Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
overtreatment of papillary thyroid cancr
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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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overtreatment of papillary thyroid cancr

Dr Lupo,
Can you shed any light on the retrospective analysis that have been done looking at overtreatment of low risk patients with stage 1 papillary thyroid cancer? From different things I have been reading it seems though there has not  been a big difference in removing someones whole thyroid vs just doing routine observation with ultrasound to monitor changes when you compare long term outcomes ( studies by Ito and Davies) ? It seems like there hasn't been much current research done on thyroid cancer and they have been treating they same way no matter the differences in patients and types of cancers. I realize this one day needs to be addressed if there are changes in its growth,  but for me timing is tough right now.  I had surgery last year to remove endometriosis to help get me pregnant.  If I am not currently pregnant I was going to do IVF. I fear if I remove my perfectly functioning thyroid my hormones will be out of wack for a long time which makes it harder to get pregnant and the endometriosis could come back and I would then need surgery for that again. I am seeking many opinions in the safety of waiting to address my thyroid in a year and focus on pregnancy now.  Your thoughts?
97953_tn?1193367871
This is a big question, probably best to focus on your situation.  In general, stage I patients do not benefit from radioactive iodine.  If I understand correctly, you have had a biopsy showing thyroid cancer?  If that is the case we would usually do thyroidectomy and then stabilize your levels with Synthroid or other brand of thyroid hormone and then move forward with pregnancy/IVF therapy.  If this is a T1 or T2 tumor without lymph node involvement, radioactive iodine is not likely to be offered.  While thyroid cancers tend to not to grow quickly, if we have a biopsy suggestive of cancer most experts would recommend surgery prior to moving forward with pregnancy plans.
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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