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451191 tn?1264432890

Suspicious for Papillary

I had FNA on Tuesday of last week and got my results on Thursday- "suspicious for Papillary Cancer" and Endo has recommended TT, but the Surgeon she recommends can't even consult until 5/9!  This is not acceptable to me.  If this is Cancer, I want it OUT of my body immediately.  I don't want to sit around knowing I have this thing in my body that could spread to other parts of my body.  Why is it so difficult to get this scheduled?  How can my Endo just drop a bomb on me like that and then say "my office will call with an appt for the surgeon"?  If this is Cancer shouldn't we be springing into action immediately and finding our what is going on?  I don't get it.  I'm devastated by this news.  I assume the chances that this isn't cancer are pretty remote, but I still hold onto the hope that maybe it's benign, or pre-cancerous and I won't have to do RAI.  I don't know.  I'm just really scared...
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Avatar universal
I don't "work" in the sense of working outside the home.  But I'm extremely busy taking care of everything in the house (my husband works 12 hours a day), two kids that are involved in numerous sports & activities, serving on a few committees at school and heading up a few areas (vacation bible school, marriage retreats, camping trips) at church.  Since my kids are now both in school people sometimes ask when I'm returning to work.  I jokingly say to them I'm too busy working to think about returning to work!

After my TT I was back to doing everything (except lifting heavy things) like normal.  If I did work outside of the home I could have returned to work one week after surgery.  

I did wear some turtlenecks for awhile, but not long.  I've always hated turtlenecks!  We're heading to Florida in two weeks so I'll be breaking out the bathing suits!

Keep us posted on how your consults go.
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451191 tn?1264432890
Glue may be a similar way to close the incision to plastic.  They basically stitch underneath the skin and seal with glue and steri strips.

I sincerely hope that my results of my TT are similar to yours and that we caught it very early.  I hope and pray that I don't have to do RAI, but obviously am willing to do whatever it takes to eradicate this disease from my body.

Do you work?  How soon were you back to work?  You're "lucky" you got your TT during turtleneck season.  I will have mine right before bikini season.  Sweet.
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Avatar universal
My surgeon used "glue" for the closure and not stitches.   I'm not sure what a plastic closure is.  I'm 6 weeks out from my surgery and I have to say my scar looks much, much better than I thought it would.  It was puffy for about four weeks after surgery but in the last two weeks that has gone away.  (Sorry, I don't know how to post pic)

It sounds like your FNA was similar to mine.  They only found one slide that showed characteristics of papilliary cancer.   The nodule that contained these suspicous cells was 1.3cm.  After the TT a unifocal spot of papilliary cancer with a follicular variant was found but it was less than 5mm and it was totally contained within my thyroid so therefore no RAI.  If the cancer is less than 1.0cm and it's totally contained in the thyroid protocol is to not do RAI.  Did you only have the one nodule biopsied?  

It's fortunate that the FNA detected the suspicious cells.  I understand that FNA's are notorious for not catching the beginning of cancer.  My ENT kept telling me how lucky I was that the needle hit the exact spot it needed to in my nodule for it to show the suspicoius cells.  


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451191 tn?1264432890
It seems that I didn't hear my endo correctly when she gave me my dx last Thursday (no, really?  how could that be?  lol).  Apparently they are almost 100% sure that it is Papillary Cancer after all.  One of the slides showed characteristics of it and she would "be surprised if it wasn't a Papillary cancer".  She also told me that my nodule is between 1cm and 1.5cm.  I am back to being scared about all this.  I had told myself that there was still a chance that I don't have it, but now it's pretty definite that I do.

I called the Surgeon's office and moved my appointment up to 3/31 (from 4/3).  I want to get things moving, although I am terrified of all of it.  She said to pretty much count on having to do RAI and that they prefer to keep thyca patients hyper, but that I would have to be hypo to do the RAI and that it's probably the hardest part of the treatment plan.  Great.

I did some research on the Thyroid Center at Beth Israel and they do all their closures with plastics, so the scarring is minimal.  Did anyone else have plastic closures?  Pix?
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Avatar universal
898
In present time, the common trend is not to do biopsy for nodules less then 1 cm (mostly due to the ultrasound guiding quality). I was in the design team that made the smaller handpiece for ultrasound tester, but its accuracy is, unfortunatly,the same level as the old ones.
In many cases more then one nodule used to mean lesser chance for cancer, opposite to the solitary nodule.
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451191 tn?1264432890
TriciaS:  I think we may have gotten our dx on the same day!  My Endo called me on Thursday night and it was a terrible weekend.  I also ended up succumbing to a cold I was fighting, which was terrible for my mental outlook.  I'm definitely feeling better about things today, after talking to the people who have been through this and other Thyroid disorders that required TT and/or RAI.  The first surgeon that my Endo wanted to refer me to wasn't even doing consults until 5/9, so I made my own appt with Dr. Parangi at BIDMC on 4/9 and then my Endo got me in to consult with Dr. Mowschenson at BIDMC on 4/3.  They have a Thyroid and Parathyroid Center at BIDMC, so I would be very confident with either of them performing the surgery.  I have heard good things about Dr. Roberts as well and am trying to get into see Dr. Daniels for a second opinion.

898:  I have wondered why further testing wasn't indicated since the results did not come back that I definitely have cancer, only cells that look suspicious for cancer.  I think they generally try to err on the side of caution and hopefully mine is contained and they will only have to remove half of my thyroid, although, my Endo did mention that I had a very small nodule on the other side, which we did not biopsy.

imedicmommy:  I totally know what you mean about the post-pregnancy thing.  I literally feel like I just came out of that whole fog (my daughter is 18 months) and was just starting to feel like myself again and now this.  It really angers me, but I feel like if I could deal with pregnancy for 9 (10) months then I can deal with this hormonal change as well.  I bounced back so quickly after my C Section, people were amazed.  I think it is because I practiced Bikram Yoga throughout my pregnancy.  I plan to practice a ton before this surgery and as soon as I can afterwards.  I truly believe in it's healing effects on the body.

Thanks everyone for your responses.  This board is amazing.
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Avatar universal
Hi,

I'm in the Boston area too.  I just found out last week that I have papillary cancer, and am searching for a surgeon.  The first person we went with couldn't see me until 05/06, so we went with another person who will see me on 03/31, which is much more manageable!  I can hardly stand to have the cancer in me for that long, but as the week has gone on I've accepted it better.  I was totally freaked on Thursday/Friday, but am much more relaxed now.  My family (sisters, brothers, and parents) and friends are more upset about this than me now!  I'm scheduled to see Dr. Roberts from Mass Eye & Ear, follow up with Dr. Daniels at MGH. . . who did you get to see?

Thanks,
Tricia
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Avatar universal
The nodule they found the papilliary cancer in was actually 1.3cm.   The focal of papilliary cancer they found within the nodule was only less than 5mm.  I had three other nodules tested during FNA.  They were 1.5 cm, .8cm, and 1.9 cm.  There was no cancer found in any of these.

I was also surprised to learn three people I knew had their thyroid removed due to papilliary cancer.    All three of these underwent RAI and are all doing fine now.  

Please continue to keep us posted.
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Avatar universal
898
Shannon, have they discussed with you the coarse needle biopsy (to sample out the nodule tissue, not just few cells). Despite being more painful then FNA this is a really good chance to find more conclusive results.
As a side note some doctors do not worry at all about the patient's mental and moral well-being and as a part of this they only share whatever is necessary at their opinion.
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168348 tn?1379357075
I got very sick of the "you will be fine .. chances of getting killed crossing the street are higher than with what you have ... "   ... I finally told them I don't like Stats and that the Docs were merely using the Stats to comfort themselves when they didn't know what to say otherwise .. it becomes reading from a textbook ..

You have 95% chance it is nothing .. before the ultrasound

Then when the results come back they still soothe you with Stats

Then when they go in and take the thyroid they still give you stats when the other side stops working (my case .. "oh 20% stop functioning")

After I told the Endo and Prim Doc not to quote stats we were ok from that point fwd when I told them they have to understand that everything escalated from a small lump found and told no big deal to fast fwd and ultrasound, FNA and surgery and finding small cancer findings!!!!!!  I reminded them that STATS come from someplace and we need to remember ANYBODY can be that one Stat nobody wants to be.

PS :  I'm not bitter; that was in the heat of the stress when my anxiety was off the wall .. post op .. but now I am just fine and a better person overall bcz of my cancer experience.  6mos later when they found Melanoma (stage I and cured) I was better prepared to handle that without a problem at all having endured my thyroid woes.

Cheryl
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425199 tn?1313068997
I'm right with you -  my GP found my thyroid enlarged in October, I had the ultrasound in October, the uptake scan in December, and the FNA in February.  I was supposed to have my TT last week, but it got rescheduled to April 7.  I also just scheduled my consultation with the RAI doctor.  

It's a roller coaster they put you on with this, isn't it? You've come to the right place to learn all you can about it, though. I cannot tell you how much this forum helps me every day.  

I saw you got 2 surgical consults scheduled in a few weeks - that is wonderful news! Keep us posted, and good luck!!
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451191 tn?1264432890
Thank you SO much for your responses.  I am pretty pissed that my GP treated this as routine and here I am four months later fretting over this.  This ordeal should be over by now!  My OB discovered the lump in November, had my levels tested and then had an ultrasound. After looking at the u/s they determined it was "routine" that I see an Endo and now this.  It really makes me mad.  I have been on the phone all day trying to get surgical consults and second opinions and it's so difficult.  Why?  When someone sees the word "suspicious for papillary" shouldn't they spring into action?  I don't know.

KJ5854- I hope that the results of my TT are similar to yours,but I think my nodule is closer to the 1.5cm range.  I really don't want to do RAI, even though I have talked with a number of people who have done it and TT and said neither was that bad.

I am amazed at how many people I know in my life who have dealt with this!  I know three women who have had TT due to Thyroid cancer!  How is that even possible when the chances of getting it are so low?!
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Avatar universal
I was in your shoes just 3 months ago.  In late October nodules on my thryoid were found through an elective screening test I had done on carotid arteries.  Two weeks later I had a thryoid ultrasound.  A week after that I'm at my ENT's office and he's recommended Fine Needle Biopsy (FNA) on two nodules.  On December 5th I have FNA on four nodules and the doctor performing the FNA tells me I have Hashimoto's (never heard of it) and that there are no signs of cancer.  I'm thinking great news, no cancer.  On December 18th I go back to my ENT for follow-up on the FNA and he tells me the full FNA report shows one nodule is suspicous for papilliary cancer.  My ENT felt that based on the nodules characterists (calcified) that it was cancer and I should have TT.  My ENT is also my surgeon so I didn't need to wait for surgey consult, but I actually did wait until February 5th for the surgery.  My ENT said that because papilliary cancer was so slow growing, because I'm under 40 (barely, I'm 39), because they only found suspicion in one nodule that I could wait a few months and be o.k.

I did actually have papilliary cancer with a follicular variant but it was very small, less than 5mm and totally contained in the thyroid.  There was no blood vessel invasion or lymph node invasion.  I decided not to have the RAI. My endo said the risks with RAI did not outweigh the benefits for me.  

My TT went smoothly and I haven't had any post-surgery complications.  I actually feel pretty good.  I've only gained half a pound since surgery.  I am currently on 125 mcg of Synthroid.  I have my first blood test this week to see where all my numbers stand.  I'm guessing my meds will go up because my hair is still coming out quite a bit and I don't quite have all my energy that I used to.  

It's natural to be worried and scared about all this.  I know I was too.  But the more I learned about thyroid cancer and treatment the more prepared I became and the less scared I was.  We're all here for you.  
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Avatar universal
Just wanted to address your concern about feeling like you after all this. I kind of related it to pregnancy. I remember when my daughter was 6 months old, I asked a friend when I would feel like myself again. She said it would take awhile, and it did. I had to adjust to the changes in not only my body but my life. I had to adjust to bigger hips, leftover stretchmarks and that I was now someone's mother. Having thyroid cancer felt like the same to me. I was 29 and otherwise healthy when I was diagnosed and I have 3 young kids. I had to adjust to a thinner neck, 2 new scars and the fact that I was now a cancer patient. I was pretty angry for awhile. I hated that this was going to follow me around for the rest of my life. I hated that for the rest of my life I was going to be a cancer patient. I REALLY hated that I had to go to a place called Missouri Cancer Care. I told my husband they should name it something else like Happy place or something. I hated that I had to take meds everyday for the rest of my life. I was pissed.
But now I'm 6 months out. I'm getting ready to undergo my anniversary scan and am already scheduled for tentative 2nd RAI. It's not as scary this time. I know what to expect. I've also learned about living with cancer and that it is not my whole life. Just a part of it. I've adusted to the scars, the meds and their fluctuations, the look on peoples face when they hear you've had cancer and it's okay. It's okay because I'm still a mom, I still have a job that I like most days, my family and friends still love me and I can still do most of the things I want to do most of the things and I've adjusted to the things I can't do (mostly because I'm tired) I've even started planning my eventual cancer free party
One thing really put it in perspective for me. I was diagnosed in July of last year. My mother in law (whom I really love) was diagnosed with ovarian cancer in September. They told her at the time her life expectancy was 5-7 years with the expectation that in that time they would find another treatment for her cancer. No one EVER, EVER put a limit on the number of years I had left and had I been 20 years older at the time of diagnosis I would have been a stage 4 cancer due to distance metasasis. Because of my age they kept me a stage 2. My mother in law died last week.
So the answer to your question about being a different person afterwards. You will be. You'll be a person who had cancer and lived to tell about it. I does get better.
I promise.

I hope this helps some.
Margie
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451191 tn?1264432890
Thank you fo much for your response.  I guess I'm still just reeling from the news, but ultimately am just ready to move forward with all of this.  There are special Thyroid units in just about every hospital in Boston, so I couldn't be in a better place to deal with this.  I am not as worried about the TT as I am about RAI.  That scares me.  I am so worried that I won't be who I am now when this is all over with.  I think I am too vain for cancer ;)  Kidding, but seriously, these are the things I worry about.  I know they are petty, but the larger picture is too frightening to take in right now.  This has been the hardest 3 days of my life and I am actually looking forward to going to work tomorrow so I can maybe get some time not thinking about this!  Ugh.
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197575 tn?1215532624
You sound like me!  I was 37, lasty year, physically fit, no problems, except a lump in my neck.  Mine was suspicious for pap. carcinoma and I too was blown away by the results.  I went to a surgical oncologist that specialized in head and neck surgeries. He took out the lump and had a frozen section biopsy done while I was still on the table.  If it was cancer, he was going to take out the whole thyroid.  If it wasn't, he was going to take out just partial.  The waiting SUCKS but it is slow growing.  Mine was 2.65cm and .1cm (multifocal) with cancer found in two out of ten lymph nodes.  Based on the size and it spreading to the lymph nodes, RAI wasn't an option.  Call the office daily if you have to - the squeaky wheel gets the grease.  AFter my TT and before RAI, I wasn't in thyroid meds.  Since I had lost 7 pounds after surgery, I only gained that back plus maybe 3 more.  I am in the process of doing Weight Watchers.  My surgery was in May of 07.  I was so worried about the weight gain, but afterwards, I thought that the weight was the least of my worries.  It took my doctor 6 months to get me on the right dose of synthroid- I am on 250mcgs, which is pretty high.  He is blown away- he started pretty conservative, so that's why it took so long.  I was miserable.  Now I am gearing up for my anniversary tests and pray I don't need RAI again.  Good luck.  You will be fine.  We are survivors.
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Avatar universal
Hi Shannon,
I will be having my biopsy Mid-April after my US found two larger nodules.  The one thing that I have learned after doing much research is that the surgeon that you go to is VERY important,. You want to make sure that he has a lot of experience in TT. You want to make sure that he has alot of experience doing radical neck surgery and that he does these types of surgeries every week. I also have learned that this type of cancer is a very slow growing type so that it may be worth waiting the extra month for the best surgeon. If anyone disagrees with what I said please let me know because I do not want to give someone incorrect information.
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168348 tn?1379357075
It makes total sense bcz I was so so fearful of any meds changing me that I actually had anxiety attacks over it and would cry and cry in the Endo's office when she asked how I was doing!  Honestly, I am better than before the surgery and no more ups/downs with my life .. I used to have to take Ativan for bad PMS 3X month and not once for that reason since my partial.

The orig. two nodules were benign .. it was 48hrs later on final pathology that two small areas of pap carcinoma were found elsewhere in the gland.  Fully encapsulated and no lymph node involvement.  

I had 4 opinions after the surgery . 3 said to keep the other side bcz of size and incidental finding and one opinion by the textbook said to do TT and have RAI.  But in my case all 4 agreed either choice I would be ok bcz of size (very small). The 3mm on the other side looks on u/s like the 1.7cm one they removed so we ultrasound it ev. 6 mos.

I am on synthroid for the long haul regardless of cancer supression of TSH bcz the other side never functioned again.  happens 20% of the time.

I am actually a better person having endured this cancer and also a dx of melanoma only 6mos after my thyroid (stage I early top layer only and GONE!!!) .... I really believe I am better emotionally with living ea. day and enjoying w/o worrying about tomorrow.  

I have not gained one ounce since my surgery.  Same weight for past 3yrs on or off Synthroid.  Take a look at my photos in my profile to see a before/after of my incision .. they become almost invisible and we cancer survivors call it our Badge of Courage or Double Smile Club .. one smile for Cancer, the other for the surgery.

You sound really on a great track .. keep us posted ... and we are here for you.

I found the first month after the cancer DX the hardest emotionally .. I thought I'd be so strong and conquer it all 1-2-3 but the emotions of fear go to me ... took a good 6 weeks to accept it .. really caught me offguard maybe because inital path on surgery was benign so ups and downs all over the place.  Nonetheless I have realized that the only thing to fear is fear itself and your mind can be your worst enemy if you let it.

C~
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451191 tn?1264432890
I live in the Boston area and there are many very reputable, very experienced Thyroid surgeons here.  Probably the most of anywhere in the country due to the Hospitals' proximity to Harvard Medical School.  The surgeon my Endo recommended is Dr. Gawande and he works out of Brigham and Women's.  I called a Thyroid Surgeon at MGH (they have also have a special department for Thyroid Surgery) and she could see me 4/9 (Dr. Parangi- MGH).  My Endo's assistant told me that they will check other hospitals/surgeons on Monday and see if I can be seen sooner.  I just want to meet with a surgeon and see what he or she recommends.  I am fine having the TT.  I'm 37 and very physically fit and thin and have always been that way.  As worried as I am about gaining weight, losing hair, having a big scar, I know that is all temporary and just part of the path to healing from this and I want to start now- not wait 2 months to start the 6 month (or whatever it is) process, you know?

I'm confused about your diagnosis, you said your tumor was benign, but then said you had papillary microcarcinomas.  Did you have TT?  Did you have to do RAI?  Do you feel like a different person now?  This is my main concern, that I won't be "me" anymore.  Does that make sense?
Helpful - 0
168348 tn?1379357075
I can fully understand and appreciate your sentiments.  First off ... get on a waiting list for this surgeon and call ev. Monday to remind them ..if not more often .. they may get you in to get rid of you calling.  You are not locked into this one surgeon.  You want somebody who is expertise in thyroid removals and has done alot of them.  Do ask how many they have done.  If you post the State you live in people on this board may be able to share with you (off the board thru priv mesasge) the names of their surgeons who they may have liked/disliked.

I know how you feel and I totally agree with you ....... that is a long time to wait with timeon top of that for a date to get it out!!!!!  You probably are ok waiting as this type of cancer is very slow growing but I am with you 100% ... I would go nutso waiting 'til 5/9 just to be seen .. it really isn't fair.

My FNA was atypical follicular cancer and turned out benign .. I waited 9 weeks to get on the schedule with my surgeon but my first consult took only 2 weeks to get in .... it was my choice to wait out the 9 weeks as he was perfect for me in my book.  I had antoher surgical consult and dismissed him 1-2-3.

You have to trust your instincts ..... shop around if you are able to and use the next opinion as your first and maybe this guy will get you in sooner as a 2nd opinion?

Cheryl (papillary microcarniomas 1/07)
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