Thyroid Cancer-Does the thyroid have to be removed?

[Lori707]

With thyroid cancer, does the thyroid have to be removed and if yes,do the parathyroids have to be removed? Would there be chemo or radiation given? Can a person live without a thyroid?

[Lori707]

He's always tired and has aches. But he has psoriatic arthritis (autoimmune) so I don't know where the symtoms are coming from. He's been on Synthroid for about 15yrs due to hypothyroidism.

ALSO..I have another question. My son who is 32 got in an auto accident a couple years ago. In the ER they took a head CT scan. That evening he was told that the CT picked up calcification on his thyroid. He has yet to see a doctor about this. I'm worried. In your opinion, what does calcification on the thyroid indicate?

[MANmom]

An ultrasound will not tell the doctor if there is cancer or not, only if the nodules are solid, cystic, mixed, vascular, etc.  I can tell you things that may indicate cancer, but you must get an FNA biopsy to really be sure, and sometimes that isn't even a certain test (mine wasn't).  Irregular borders on the ultrasound are not good (nice, round ones are better, but mine were all that way, I still had cancer).  Calcifications are another not-so-good thing, so is increased vascularity.  If you can see the dopplar image, it would be blue and red, blue is blood in, red - blood out.  The more color on the screen, the more blood flow.  Cancer need a blood source, so vascularity is sometimes another indication.  My big tumor had mixed consistency, kind of looked like a spider web.  No matter what, they really cannot comfirm a diagnosis with ultrasound, they must gather cells to make a determination.  The biopsy should be next if they are concerned.  They can also do an uptake scan, the patient swallows a radioactive iodine 131 pill, then a nuclear scan is done to see how much iodine the thyroid takes up.  Even with all these tests, sometimes they cannot tell...My biopsy found "benign follicular clusters" but my cancer was only found when they removed 1/2.  It was my choice, doctors told me I could wait.  My symptoms were hoarseness, fatigue, weight loss, night sweats, tendonitis in my elbows, blood pressure spikes, chapped lips...some of these are hypo symptoms, but the hoarseness was not.  What symptoms does he/she have?

[blsdnsvd]

Many people on this site are "thyroid-less" due to different reasons. I had a Total Thyroidectomy in Dec due to a multi-nodular goiter that had the potential to become cancerous if not removed. The reasons for  a TT are: Thyroid Cancer, Enlarged Goiter, Thyroid Nodules and certain Thyroid Diseases. In lots of cases, only half of the thyroid is recommended. The parathyroid glands (4 of them) are located behind the thyroid gland and can become embedded within the thyroid gland and can easily be mistakened during surgery, which sometimes cause removal of at lease one parathyroid gland. This gland controls the blood calcium level and in most cases are pushed around during removal of the thyroid gland and will causes them to stop working, causing a decrease in the calcium levels, where the patient will have "symptoms" of low calcium until these glands become active again and in that case, calcium supplements are needed.  Radiation will be given if there is a moderate amount of cancer in the thyroid in order to "kill" any remaining cells if any. Be sure to advise your relative to keep copies of all of the tests results for his/her records. A second and third opinion is also helpful to get a accurated diagnosis...

[Lori707]

Thank you for your advise. This is not for me but for a very close relative. Doctor is suspicious of cancer and had an Ultra Sound taken the other day. Wondering what is next. Do you think they can see if there's cancer from and Ultra Sound and if positive, what kind of cancer? I had the CD from the Ultra Sound and opened it on my computer. I looked at different pictures but noticed on a couple there were uptakes of red and yellow. Do you know what that means?

[MANmom]

Well, there are several answers.  Have you gotten a diagnosis?  It depends on the type and stage of your cancer.  If you have Papillary or follicular cancer, you probably should have the gland removed.  There is some evidence that doing nothing for a while will not do harm.  I found out that I had stage 1 papillary after they removed 1/2 of my thyroid (3 small tumors, less than 2 mm), I could have left the other half, but it had a nodule as well.  I chose removal, they found the big tumor there (1.5 cm).  I am glad to have it out.  When they do a TT they try really hard to preserve the parathyroids, they are necessary for your calcium regulation, most of the time they can.  In regards to chemo and radiation, it really depends on the type of cancer.  Pap and follicular cancers do not usually have to undergo chemo, usually only radioactive iodine treatment and sometimes if the cancer is very small, no RAI.  The thyroid gland is the only gland in the body that uses iodine, so if they give you radioactive iodine (RAI) it kills the leftover thyroid tissue preventing recurrance.  If you have medulary or anaplastic thyroid cancer, you have more of a chance that the cancer will or has already spread, so you may have to undergo chemo.  If any one of the cancers have spread beyond the thyroid, say into the lymph nodes or other tissue, then they may want to do more than just removal and RAI.  The great thing is that many of us live perfectly fine without our thyroids, I am feeling great, I had my surgeries in April and June of last year, RAI in July and finally got on the right meds in November.  A great place to find more answers is Thyca.org.  Good luck.