should I get a thyroidectomy?

[pt6995]

Hi,
I am on the fence on whether I should get thryoid surgery. I have had 3 biopsies over the last 5 years that have come back non-diagnostic for both nodules. I have a "cold:" scan. I am 39 y.o. and very healthy and active--with normal thryoid levels. My endocrinologist--very respected in Philly, states that his 35 years of clinical experience tells him it is most likely benign (by the way the nodule feels upon palpation) but is concerned because one of the nodules have grown in the last 3 years and of course the cold scan and damn non-diagnostic FNAs.

I REALLY don't want to have surgery. Are there any other options?  My only symptom is occ. coughing with certain hyperextension of my neck and occ "pain" at the site of my nodule-but hey, that might be psycho-symptomatic.

Looking for options here. I would hate to have to go through this surgery just to be told the nodules were benign!

Thanks

[utahmomma]

Well . . . you basically have two choices (as you know).  Watch it or get it out.

The cold nodules (as you know) are a worrisome sign - so is having "normal" labs.  Both lean towards malignancy.  Growth is also a worrisome sign.  Benign results on an FNA really don't mean much - it's very, very easy to miss any malignancy with the needle (happened to TWO of my sisters).

If you can live with it and really don't want the surgery, get regular ultrasounds every 6 months or so.  A PET scan may (or may not) also help.

If you can't live with the "what if?" then your next option would be surgery.  If that is what you opt for there is a couple of things you need to know.  As surgeries go, this isn't a bad one at all (I've had many others and they were all worse) but removing your thyroid WILL change your life forever.  You will be on meds forever (not a big deal in the big scheme of things).  Your metabolism will change.  You will have a scar (which will fade over time).  You will need ongoing followups for the rest of your life (like any other chronic condition).  You may have other problems associated with changing your hormones.

For some of us it is a "I can't live with the idea that there may be cancer" choice.  Others want to wait and see.   But it sounds like you know this already and have a good doctor.

Just remember - we don't always fall into neat categories.  Just because your doctor hasn't seen this in 35years doesn't' mean it can't happen.  My family has a "non-genetic" type of thyroid cancer all throughout the entire family.  We are in the 1% of the 1%.  Like I mentioned - two of my sisters had FNAs that were benign - both had cancer.  What are those odds?

Here's a web site that may give you a bit more information but it sounds like you are pretty educated on thyroid conditions:  http://www.endocrineweb.com/thyroid.html

Please let us know what you decide to do and feel free to ask all the questions you want!  Welcome to the forum.

Utahmomma
papillary carcinoma '03, second surgery '04
  recurrence and RAI '06 and '08
three sisters with papillary carcinoma (one with three recurrences/RAI and distant metastases)
other sister with precancerous thyroid nodules
daughter with precancerous nodules

[898]

The benign nodule can grow over the time; about 15 % per year on two sides: was 10 by10 by 8>can be 11.5 by11.5 by 8 in one year [size in mm]