Hi Dr. Lupo,
I'd like your opinion on my latest developments.
I had an ultrasound a few weeks ago which showed a cluster of lymph nodes, the largest of which measured 1.1cm.
My endocrinologist recommends surgery, but my surgeon does not.
My surgeon said without radical next dissection, he can't be sure he'd get all the positive nodes. So his recommendation is to repeat ultrasound in 6 months and see if the nodes have grown.
My surgeon also does not recommend radiation alone due to risks of additional radiation, and risk of saliva gland damage - and his belief is surgery would produce better outcomes anyway.
However, my endocrinologist recommends radiation!
So, you can see I'm stuck between the 2 doctors' recommendations.
Oh, as noted in previous post, Jan08 Tg was 12 but with TgAb of 152 - recent blood work was inconclusive for Tg.
I'd very much appreciate your advice. Do you think there is any reason for nuclear scan since the surgeon doesn't want to pursue
surgery at this time?
Sincere thanks in advance.
Could it be that your thyroid med is not adequate?
I am 3 months post TT ( papillary ca)...achey joints, malaise/fatigue have returned. I"m trying to understand what happens to the feedback loop ( pituitary/tsh) after thyroidectomy. I have my daily dose of TH. What compensation does my body have for a needed increment during any given day? Thank you.
Hi Dr. Lupo,
I'd like your opinion on my latest developments.
I had an ultrasound a few weeks ago which showed a cluster of lymph nodes, the largest of which measured 1.1cm.
My endocrinologist recommends surgery, but my surgeon does not.
My surgeon said without radical next dissection, he can't be sure he'd get all the positive nodes. So his recommendation is to repeat ultrasound in 6 months and see if the nodes have grown.
My surgeon also does not recommend radiation alone due to risks of additional radiation, and risk of saliva gland damage - and his belief is surgery would produce better outcomes anyway.
However, my endocrinologist recommends radiation!
So, you can see I'm stuck between the 2 doctors' recommendations.
Oh, as noted in previous post, Jan08 Tg was 12 but with TgAb of 152 - recent blood work was inconclusive for Tg.
I'd very much appreciate your advice. Do you think there is any reason for nuclear scan since the surgeon doesn't want to pursue
surgery at this time?
Sincere thanks in advance.
Dr. Lupo,
I can't thank you enough for your response.
This is the most valuable feedback that I've received. My doctor has not been responsive and is not addressing my concerns.
So ,sincere thanks. From your feedback, I feel I have a plan of action and am now going to take things into my own hands. It is my health and life, after all.
Best Regards,
The Tg level is high but somewhat difficult to interpret in the face of Tg Ab's. The source is likely the neck nodes. Usually we observe these until one or more is greater than 1cm in size -- then careful ultrasound lymph node mapping is done prior to surgery so that the surgeon can "clean-out" all the involved lymph node levels. This is called a modified neck dissection and is a major surgery.
A PET scan may be of interest as a PET positive node is considered more aggressive - the protocol though is to usually have a negative WBS before going to PET. But with a positive WBS that brings up the possibility of I-131 treatment -- which may help the nodes, but is not likely to cure them like surgery could.