Please answert this cancer question

[kyrela]

If you had only one nodule and it comes back cancerous and they removed that side of the gland, why do they have to remove the other one if theres nothing there.. Cant they just give you treatments so you can keep at least half of your thyroid gland? I dont want to lose all of mine, I dont want to go through this surgery again either. Having to adjust meds and feel side effects of them and mine being alittle different as I malabsorb them because of having had gastric bypass.. ugh! SiGH!

[kyrela]

I;ll read that again when Im NOT on percocet....lol thanks for answering it though :)

[utahmomma]

The amount of RAI they have to use for cancer is *huge* compared to what they use for scans, to kill off thyroid for Graves, etc.  For a scan dose it is about 4mCi but for cancer treatment (ablation) they usually use 100mCi or more.  The radiation they use for this is a beta wave (I had a long time to sit in in nuclear medicine today discussing this stuff) which kills off tissue surrounding it.  It is meant to stay there (attached to the iodine) and kill.  

The type of radiation I had today (PET scan) is an alpha wave - like x-rays.  It has a very short life and doesn't stay put - it "radiates" out, (hence the pictures they can get).

Okay, long story short, if you have half of a thyroid left the amount of "killer" radiation that it would absorb would basically do two things:  suck of all of the radiation and hold it (which could damage nearby, healthy tissue) and possibly not leave enough radiation with any other cancer cells to kill them off (which is the goal, after all).

Make sense??  I'm a bit under the weather and doped up on TheraFlu so I don't' know if I'm coherent or not.  :-)

[kyrela]

They cant do RAI with a thyroid remaining?

[utahmomma]

Sometimes if it is classical papillary carcinoma and it is a very small, encapsulated area they will only take one lobe.  However, papillary carcinoma is notorious for microcancers - areas of cancer so small they can't be readily identified.

I only had my right lobe removed.  My papillary carcinoma was small (5mm) and encapsulated.  There was no reason for them to take the rest out . . . until EVERYONE else in my family decided to be diagnosed with either papillary carcinoma (3 of them) or precancerous nodules (2) over the next year.    I had the other lobe removed and it was diagnosed as benign.

Two years later my labs showed I was having a recurrence, which blew everyone away since my cancer was localized and so small.  I had to have radioiodine (RAI) which I couldn't have had with half of my thyroid remaining.  (we would have missed the recurrence too if half of my thyroid was remaining since it would have thrown off the thyroglobulin levels - that is the cancer marker)

Even though my cancer was not supposed to spread, it did.  Papillary carcinoma can do this.

Talk to your doctors and weigh the options.