Thyroid Cancer? Please Help...

[lilitone]

I'm a 41 year old otherwise healthy female. Never had any thyroid issues or abnormal bloodwork.

I started having weird feeling of "pressure" in front of my neck around May 17th 2018. It came and went in two sporadic "episodes" in one month. I went to see a GP on June 23rd. He did not feel my thyroid is enlarged, ordered bloodwork, came back unremarkable. But, ordered a sonogram of my neck.

Sonogram results - multiple nodules, about 5 all over the gland, all under 1 cm. GP ordered a follow up with ENT for a possible biopsy to be safe. Lymph nodes were not remarkable.

Since then, symptoms worsened. Chocking feeling and pain in ears are pretty much non-stop. Fever 100F. Throat hurts to breathe in, "hot and feverish" feeling.

I went to urgent care on July 20, three days ago, and demanded an xray of soft tissues of my neck to see if there is anything visible that could be causing this obstruction. Xray was "no abnormalities".

I'm seeing an ENT soon. Petrified. A single mom.

Based on your symptoms, could this be cancer?

[Krysjean33]

I was 26 when diagnosed with thyroid cancer.  I really didn’t have any symptoms other the. My hair was falling out.  Went and seen my GP and he felt my thyroid was in larger and was sent for an ultrasound and blood work.  And they was one single small nodule that ended up being cancer.  My husband had Similar symptoms as you and when they removed his it came back perfectly fine he had sereval larger nodules.  

[lilitone]

Krysjean33, thank you for sharing. I hope you are in the clear now and doing well!

[Gracevd70]

SEE Endocrinologist not Ear Nose and Throat.....I made this mistake.

[sylance9]

If you're talking about the OP grace she should be seeing a ENT first - shes having ENT symptoms not Endo symptoms.  ENTs can help her with the globus sensation, endos cannot.  She wont need to see a endo until she needs hormone control.

[tsh143]

I was 43 when my mom noticed a lump in my throat area.  She and ALL the females on her KY side have had benign goiters.  I consulted with endocrinologist, had 7 fine needle aspirations (all came back inconclusive) so he sent me to surgeon.  Surgeon was against total removal but called me back after reading my chart and said he felt more comfortable removing it all.  I had the surgery and when I got my bandage off 4 days later it came back as CA.  I was diagnosed with Hurthle Cell Carcinoma.  I had a 4cm cancer growth inside my thyroid gland.  I had 100mql RA131 Jan 2010 and 29mql RA131 Aug 2012.  Been on 150mcg synthroid for a few years but now TSH is 0.013 and T4 free was 180.  I just switched to lower synthroid 137mcg.  My advice to you is #1 STOP worrying.  Go to doctor and ask for FNA of goiters.  My mom's and all aunts and cousins were all benign but they have had to have surgery to remove multiple nodules.  Thyroid cancer is slow growing and has great prognosis if treated early.  Don't be afraid to share what you have learned here from real people's stories.  Good luck!

[lilitone]

tsh143, thank you for sharing as well. So sorry to hear it turned out to be cancer, but it sounds like you are managing and doing well?

My update: I went and saw an ENT end of July, and she absolutely REFUSED to even consider a biopsy based on the sonogram results of the nodules and their sizes. She said I am fine, and I need a follow up sono on the nodules in one year...

She went down my throat with a camera and made a video and did not find anything. She said she cannot explain my symptoms, but that it is possible I have a GERD?? She said it sometimes causes tightening of the throat and pain. She ordered a swallow procedure, but I have not yet done it.

The symptoms since then went away, but it was definitely "cyclical" in nature - my throat would tighten and harden for few days and I would have ear pain and then it would go away.

I had been eating a lot of peanuts around that time. My own theory is that I have caused myself a food related goiter  (forget exact medical term), but my GP and the ENT looked at me like I was from the moon when I suggested that.

When I went to urgent care with enlarged what I thought to be "thyroid", the doctor on call said that my thyroid is very enlarged upon examination. Somehow, she did not document that in the notes, the ENT said when looking through my records online.

I was very relieved to hear the ENT was not concerned, but I was and still a bit skeptical about not having a needle aspiration to check the nodules. I will follow the orders and redo my sono in one year.

[Asweeney78]

I've had thyroid nodules for 5 years, i had a biopsy 4yrs ago on 3 of my nodules as they were presenting irregular features, came back benign.
I was told to return annually for ultrasounds and biopsies, i decided i would skip the FNA part as i found it quite uncomfortable and believed i could shrink them with lifestyle changes.
2wks ago i went for annual ultrasound but the endo insisted on FNA due to size increase and appearances.
Turns out i now have papilliary carcinomas on both lobes.... since diagnosis i can honestly say i am feeling discomfort swallowing more than before,  thats part due to the FNA and part Psycholigical i'm sure.
Its quite possible ive had this cancer for 4 years, its slow growing and has an excellent cure rate according to findings.
I am now on an alkaline diet, no animal produce,  no sugar etc.
Having cancer scares me a lot less than the prospect of having no thyroid.

[lilitone]

Asweeney78 , if you do not mind me asking - how old are you? I am almost 42.
Thank you for sharing your story. What was abnormal in the features that prompted the yearly sonos? One of my nodules has received a score of 3 out of 5. It was less than 1 mm in June 2018, so I am supposed to check it next June.

I have generalized anxiety, so it is super easy for me to get scared of anything, but I would me way more scared of cancer (chance of spreading and it being in such an area that is close to brain, throat, etc.) ... I hear that thyroid cancer is easily treated, specially papilliary carcinoma.

Will they be removing the thyroid?

[Asweeney78]

Hi, im 40. On the countless ultrasounds i had done 3 of my many noduls were a concern, the margins were irregular, hypoechoic with punctate calcifications, solid masses not fluid filled...2 are now malignant, possibly more but they fna'd the 2. 5cm one and another 1.5cm.
Surgery is my only option according to endo and drs, im trying many alternative protocols, but will re-evaluate in the next month to see if there has been a reduction in size, if there has i will continue as i am trying to eliminate the cancer, if they have not lessened then surgery before christmas. I wish you the very best, its a horrible feeling not being in control, i too suffer from anxiety. But alkaline diet, b17, curcummin, vitd and c, NO sugar, no processed, vegan diet has made me feel better this last month.  Fingers crossed its working. Xx

[Asweeney78]

I should add that i am very very reluctant to have a total thyroidetomy..... it petrifies me. I have done a ton of research, and it seems the majority of people that have their thyroid removed suffer for the rest of their life, with hypothyroidism . Couple that with the risk of the cancer being spread from the surgery,  and the monitoring for life, ifeel like ive got on the wrong ride. It makes me very sad.

[lilitone]

Asweeney78, have you sought out a second opinion? It sounds you are doing everything in your power to control things outside of surgery options. From what I read back in the summer when I was looking into things that the type of cancer the diagnosed you with is very slow growing...
I wish you the best, please keep us updated?

[ChitChatNine]

How large are your nodules?  They generally won't do an FNA biopsy unless >1 cm, or show signs on ultrasound suggesting a biopsy. Please keep us posted!  C~

[lilitone]

ChitChatNine, the biggest was 7.5 mm, I think. That's why they did not want to do an FNA. Actually, this is my summary in all its glory:

Narrative
EXAM: US THYROID HEAD AND NECK, DATE: 6/29/2018 10:21 PDT CLINICAL HISTORY: Swedish chart note indicate hard lump in throat when swallowing.; Impaired swallowing,throat pain. DIAGNOSIS: Thyroid nodule. TECHNIQUE: Multiple real-time sonographic images of the thyroid gland were obtained using grayscale and color flow Doppler interrogation. COMPARISON: No relevant prior studies for comparison. DATA: Right lobe: 1.8 x 4.9 x 1.3 cm, 5.9 mL Left lobe: 1.7 x 5.0 x 1.6 cm, 7.3 mL Isthmus: 0.2 cm FINDINGS: Thyroid Gland: The thyroid gland is normal in size. Background echotexture is homogeneous. Vascular perfusion is normal. Thyroid nodules are present as below. Nodule #1: Size: 0.9 x 0.5 x 0.7 cm Location: Left interpolar Composition: Mixed cystic and solid (1 point) Echogenicity: Hypoechoic (2 points) Shape: Wider than tall (0 points) Margin: Smooth (0 points) Echogenic Foci: None (0 points) Summary Assessment (level of suspicion based on features): TI-RAD 3 An additional solid nodule measuring 7.5 mm in greatest size in the inferior right thyroid lobe, as well as a mixed cystic and solid nodule measuring 5 mm in greatest size in the superior left lobe and a isoechoic solid nodule measuring 6 mm in the mid left lobe are noted. These do not meet TI-RAD criteria for specific follow-up. Lymph Nodes: No significant cervical lymphadenopathy is identified.
Impression
IMPRESSION: 1. Probable multinodular goiter. The largest nodule on the left is scored as a TI-RAD 3. No specific recommendation for follow-up based on TI-RAD criteria is offered. If desired 12 month ultrasound follow-up could be performed to assess for any significant change in these nodules. SUMMARY ASSESSMENT AND RECOMMENDATION, in order of significance: Nodule #1 TI-RADS Category 3 Note: Clinical judgment may appropriately upgrade or downgrade level of suspicion for malignancy, particularly with relevant exposure, clinical history or physical exam findings. _______________________________________________________ Adapted from: ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee, J Am Coll Radiol 2017; 14:587-595. Created:6/29/2018 17:34 PDT;DIPAA722D

[BigDrew86]

I wouldn't get petrified for 2 reasons. First is that while nodules are very common (especially in women), the majority of them are not cancerous. They may be toxic or autonomous nodules, meaning they produce their own thyroid hormones or interfere with thyroid function, but they're benign. Second, if they do turn out to be suspicious or straight up thyca, the treatment tends to be pretty straightforward and not terribly complicated, given 95% of thyca responds well to simply surgical removal or surgery and RAI treatment with very low rates of recurrence. I say this as a 33 year old man who was diagnosed with papillary thyroid cancer by accident.

As for symptoms, no two people are alike. Unfortunately, other than perhaps neck pain,  headaches, or difficulty swallowing,  there isn't a "standard list" of thyca symptoms one can check off and self-diagnose. In fact, the majority of patients are asymptomatic with normal TSH levels. Even though thyroid patients know their TSH readings doesn't even begin to tell the story.

Before my diagnosis, here's what I myself experienced over the course of 7 months:

-Left neck pain
-Left shoulder pain
-Left arm pain
-Left-sided headaches
-Various joint and muscle aches all over body
-Parasthesis in the fingers and toes
-Intolerance to exercise
-Intolerance to heat
-Persistent cough
-Wheezing
-Persistent allergic response that didn't respond to antihistamines or meds
-Persistent sore throat
-Various stomach ailments (gas, pressure, hiccups, indigestion, altered bowel habits)
-Appetite changes
-Rapid weight loss, then weight gain without changing diet or exercise habits
-Short term memory impairment
-Mood swings and sudden-onset anxiety
-General feeling of malaise and ill-health

All of these symptoms crept up on me insidiously over almost a year. Needless to say, without any history of thyroid problems in my family, my personal physician spent a lot of time and visits playing detective with no results (as my blood work and various testing/imaging studies came back unremarkable) until a mass was found in the left lobe of my thyroid. One partial thyroidectomy and a month later, I feel like a brand new man.
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[lilitone]

BigDrew86, thank you so much for sharing your story!

[BigDrew86]

Not a problem. I know it may not sound like it, but you're fortunate to be a female. Given thyroid problems are much more prevalent in women than men, physicians will at least consider it a possibility to look at and order imaging studies, like yours did. My primary, as good and pleasant as she is, never even once considered my thyroid in over 7 months of me being sick.