PET / CT Imaging with hardware fusion Confusing Results

[VeeMacgill]

Background: I (53 yo female) had RAI ablation 15 years ago when multiple nodules were found and then was diagnosed with papillary thyroid cancer in 2005 -a  2cm nodule was removed from area of my left thyrod - No remaining thryoid tissue was found.  Followed by another RAI treatment and 2 clean scans one in 2005 and one a year later 2006.  Now due to incease thyroglobulin level (.5)  I have had an ultrasound of my neck - nothing found and then a  PET/CT imaging with hardware fusion.  My endo's response when she got the results was to wait and see 6 months repeat the blood work.  I obtained a copy of the report and the results vs my endo's approach have me confused.
The results show  a 2mm nodule behind the left jugular at the level of the cricoid cartilage, pair of 1-2 mm nodules just below that level, 3 3mm pulmonary nodules in the inferior lingula, and several small aortovcaval lymph nodes below the level of the renal veins.  All nodules/nodes found  have the comment  "too small to characterize". and the impression is "No hypermetabolic foci are seen"
My Questions:
1. Has the thyroid cancer spread?
2. What does "too small to characterize mean" - that the machine is not able to resolve to the size of the nodules in order to tell if they are cancerous?  Is there a better mouse trap for small nodules?
3. Given the results would a course of treatment be another RAI ablation? If so why wait 6 months?  so the nodules can get bigger?
4. Do Nodules/nodes have to be removed before more RAI - if so, are the ones I have operable?

I am realizing I have a long way to go to being able deal with living my life with thyroid cancer "hanging over me". I want to deal proactively with the cancer and the 'wait and see' approach is just the opposite. Depressing and unsettling.  I feel like I am missing a piece of the understanding my cancer puzzle.

Thank you in advance for your time and response.

[ChitChatNine]

After my thryoid woes I became very much against the stats hearing them from the Dr's bcz I began to realize that they relied too heavily on them to "ease my fear" when they had no other way to say I'd be ok .. they drew from stats ... and on every "stat" I failed and became one rather than beating the odds so I am no anti-stat as stats come from someplace LOL!!!! However, all kidding aside, I do know what you mean and where you are coming from .. I don't have the answer but you can try posting your ? on the Dr. Patient forum as Dr. Lupo is very knowledgable on many things and will answer your ? if you can get a post on it!

I often wondered about insurance, etc.  This year I also got DX'd with Melanoma 6m os after my thyroid surger .. but thankfully it was non-evasive very early early and now all gone .. but ins. co's don't care about that mumbo jumbo language and only see it as Cancer I would assume..ugh.. always something eh?

C~

[VeeMacgill]

YES!  that is exactly it - after finally getting a diagnosis and suregery and treatment, now to be in a holding pattern knowing I am not 100% cancer free.  Frustrating to say the least at a number of levels.  When I tried to increase my life insurance coverage last year after the 2nd scan was clean - I was told I have to have 3 more years of clean scans.
Is it a **** shoot for how long it is before the nodules grow and hypermetabolic foci are identified? Or is there a typical growth pattern for the nodules?  
I am a numbers kind of person - is there a site that reports stats for thyroid cancer?
Seems like being more of procrastinator would help me handle this stage of the disease!

Vee

[ChitChatNine]

I know where you are at and share your sentiments as I had a partial in Jan and they found two microcarcinomas in addition to two other benign nodules.  My micros are under 6.0mm and fully encapsulated BUT I have a 3mm on the other side still intact.

After careful review and long decisions I have decided to take the wait and see approach so I know how you feel and I know just having anything inside of you that can remotely resemble the orig. diagnosis makes you feel as though you just want this ugly monster OUT OF YOU and OUT NOW~!

I am not a Dr. but my initial thoughts are that they are just way too small to get any kind of definitive idea what is going on.  I have kidney stones that size so I know how they feel to the touch to be that tiny and can understand how diff. clinical implications can be of something that tiny yet it shows up on the CT scans, etc.

I go ev. 6 mos for serial ultrasound of my thyroid and so far both u/sounds show STABLE with no change.

Anything less than 1.0cm they usually do not biopsy  so that adds frustrations, too.  Can they do any kind of cold/hot scan ? Would that help or just add more frustration to the puzzle?  I decided to pass on the scan as it isn't totally conclusive and felt it would just add anxiety.

I have major scarring issues so I've been adivsed the complications from the surgery to have a TT in may case outweigh remvoing the oteher side at this time .. 3 of 4 opinions helped me come to that conclusion and I feel 80% ok with it ... the other 20% I feel as you do .. GET RID OF IT AND GET RID OF IT NOW .. but I know I always have the choice so I'm ok with it as of today.

Keep us posted,
Cheryl