Thyroid nodules w/ family history of hypo and thyroid cancer?

[Dnmh]

Recent discoveries to my family health history are causing me to think I should follow up more on tests perforemed over a year ago. Here is my "story". I apologize if it's too long.

In 2007, a CT on my chest reveled thyroid nodules. My primary doctor ordered a Thyroid Echo which revealed "three hypoechoic nodules measuring 2mm, 3mm & 3mm" on the right lobe "within the left lobe there are two small nodules within the upper and mid-pole measuring 3mm & 2mm" and "Within the inferior pole there is a complex nodule measuring 1.4 x 1 x .08 cm. Remainder of the thyroid parenchyma is diffusely irregular in echogenicity. Contour of thyroid gland is also mildly irregular" Impression: Findings consistent with multinodular goiter with a single large nodule measuring 1.4 cm in greatest diameter. Malignancy cannot be excluded and hisologic evaluation is recommended. - Needle biopsy was performed and to my recollection came back as not being cause for concern at the time. (Sorry, don't have that report) My primary also ordered thyroid blood test. Results: Thyroxine, Free 1.03 and TSH 1.39. The endo I saw basically told me he didn't want to see me again and just follow up with my primary. (Switched doctors because I was mis-diagnosed as having progressive scleroderma - was undiagnosed by a sclero specialist) I do have morphea sclero with a slightly elevaated ANA. I mention this just in case it's relevant.

My biggest concerns are based off my families history of thyroid problems - all on my father's side. One of his uncles died of thyroid cancer, my father and at least 4 of my cousins (2 male, 2 female) have hypothyroidism, and I was just informed that another cousin who recently passed away from complications of leukemia, also had a large mass on his thyroid but that it was put on the back burner because of the leukemia. My father and cousins never exhibited the outward appearance signs of hypo - no weight gain... but dad also has very itchy skin.

I'm tall and thin, but have recently lost 8 lbs in a one month period, my skin itches all the time, I am very sensitive to cold (could also be due to lower than "average" blood pressure and having no body fat) and have been prone to hot flashes for at least the last 15 years. I'm only 42 years old. Not sure if this is related either but after my first normal pregnancy - I had one miscarriage in the 4th month , and my last 2 I delivered in the 7th month, first one happened and daughter was on apnea monitors for 4 months, last one almost miscarried in 4th month, and at 7th month ultrasound indicated failure to thrive so I was induced.

Should I be seen more often about all this? Is it something I should be more concerned with? Should I have had a more involved thyroid blood test and not just T4 & TSH? Any insight into the direction I should follow with all this would be greatly appreciated.

[898]

The ultrasound finding shows the result of severe thyroid inflammation in the past. I t can be as a result of postpartum thyroiditis as well as chronic autoimmune disorder.
Testing for TPO antibodies could be helpful.

[Dnmh]

Thanks. I meant to post this in the experts forum but it met it's quota for the day. The morphea I have is an autoimmune disease that over produces collagen, but morphea only affects the skin, not internal organs like other forms of the disease, and I've had it since I was around 7. I'm now 42. My biggest concerns are the high prevalence of thyroid problems on my dad's side of the family, plus the fact that one died of thyroid cancer. My research tells me there is only one that causes death. Granted, it could be because it was in 1977 and they may not have had as much info as they have now. My great-uncle had 4 brothers, one being my grand-father that had different types of cancer - all fatal.
I currently have no health insurance, so have avoided seeing a doctor for anything.

[utahmomma]

Do not overlook your family history of thyroid cancer.  You need to consult with a thyroid specialist - most endocrinologists only deal with diabetes and there are some ENTs who are great with thyroids.

If cancer cannot be ruled out and you have a family history of thyroid cancer then surgery may be indicated.  Do you know what type(s) of thyroid cancer?   If it was anaplastic or medullary then you really need the thyroid removed - if it was papillary or follicular then surgery may still be indicated but those types of thyroid cancer are less aggressive.

Please, don't put it off too long.

Utahmomma
papillary carcinoma with 2 recurrences
three sisters with papillary carcinoma (one with three recurrences)
sister with precancerous nodules
daughter with precancerous nodules

[Dnmh]

Utahmomma,
Thanks. We don't know what type he had. I tried looking up his death certificate online to see if it was mentioned but couldn't find it. We lost track of that part of our family.
I'm not afraid of thyroid cancer, just know that it needs to be taken care of.
Thanks again.

[utahmomma]

Usually the only fatal types of thyroid cancer are anaplastic (like Chief Justice Rehnquist had) and medullary.  I said *usually* because the other two types are usually caught before they can become life threatening and they have a very specific post-surgery treatment plan (radiated iodine - RAI).  RAI doesn't work on anaplastic or medullary.

I'm glad you understand the importance of taking care of it without freaking out.  :-)  that's often a difficult like to walk.

[Dnmh]

Thanks again! I've had an "interesting" health history. I won't repost here, but in the Arthritis Community I have a post titled "Need Direction..." That is why I no longer freak out over anything medical. Bad doctoring has taught me to research and understand, then deal with it...