Papillary Cancer

[Nicator]

My wife (37 years) was diagnosed with papillary cancer and had gone for the surgery. The doc. has removed the complete thyroid gland. The biopsy showed 1.5 cm size and it is negative for the adjacent lymph nodes. the doc. says the biopsy report looks good. She is scheduled to be seen by endocrionlogist this week. My question: what are the chances of Papillary coming back (eventhough the complete gland is removed) and what kind of questions or treatment she will have to follow?
thanks.

[Nicator]

Your comments are very valuable. My wife was seen by endo. and has gone for the full body scan last week (two months after the surgery). The scan showed negative for other parts of her body, except some local tissus around her neck (where the actual thyroid was located). The doctor said the scan looks good, and the existance of few tissues may or may not be canceros. To kill it, they gave her RAI (100 m/c) dosage. Now she is schedule to go back for second scan next week. The doctor also said, it will take few weeks to kill the remaining tissues, so the next week scan may still show the tissues (not to be scared). Her blood work was also done and showed the little higher TSH level.
One other thing, she was also complaining about the chest pain after the scaning and RAI. Is this related? Thanks.

[KelDC]

Your wife's diagnosis sounds similar to mine.  Unfortunately, thyroid cancer can always come back. I don't know the actual statistics, though.  www.thyca.org's website is wonderfully helpful. It's the Thyroid Cancer Survivor Association, and it's great.  

As Venora and Utah have both said, Thyroglobulin is the important test to have. My endocrinologist explained it to me this way:  thyroglobulin is only manufactured by thyroid tissue. Theorectically, you shouldn't have any (I had my thyroid removed last month), so if thyroglobulin shows up, we know we have a problem. A simple blood test can test for it. I think she said it would be once or twice a year.  

As for treatment, thyroidectomy followed by RAI (radioactive iodine) is the standard.  She will also, as Utah said, need to be on replacement thyroid hormones for life. I have been on them for 3.5 weeks now, and I have had no problems thus far. I hope it continues. I will have bloodwork done almost monthly, though, until my thyroid levels are "normal."

I wish your wife (and you!) the best of luck.  This forum is a wonderful place for support and knowledge - I don't know how I would have gotten through my surgery and diagnosis without it!  Keep us posted!

[utahmomma]

When the thyroid gland is removed there is *always* some residual thyroid tissue left on the nerves, vascular structures, etc.  It's impossible to remove it all  safely surgically.

Your wife may be scheduled for radioactive iodine treatment (RAI) to kill off the remaining tissue and to check for any distant spread (the treatment also shows any remaining spread - it's kind of cool).

Your wife will need to be on thyroid replacement hormones the rest of her life.  Really not that big of a deal.  She also needs to have her labs checked at least every 6 months to ensure she is on the correct dosage (she will be on a high dose to suppress any remaining thyroid tissue/cancer).  Please make sure that on top of the regular thyroid labs that her endocrinologist checks her thyroglobulin (Tg) level - that's the cancer marker.

As for the chances of it coming back.  I can only tell you my personal experience.   Mine (even though it was only 5mm and encapsulated) came back three years later and I had to have RAI.  My youngest sister has had three recurrences - one of them showed spread into her lymph nodes and breasts.  Yes, it can come back - it often has "micro-cancers" in other places of the thyroid tissue.  That's why following her labs regularly is so important.

My best to both of you!

Utahmomma
papillary carcinoma '03
recurrence and RAI '06 and possibly '08
three sisters with papillary carcinoma
one sister with precancer (atypical thyroid cells)
teenager daughter with precancer/atypical thyroid

[Venora Moonwind]

Well thyroid tissue is very persistant and sometime it grows back  As much as they try to remove all the tissue ,it is very hard to do without damaging the parathyroids. I dont think that happens very often but your doctor will be watching her thyroglobin or TG to see if it rises. this is a marker for cancer If it rises it is a good indication the cancer has returned and she will need further RAI treatment
but like I said I dont think it happens that often although there are a few posters here that have had that happen. good luck and let us know how your wife progresses.
Love Venora