Should I have Thyroid Surgery

[Julie143]

I ama 40 year old healthy female, during a routine physical a thyroid nodule was found. Ultrasound shows it to be 1.4x1.8 cm. It has not grown any larger during the past year. Last week I had a fine needle biopsy, two cytopathologists have examined it. It shows abnormal cells with a follicular neoplasm. My doctor states that they do not know if it is cancerous unless they do surgery to remove it and the thyroid. The pathologist tells me that the chance of it being cancer is about 1%. All my thyroid levels are normal, my antithyroid antibody was marginally normal. My doctor is pushing me to surgery at an alarming rate, and to medication for the thyroid. I am hesitant to make this drastic change only to find out there was nothing wrong.My question is, what should I do? Is there a way to monitor this node,or to get more insight as to whether or not it is benign?  is my doctor being to anxious to remove my thyroid?

[Applecore]

I have just had my doctors appointment to see how I was doing after waiting 3 weeks.  I had lots of questions (thanks to this forum).  I found out that he is an endo but all he does is thyroid patients.  He said the nodule on the left side of my neck is 4 times the size (of what I don't know).  What size would that be?  My tsh is down to 6.7 but I am not feeling myself yet but oh so much better than I was.  He doesn't want to do anything with my meds at this time as I am so super sensitive to the hormone.  He said I am the most sensitive he has. He said most people with my levels take 150 to 200.    I am taking 37.5 mcg levothyroxine.  After the holidays he will test me again and might alternate days with 50 and then 37.5 and see if that will bring my levels down so I can feel better than I am feeling now. He said if he fools around right now I could get the symptoms back, anxiety etc. and I surely don't want that.  I also was told that I do have hashimo (spelling?)  I read on the internet that it is a disease that gives you hypothyroidism and hypothyroidism by itself is a condition.  Also a lot of my symptoms were brought on by this dis

ease.  They said that anxiety and depression come in the middle of the night from this and that is when mine started.  I find the different web sites so helpful but they can be confusing.  If we continue to muddle through we eventually get an answer.  I guess my question to all is if you have any comments about these issues I would appreciate it.  It kind of upsets me to know that I have a disease and not just a condition.  Does anybody know about this.  Also the comment about nodules progressing into cancer didn't feel good either.  I also had a needle biopsy and it was benign.  Doesn't that mean anything?  Can't I feel ok because of that.   Feel free to make any comments even if they don't make me feel good.  I have to face the facts although I am still believing that God will totally heal me.

I agree with most of the posts that I wouldn't take a chance on not having my thyroid out if I thought that it was cancer.  PFY - praying for you - lol linda from Maryland  

[Julie143]

Thank you for taking the time to respond, your stories are very helpful and I will find out why a total thyroid removal is necessary. Best of luck to you, Julia 143

[KoalaEm]

I am 36 and have a similar circumstance.  My nodule is larger 3 x 3 x 2.2cm and causing annoying difficulties with swallowing etc.
I wonder why they want to remove the whole thyroid? At this point the nodule is small- mine is larger than yours but they will take out only 1/2 my thyroid with a 'wait and see' attitude until the final results come in (5 days post op)- and only then will they remove the remaining section of thyroid IF it is malignant.
What I would be asking your Dr is why the whole thyroid. If the whole thyroid comes out you will need medication- if only 1/2 comes out there's a good chance you may not need medication.  Not to mention the risks of damage to your parathyroids and vocal nerves with a total thyroidectomy.
It is my understanding as a NON MEDICAL person... that many benign follicular type things can in time turn cancerous anyway. Naturally enough no one can tell you how long that timeframe might be.
At 40, you have alot more life to live- is it worth leaving it? True- chances are it is nothing- but look at the post above mine by utahmomma- SOMEONE is that 1%, 5% or whatever % they tell you.  You might just BE that someone.  What if you are and you leave it, then later find out it's too late and your life is shortened?
Let's think about 'if' it were malignant- at this point it would be very treatable (I have been told 98% full recovery)- BUT if it is left and is becomes vascular and starts growing elsewhere in your body... the statistics change for the worse.  
I am very angry at my body for making this stupid complication, and putting me in a position where I need such radical surgery based on a "WHAT IF"... but when all is said and done "IF" I am that "someone" then I will be grateful to have it out.  Yeah, I will be cranky if I am not and I have chosen to have the surgery as it would have then seemed a pointless stress and uneeded operation with possibly negative long term outcomes with the thyroid.  But, I have children- so I owe it to them to not risk my health.
What I would also ask the Dr is WHY the sudden push? Is there something they haven't fully disclosed?
Anyway, that's my 2 bob worth as a non medical person.
Best of luck as you face this difficult time,
Em

[utahmomma]

Welcome.

I'm probably the wrong person to answer you because I have broken every textbook rule on this stuff.  I think there will be a footnote in some medical journal about my family and me.  Not exactly what I wanted as a legacy.

They found a thyroid nodule in me when I was 36 on a completely unrelated test.  I talked to my doctor and, just to be safe, we decided to get the ultrasound.  The ultrasound showed a small, complex nodule but after reading about that type of nodules (and listening to my gut) I decided to skip the biopsy and just get it out.  It was 5mm of papillary carcinoma.  My youngest sister (24 at the time) was in a car accident a few months later and her chest x-rays showed a nodule in her thyroid.  She had it out too - Stage II papillary cancer.  Three more sisters with nodules, two were cancerous (other was precancerous) during the same year.  My (then) 16-year old daughter's was also precancerous.

We were aggressive with our nodules and none of ours were as large as yours.  Oh, two of my sisters DID have biopsies - both were negative (and both had cancer).

Abnormal cells are something to pay attention to.

I don't know.  I figured I'd just stress and wonder if there was cancer growing inside of me if I didn't do anything.

Oh - and all of our labs were normal (or just mildly hypo).  Thyroid cancer doesn't change thyroid labs.

Just my story.  Talk to lots of other thyroid patients and get a second opinion.

IF you do decide on surgery; for my sisters, daughter, and me (twice) it was the easiest surgery we have had.