Take out half or all??

[delphinium2942]

Hi, I just joined this forum because I have to have surgery to take out atleast half my thyroid.  I have a 3x2cm nodule on my right lobe which came back 'suspicious for follicular neoplasm'.  I also have a .7cm nodule on my left lobe.  I have been going crazy thinking how this could be cancer.  I'm 33 and have a 19 month old daughter.  Had been trying to have another but this puts a stop to it for a little while atleast (long while if it is cancer).  My question is, should I just have the surgeon take out my entire thyroid, both sides while he's in there?  I'm worried they may say no cancer during surgery and then find small traces of it later on OR that the other nodule will grow down the road and I'll have to get it biopsied and go through this all again.  Part of me just wants to get rid of it all and not have to worry about it, but the other part realized that there are more risks involved with a TT such as damage to the parathyroids and vocal cords.  What would you do?

[naenae9155]

I came across this. Can you help me .  I had a sono on 9/13/2010 and again on 1/24/2011 due to spasms and a large golf size knot coming up in front of my neck for abut 30 seconds each time this happens.  I also can feel and see an enlargement on the right side.  This is what the radiology reports says.  The current study compared witht he previous examination of 9/13 shows the right lobe to be 6.1x2.1x1.8 cm.  There is a 0.8 cm hypoechoic complex nodule in the lower pole.  the left lobe of the the gland measures 6.1x1.5x1.6 cm.  No deiscfete nodule or cyst in the left lobe is seen.  The isthums is 0.4 cm with a 0.7 cm isoechoic nodule seen

Impression:  Enlarged gland with significant enlargement seen since the last study of 9/13.  There is a single nodule in the right lobe and another nodle in the isthmus.

I am having probelms swolling and and always feels like I have something stuck in my throat.  Also i feel tired all of the the time and I just do not feel like my self.  I have no motivation at all anymore.  Thanks for your help.

[MANmom]

You will get your answer soon, and the surgery is really not a big deal.  I was up walking withing a few hours, then walking a couple of miles within a couple days.  I did not have any complications from either surgery.  My biggest nodule was 2.1 cm, but they found the biggest foci of cancer in the 1.6 cm nodule, it was basically all cancer.  Good luck.

[delphinium2942]

Thank you MANmom for your response.  It just seems I've read on these forums of people having surgery to take out a nodule and then being told in recovery that there actually is cancer and then having to go back for another surgery.  That scares me, I really don't want to go through all this again in a month from now or years from now.  I am having hypo symptoms and my endo that found this nodule was going to put my on a low dose of synthroid before we found out the biopsy result.  I didn't have antibodies though so maybe it was the nodule itself that's causing the symptoms?  Luckily I live very close to the Cleveland Clinic and there are excellent surgeons here.  I have a meeting with the sugeon next week and will ask about the risks to vocal cords and parathyroids if I get the whole thing out.  My nodule is already pretty big so perhaps there will be more risk.  Unfortunately I may have to wait until March 14th for the surgery.  It is all this waiting which is killing me!  I just don't want to go through this again, I want to look back at what I'm living through right now and KNOW I don't have to go through this again!  

[MANmom]

I had just that, although my result from the FNA was "benign follicular clusters".  I still had cancer.  Two surgeries, went throught the same incision, I hardly notice the scar and a year and a half later I feel great.  But, you are younger than I was (46), I would be leary to remove the whole thing, however, you probably are only delaying the inevitable.  Sometimes they can tell while you are on the operating table if it is cancer, but most times they have to send it to pathology.  I think the conservative choice is to take out 1/2, then have it tested...that is as long as you have good insurance and can have two surgeries.  Luckily, thyroid cancer grows so slowly (most of the time) and usually doesn't spread.  If you remove 1/2, then find no cancer, you will probably still have thyroid function of some kind, sparing you of having to take a lot of meds, it may even compensate as you are young (40% of lobectomy patients have full function).  If you choose this you will have to watch the other side, and eventually you will probably have to have that one taken out, as well...Pay me now or pay me later?  Do you have any other problems?   Hashimoto's or Graves?  You have a decision to make, I had the same.  Since I had Hashimoto's I knew I would be losing thyroid function anyway, so I was not really anxious to lose the entire thing, eventually I would have had no thyroid function anyway.  In regard to vocal chord damage, there are things to consider...#1 is get a really experienced surgeon.  I can't stress that enough, I am a singer and I was getting hoarseness, so I needed to do something. I had the head of the otolaryngeology department do my surgery, I had no damage whatsoever, I was talking fine the next day after both surgeries.  #2 don't wait for the nodules to get too big, they may grow into the nerve that controls vocal function.  It is harder to take out bigger nodules without damage.  Parathyroids are the same, the bigger the nodule, the more likely they will not find them or have to remove them with the nodule.  The risks are lower with an experienced doctor and with smaller nodules.  I hope this helps.