recurrence - I *knew* it but still frustrating

[utahmomma]

Okay, I'm pounding my head against the wall.  I've suspected for quite a while that I was having another recurrence but the labs are in.

Here's my results August 20th:
TSH     .64
Tg        .2
TgAB:  0

Here's my results from yesterday:
TSH   4.93
Tg       .2
TgAB:  2

Aside from the (gasp) rapid climb in TSH even though I'm on stable meds and the still existent thyroglobulin (despite one round of RAI), here's another thing that concerns me (from ThyCa:)

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Serial TgAb Measurements: It is important for the laboratory to measure TgAb in every specimen sent for Tg measurement. This is both because a patient'ss TgAb status may change from positive to negative or vice versa, and also because the trend in TgAb values over time (i.e. 6 to 12 months) gives additional information on how well the tumor is responding to treatment. A trend down in TgAb levels overtime (years) is a good sign that treatment is effective. In contrast, an increase over time may be an early sign of a recurrence. When a patient has TgAb detected, it is not unusual to see a temporary rise in the TgAb level during the first six months following radioiodine therapy. This may even be a sign of the effectiveness of the treatment. Usually, TgAb values return to the original value or below after six months.
**********************************

I see Dr. McBaldy (my endo) on Wednesday to discuss when I go all nuclear again.  Sigh.   Yeah, it's depressing me and add to that the liver/bile duct pain (from the last RAI scan and scarring it caused) and I'm frustrated.  I'm betting the recurrence is in my liver (or maybe still in my head too) - guess we'll see.

Just wanted to vent.    Argh!!!!!

Utah

[ChitChatNine]

Hey there Utah ......................you are awake and so am I ................ *yawns*

C~

[utahmomma]

The reason I had to go hypo for my TREATMENT dose in 2006 was because the FDA had not approved Thyrogen for treatment - only scan dosages.  My very conservative hospital would not use Thyrogen for treatment because of it had not been approved for that use by the FDA at that time (although other hospitals *would* use it for treatment).

That changed last year.  Here's a quote from Genzyme's website's press announcement from Dec 2007:

"Genzyme Corp. (Nasdaq: GENZ) announced that the U.S. Food and Drug Administration (FDA) has approved a supplemental indication for Thyrogen(R) (thyrotropin alfa for injection) to be used in combination with radioiodine to ablate, or destroy, the remaining thyroid tissue in patients who have had their cancerous thyroids removed. Remnant ablation is a procedure that patients commonly undergo when being treated for thyroid cancer.

"This new indication extends the significant benefits of Thyrogen to patients during their initial treatment for thyroid cancer, in addition to its current use in follow-up diagnostic procedures to detect recurrence," said Mike Heslop, senior vice president and general manager of Genzyme's endocrine business. "This is an important milestone in our ongoing effort to expand the clinical applications of Thyrogen to improve patient care."


Yeah, hypohell was NO fun and I don't want to go through it ever again but, if there is enough recurrence to warrant another large treatment dose, it will be a long discussion with the endo.  :-/

[amela321]

I could be wrong, but isn't Thyrogen only approved by the FDA for the first RAI treatment a patient has?    Having recently gone through hypo hell myself, I wouldn't wish it on anyone, but I thought I remembered reading that somewhere.  

[utahmomma]

Hey Lori - no LID this year (so far) - this will just be the scan dose.  If a recurrence is found then I'll sit down with McBaldy and discuss whether or not I want to go through hypohell and the LID for the treatment dose or do another course of Thyrogen.

Yeah, don't you love drinking the stale, distilled-water tasting radiation?  yum, yum.   They just have me stick my head into the radiation hood (where *they* use tongs and gloves to unscrew the large metal cask and open the little vial of nuclear love), put in the straw, slurp, add more water (3-4 times) and slurp again.  Then I sign a form, set of the geiger counters, and run for the door.  :-0

Fingers crossed on your scans.  Let us know!!

HUGS

Utah

[kipland]

Oh Utah.....it's too bad we couldn't have coordinated!!  I'm glowing NOW!  Funny thing is, I thought I was going to be getting a pill like last year.  Nope ~ they switched to liquid.  And again, I felt like a lepper sitting in the chair covered with those blue plastic hospital things, one taped to the floor, she had me put one on like a bib, then covered my lap with one.  Sheesh!  

I have scans tomorrow and Friday and hopefully (fingers crossed) nothing will be found, and I'll be done.  

Good luck to you in a couple of weeks - I'll definitely be thinking about you.  Do you have to start the LID now too?  Ugh.  Tired of it.

Hugs!
Lori

[amela321]

Sorry to hear your news.  I'm still going through my recurrence, so I can certainly sympathize.  Best wishes to you!