Worried about surgery

[shane79]

Hello,

I was scheduled for a hemithyroidectmy today and my surgery got cancelled. I live in Toronto and had my surgery scheduled for PMH.

I am wondering if I should go back for surgery my nodule is 3cm-4cm in size. What are the chances this could be maligiant? Both biopsies came back with focciular neoplasm. What does this mean?

Thanks

Shane

[shaerich]

I had a TT on May 11 due to suspicion of Follicular Thyroid Cancer.  All of my biopsies (I had 3 total) were benign, but b/c of my Tg levels, some Dr.s (I consulted with 6 endos total) were concerned that I had Follicular Cancer despite the negative biopsies.  From what I was told, Follicular Cancer looks SO MUCH like regular thyroid tissue it's hard to diagnose at FNA and even with a frozen section at the time of surgery I was told to EXPECT a benign result... that they would most likely find the cancer at final pathology.  

Fortunately everything came back benign at final pathology too, but given how Follicular cancer spreads and is more aggressive than Papillary, I was not going to take the chance.  You have to do what is right for you.  

As for the percentages... I'm sure your dr. is basing that on his experience with what he's seen:  how your ultra sounds look, the details from your biopsy, etc.  Statistically speaking only 5% of nodules have cancer and of those, Follicular cancer is the second most common.

Also, the surgery is pretty easy.  I'm no hero when it comes to pain and I was back to most normal activities 4 days post op.  I worked out (and had no problem) 15 days post op.

Hope that helps!  Keep us posted on what you decide.

[Nyxie63]

Hi!   The problem with follicular neoplasms is that they can't tell if it's cancer or not until it's taken out and given a full histologic exam (which can take up to 2 weeks).  This is one of those cases where it's better to be safe than sorry.  Also, considering the size of your nodule, you'll probably feel better if its taken out anyway, even if it's benign.

Good luck and please keep us posted. :)

[shane79]

The biopsies were taken 1 year ago. Should I take another one just to be sure? Since the Dr that will be doing mine cancelled my surgery, I think the booking will be alot shorter this time (i had to wait 6 mo's the first time). The reason why it was cancelled was because there was another guy having a total done before me that took too long so they asked me to go home. Is a partial not a big deal and am I worrying about nothing? The doctor says 33% chance its cancer but I'm not sure I believe that. Also, hes a bit of a serious man if you know what I mean - and sometimes its hard to ask questions because hes a very experienced surgeon. Let me know your thoughts.

[Nyxie63]

Due to the nature of follicular neoplasms, you can't really tell if it's benign or not from an FNA.  The only way to tell is to take it out and examine it in detail.  You could probably ask for another one, but most likely, it'll have the same results.  As for the percentage your dr quoted, I really have no idea.  

Don't be afraid to ask questions. Write the questions down in advance before you see the dr so you don't forget any.  Maybe tell him in advance that you're concerned, scared, and want to ask some questions for your peace of mind.  Be a pain in the butt about it if you have to.   It's your health.  

Any surgery is a big deal.  However, most people have a very quick recovery from thyroid surgery and are about their usual business in a week or so.  This is just from reading various message boards, as I haven't been through the surgery myself (currently doing a wait and watch).  I'm sure someone will be along who's been through it and can give more info.

[NJ Yogini]

Hi Shane,

I had 4 nodules, 2 were 1.8 cm so had FNAdone with a report of follicular neoplasm and was told the only way to determine if it was or was not cancer was to remove it and examine it.  I had the right side of my thyroid, the side with the nodules, removed on 2/12/07.  The frozen section during surgery could not make a determination about cancer so the other side was left in.  10 days post surgery the pathology report came back...a 6 mm papillary carcinoma was found.  It was NOT inside a nodule, but in the thyroid tissue, so throw out the 5% theory.  The tissue was also described that it showed hymphocytic thyroiditis (Hashimoto's) and hyperplasia (pre-cancerous) and was focally nodular (whatever that is) andpartly calcified. Yikes!
I had the TT done May 10, 3 weeks ago.  The 2nd surgery was slightly more painful, just used the pain meds more, but the incision has healed so nicely that you barely notice it nw, and it's 6 inches!  My doc believes in a larger incision so there's plenty of room to isolate the vocal cord nerve & parathyroids, with minimal tissue trama.  I was out shopping with my daughter 3 days after surgery, with a scarf, of course!
If I were you I'd schedule the surgery.  It's different for everyone, but most people have a fairly quick recovery.
Keep us posted.

[shane79]

Thanks everyone for your comments. It is greatly appreciated. I booked the surgery tentatively for August 16th, 2007 now to get the procedure done. What is the point in leaving this there so that it can become something nasty? I really want to live a long time so I think I should just get it out. What is the worse that can really happen?