Thyroid Cancer and 18 weeks pregnant.

[melval9201]

I was just diagnosed with Papillary Thyroid Cancer.  I am 32 years old and 18 weeks pregnant.  I am scared and feeling overwhelmed.  Can anyone give me any insite.  I am also finding it difficult to find a phenominal specialist in my area.  I am located in Pennsylvania.  Any help would be greatly appreciated.

Melissa

[ChitChatNine]

I'm in NJ.

C~

[melval9201]

I have my appts. made for this upcoming Monday and then another consult on Thursday up at Sloan Kettering in NYC.  I hope to have a full game plan by the end of next week.  Thanks so much for all you advice and insite.  You have no idea how much I appreciate it.

Melissa

[ChitChatNine]

First off WELCOME TO OUR COMMUNITY!  I am so glad you have come over and hope you will stick around.  This is a wonderful community to give, get, share advice and in the process maybe even make a friend or two!

I agree with Thomas Jefferson University.  I had two CVS tests done there in early pregancy many years ago and they are a leader in the field in the OB/GYN dept.  You can certainly go there for the Cancer concerns and be able to get wonderful advice being pregnant with all this going on, too.

Again, so glad to see you here at MedHelp!

C~
Co-Community Leader Thyroid

[utahmomma]

Actually we all live within about 80 miles of Salt Lake City and used the same surgeon.  Her name is Theresa Reading but we call her St. Theresa.  :-)  She also took out my son's gallbladder.  We joke with her that she gets to bring the potato salad to the family reunions.

Papillary carcinoma is *nothing* like breast or ovarian cancer.  It is very slow growing and highly treatable.   Like I said, my youngest sister's had spread to her liver and breasts (a death sentence with most cancers) and, after three doses of the radiation, she is now 100% cancer free!

Take care of yourself and the baby - that is the first priority.  The cancer will be there after delivery.  :-/   Keep a close eye on it but don't panic - it's not like the cancers you are so familiar with.  Here's a bit of info:  http://www.endocrineweb.com/thyroidca.html

Take care of the two of you!

HUGS

Utah

[amela321]

I agree with Utah that it would probably be ok to wait until after you've delivered to begin treatment.  4.2cm is fairly large, however, and if you start having any constrictive symptoms, they may want to do the surgery part sooner.  The radioactive iodine treatment can definitely wait until after the baby is born.  I would think, as Utah said, they will just monitor you closely for now with repeat ultrasounds and hopefully the tumor will not grow to the point that you need it removed prior to your baby's birth.

I'm so sorry you're going through this while you're pregnant.  Pregnancy should be a time of great joy and you should not have to have this (well, no one should, of course) put a damper on that joy.

On the good news front, I was first diagnosed with papillary thyroid cancer in 1985 and went 22 years with no evidence of disease.  

Good luck to you and take care!

Amy
Papillary Thyroid Cancer
First diagnosed 1985
Recurrence 2008

    

[melval9201]

My goodness that was a mouthful.  Do you all live in the same area?  I can't even imagine.  I actually lost my mother to breast cancer almost 2 years ago.  She was 55 years young.  We also lost my mother in law to ovarian 6 years ago.  So cancer scares the hell out of me.  I am making phone calls today to a few doctors to get some opinions.  I just want this to all be taken care of as soon as possible.

Melissa

[utahmomma]

Okay, you asked.  Here's the story:

In 2003 I had an unrelated CT scan that showed a nodule in my thyroid (no symptoms, normal labs).  My doctor humored me and ordered the ultrasound.  It showed a small (5mm), solitary, complex (solid and fluid) nodule with irregular borders.  I did enough research to decide it wasn't worth messing with.  I opted for surgery (skipped the FNA).  My surgeon was going to take the entire thing out if cancer was found but, since the left side of the thyroid was nodule free, the plan was just a lobectomy.  Cancer *was* found but not until I was in the recovery room.   Okay, no big deal, right?

A few months later my youngest sister (there are 5 daughters in the family) was in a minor car accident.  They found multiple nodules when they performed a chest x-ray.  She had an FNA which was negative but she had a "gut feeling" and had it removed anyway.  It was cancerous on both sides and into her lymph nodes.

After that the other three sisters had thyroid ultrasounds - all had nodules.  One opted for a FNA which was also negative - she had cancer too.  Of the remaining two sisters one was cancerous and the other precancerous.

I took my kids for ultrasounds - son's thyroid was perfect but my daughter had multiple nodules (one compressing her jugular).  My daughter's was precancerous too.

After all that (and this was all within 12 months) I opted to have the other half out.  No cancer was found.  Two years after the second surgery I had a recurrence and required RAI.

My youngest sister had three recurrences - the last time with metastases in her liver and breasts.  She is now 100% cancer free.  She also conceived her daughter 6 months after the last RAI and is now pregnant with her second child.

My daughter is also pregnant and her TSH is out of control (it was 66 last week) and she needs her Tg (thyroglobulin - the thyroid cancer marker after surgery) checked to see if any of the remaining tissue has turned cancerous.  :-(

Papillary carcinoma is very slow growing and the treatment - RAI (radioactive iodine or I-131) targets the cancer and any spread.   I would guess that, for the health of the baby during surgery and with changes in thyroid hormones that come with the surgery, they will wait until right after you deliver for the surgery.  They will probably just want to monitor the tumor with ultrasound and keep the thyroid levels controlled until after the delivery.

Yeah, papillary-carcinoma-a-plenty  :-)

Utahmomma

[melval9201]

Hi and thanks for  your reply.  I felt a large nodule on my neck and went for an ultrasound....they saw a nodule on my thyroid (right side) it is 4.2 cm in size.  I then had a FNB and the tests results stated  "atypical follicular cells seen with nuclear enlargement, grooving and irregularities of nuclear contour. The findings are consistant with papillary carcinoma."  

I am making phone calls tomorrow with thyroid specialists within my area.  

So when you were diagnosed with papillary thyroid cancer did they do a full thyroidectomy or just a partial?  How long did it take for the recurrence?  
Thanks!

melissa

[utahmomma]

How did they diagnose your cancer?  What was the diagnosis?  What are your labs?  What did the imaging study say?

Reason I'm asking is, the most common forms of thyroid cancer are typically very slow growing.  Based on your answers to the questions I've asked, you probably don't need to worry about surgery until after the baby is born.  Keeping your thyroid levels stable are important but the surgery can probably wait.

Utahmomma
papillary carcinoma (with recurrence)
three sisters with papillary carcinoma
daughter and another sister with precancerous thyroid nodules

[melval9201]

Thank you so much for your recommendation.  I am going to research the hospital and doctor.  Thank you gain.....any help is very much appreciated.

Melissa

[Reese120]

Hi Melissa~

Where in Pa. are you?  I live about 40 minutes outside of Phila., and I had the best surgeon.  Dr. William Keane located at Jefferson University Hospital!  I also have a great endocinologist also out of Jefferson.  I just gad my 2nd surgery 3 weeks ago for papillary thyroid cancer.  This site is a great place.

Hugs~

Noreen