin panel.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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