loss of voice in pregnancy related to thyroid cancer

[judith277]

Dr Lupo
My daughter had thyroid cancer eleven years ago at age 23 and had the thyroid partially removed. She learnt a year ago that one of her vocal cords isn't working. She is now 36 weeks pregnant and her voice has gone back to how it sounded after the operation - very weak and breathy.
She has had problems withh pelvic girdle pain through most of the pregnancy - which is a loosening of the ligaments getting ready for childbirth. The loss of voice has coincided with swollen ankels - again a classic sign of getting ready for birth. As the voice box contains ligaments do you think that the vocal cords have been loosened as a result of hormones?
I'm obviously concerned about her getting her voice back after childbirth. I'd be very grateful for your help on this.
Judith

[Mark Lupo, M.D.]

Would see an ENT to evaluate the vocal cords.  It is not likely related to tumor regrowth, but this needs to be considered.  Also, testing TSH which should be in the lowish range (0.2-1.0 in this case -- or even lower depending on the cancer status) -- under-treated hypothyroidism can worsen the voice.
First step is ENT eval.

[raykaplanz]

Judith-

I encourage your daughter to find a good ENT/ radiologist. She needs imagining to rule out the possibility of a tumor infecting the vocal nerve.

[Mark Lupo, M.D.]

Would likely wait until after delivery unless things worsen.
TSH is a blood test for thyroid function.

[judith277]

Thank you for your comments. You say she should have TSH testing but what exactly is TSH? She is 3 weeks away from giving birth. Should she wait for birth for further investigation?
Judith