Total Thyroidectomy or Partial Thyroidectomy

[mario_santiago_77]

Hi Dr Lupo,
I was diagnosed with having papillary thyroid cancer on my right lobe (2.2 CM). I told my Dr to remove only the right since that is the only affected (no nodules found on the left, as per ultrasound and ct scan). He told me he needs to do the total thyroidectomy if the frozen part that was taken out will be positive of the cancer and he will leave the other one if return inconclusive or negative. Since I do not know all the medical things surrounding this, “why to do TT over Subtotal”. I just agreed (but in my mind I’m not fully convinced). I woke up without my thyroid gland anymore, after the operation. Pathology came that 1 small lymph node was found to have cancer and the right lobe have .5 cm (BUT Not Cancerous) and the 2.2 CM was papillary cancer.
Here are some of my questions:
1. Considering papillary is a small growing cancer/tumor why need to take the whole thyroid gland out when once is only affected.            See links below.
                        
(http://www.nytimes.com/ref/health/healthguide/esn-thyroid-cancer-know.html)
               (http://www.naturalnews.com/028912_thyroid_cancer_treatment.html)
Living without thyroid itself (hypo hell) to me is just like living with cancer, I was not able to regain back my normal strength and always light headed, dizzy, headache, don’t know how to explain. 
2. How will be the recurrence rate of Subtotal over Total thy? In my case I’m a 34 years old male. Stage 1 papillary cancer?

[mario_santiago_77]

Hi Dr Lupo,

Would you recomend taking RAI with regards in my case?
I'm still in the process of deciding to take the RAI or not. I understand that taking RAI increase the chances of leukemia? I have an uncle who died of leukemia thats is one of the reason why I'm hesitant of it. Also taking into consideration that I dont need it in my case?or do I still need it?

thank you very much

[Mark Lupo, M.D.]

The probability of bilateral (even mircroscopic) involvement is 25-40% so with a tumor more than 1 cm in size, we recommend taking out the entire thyroid.  This was a T2N0 tumor, stage I (b/c of age <45y) -- good prognosis overall and total thyroidectomy was the correct surgery based on current international guidelines.  The need for radioactive iodine is more debated in this case than the extent of surgery.

[mario_santiago_77]

Correction of the question above.

1. Considering papillary is a small growing cancer/tumor why need to take the whole thyroid gland out when ONE SIDE is only affected?            
See links below.

http://www.nytimes.com/ref/health/healthguide/esn-thyroid-cancer-know.html
               http://www.naturalnews.com/028912_thyroid_cancer_treatment.html