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Thyroid cancer recurrence
I had a recurrence of thyroid cancer last November. I had to have external beam radiation because RAI was not helping. In March I had a PET/CT scan which was normal and my thyroglobulin was undetectable.
My TSH has slowly increased from .07 to 5.67 so my Synthroid dosage was increased. Now my thyroglobulin has increased to 1.7 so once again I have been sent back to the radiation oncologist.
My question is, since I had a recurrence a year ago, should I do the radiation again or try something different? I was told to stop the Synthroid, and then a repeat PET/CT scan will be done. Since I am a college student studying law I was not happy to hear about stopping the Synthroid but I was told sometimes the results are more accurate than when getting the Thyrogen shots.
My TSH has slowly increased from .07 to 5.67 so my Synthroid dosage was increased. Now my thyroglobulin has increased to 1.7 so once again I have been sent back to the radiation oncologist.
My question is, since I had a recurrence a year ago, should I do the radiation again or try something different? I was told to stop the Synthroid, and then a repeat PET/CT scan will be done. Since I am a college student studying law I was not happy to hear about stopping the Synthroid but I was told sometimes the results are more accurate than when getting the Thyrogen shots.
A related discussion, Would it be safe to just periodically check Tg levels was started.
MEDICAL PROFESSIONAL
Good to hear you are already at a university center -- but I agree w/ you that thyrogen stimulated PET and Tg levels would be appropriate rather than withdrawal from medication (mainly from a quality of life standpoint).
I am currently being treated at a university based hospital (in Michigan) because that is where I was referred to.
Their suggestion also was maybe keeping a close watch on the thyroglobulin levels, depending on the results of the PET/CT which I have chosen to wait until January to have done.
Their suggestion also was maybe keeping a close watch on the thyroglobulin levels, depending on the results of the PET/CT which I have chosen to wait until January to have done.
MEDICAL PROFESSIONAL
This is a complicated situation -- the fact that you have already had XRT puts your thyroid cancer into a different class than usual as most patients do not need this. Usually it is a one-time treatment and not repeated.
Thyrogen stimulated PET/CT makes sense -- would not withdraw from thyroid hormone only for this test --(and the thyroglobulin) -- especially since I-131 treatment does not seem to benefit your situation AND you need to study.
Would recommend finding a university based thyroid program and get a second opinion. It may be best to monitor the Tg and see what happens....but a PET scan would help exclude an aggressive process.
MD Anderson, Johns Hopkins, Ohio State, Memorial Sloan-Kettering are all excellent facilities to consider a second opinion for this in the future.
Thyrogen stimulated PET/CT makes sense -- would not withdraw from thyroid hormone only for this test --(and the thyroglobulin) -- especially since I-131 treatment does not seem to benefit your situation AND you need to study.
Would recommend finding a university based thyroid program and get a second opinion. It may be best to monitor the Tg and see what happens....but a PET scan would help exclude an aggressive process.
MD Anderson, Johns Hopkins, Ohio State, Memorial Sloan-Kettering are all excellent facilities to consider a second opinion for this in the future.
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