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post I-131 scan results

Hi,

My 62 year old mom is battling through thyroid cancer. A brief history of tests is as follows:

1. May 18th, 2010 -->  total thyroidectomy
2. Biopsy results show Papillary thyroid carcinoma of size 0.6 cm x 0.4cm of singular focality.
3. August  24th 2010 --> 4.6mCi of I-123 was given.
4. August 24th 2010 --> Blood tests show TSH > 150,  Tg 168, Anti-Tg  Full body scan was done. Results are " 3 Foci of I-123 uptake suggestive of residual/recurrent thyroid cancer in the neck"
6.  August 25th, 2010 --> 102.9 mCi of I-131 was given.
7.  August 31st, 2010 --> Full body scan was done. Results are "No significant abnormality"

Her endocrinologist wants to see her in about 3 months time. Based on the results above,

1. is the cancer still there or is it gone after the I-131 ablation.
2. How are they sure after the I-123 scan that the foci is cancerous and not normal thyroid tissue left after surgery.
3. Is the Tg level of 168 normal after surgery when lots of normal thyroid cells will be remnant?

I appreciate your help greatly.

thanks
10 Responses
393685 tn?1425812522
My feeling here is the I-131 took care of the residual cells however I am not able to say much more on the other things.

I can say I don't feel that I'd like to wait 3 ths to be tested again.

I have a member here. He name is utahmomma and she hasn't been on board alot. Can you message here please? I'd like her to comment on this.  
Avatar universal
Hi,

Thank you very much for your feedback. I will contact utahmomma and get her opinion.

thanks
Avatar universal
Hi,

I have attached below the details of the thyroid cancer treatment for my mom. stella5349 advised me to get your opinion. I appreciate your opinion greatly.

thanks

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Hi,

My 62 year old mom is battling through thyroid cancer. A brief history of tests is as follows:

1. May 18th, 2010 -->  total thyroidectomy
2. Biopsy results show Papillary thyroid carcinoma of size 0.6 cm x 0.4cm of singular focality.
3. August  24th 2010 --> 4.6mCi of I-123 was given.
4. August 24th 2010 --> Blood tests show TSH > 150,  Tg 168, Anti-Tg  Full body scan was done. Results are " 3 Foci of I-123 uptake suggestive of residual/recurrent thyroid cancer in the neck"
6.  August 25th, 2010 --> 102.9 mCi of I-131 was given.
7.  August 31st, 2010 --> Full body scan was done. Results are "No significant abnormality"

Her endocrinologist wants to see her in about 3 months time. Based on the results above,

1. is the cancer still there or is it gone after the I-131 ablation.
2. How are they sure after the I-123 scan that the foci is cancerous and not normal thyroid tissue left after surgery.
3. Is the Tg level of 168 normal after surgery when lots of normal thyroid cells will be remnant?

I appreciate your help greatly.

thanks
393685 tn?1425812522
was this sent as amessage to her?
158939 tn?1274915197
Hello.

The radiation your mother was given will take some time to kill off the remaining thyroid tissue/cancer.  In about 3-6 months the doctors will need to do another set of labs.  If they can get your mother's TSH to roughly 0.1 then her thyroglobulin (Tg) level should be below 0.7.

What they will watch for now is her Tg results.  They will check them every 3-6 months.  If the levels stay the same or go down over time they will consider her cancer controlled.  If the levels start to climb then they will schedule her for another dose of RAI.  My sister had three doses of RAI (and her cancer has spread to her GI tract and breasts).  She is now 100% cured.

To answer your questions:

1. is the cancer still there or is it gone after the I-131 ablation.
- only watching her Tg levels will tell for sure.  For the vast majority of us one dose will do it.

2. How are they sure after the I-123 scan that the foci is cancerous and not normal thyroid tissue left after surgery.
- they can't be sure, just that thyroid tissue & thyroid cancer both absorb the radiated iodine.  They just know where the "uptake" was (which is good - they didn't see it spread anywhere else)

3. Is the Tg level of 168 normal after surgery when lots of normal thyroid cells will be remnant?
- the Tg level is very high which is why the doctor knew that there was still cancer - not just normal thyroid tissue left.  That's why the doctor ordered the radiation.  If her Tg levels would have been low (in the single digits) then they would have just "watched" the levels.

Sounds like your mom is on the right track.  Have her make sure that her doctors check *at least* her TSH, free T4, free T3, and Tg (thyroglobulin) levels every 3 months for the first year - then they go to 6 months after that.

Take care

Utahmomma
papillary carcinoma '03, second surgery '04, recurrence and RAI '06
three sisters with papillary carcinoma (one with distant metastases and three doses of RAI)
another sister and a daughter with precancerous nodules
Avatar universal
Hi,

Thank you for your comments on my mom's case. Your opinions on this topic are priceless.

--satish
393685 tn?1425812522
She's priceless... satish1367 -

I wouldn't know what to do without her here. She's the best!
Avatar universal
Hi,

I got a letter from my mom's doctor today with further information on the results of the full body scan done after I-131 ablation. The letter states

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
FINDINGS:

There is radiopharmaceutical distribution that corresponds to the 3 foci seen on iodine 123 whole body scan. In addition there is a new focus of radiopharmaceutical uptake superior to the thyroid bed on the left side suggestive of lymph node matastasis. There is normal distribution of the radiopharmaceutical in the salivary glands, as well as in the stomach, bowel and urinary bladder. The liver is visualized due to metabolism of I-131 containing thyroid hormones.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

1. Does the above statement mean that her cancer has spread to the lymph nodes?
2. If it has spread so, would the I-131 treatment have killed it?

I appreciate your time and reply very very much.

thanks,
satish

Avatar universal
Hi there,

My name is Patricia and I was diagnosed with Papillary Thyroid cancer in 1998, I was 29 years old. With Thyroid cancer your mom will need to go to a Doctor every 6 months for life, getting blood work all the time. I have taken the I-131 twice and my cancer was under control, its very important she takes her pill every day. In May 2009 I had a scan everything look good, however in July 2010 the ultrasound taken at my doctors office show something on my neck, my doctor ordered a needle biopsy and it came back cancerous, unfortunately it was Metastatic Thyroid Cancer, in October 13, 2010 I had a Modifiy Neck Dissention Surgery, about 18 lymph nodes were removed and two had cancer. As I am typing this note I just made my appointment for a an I-123.

I hope your mom is doing better, let her know Thyroid Cancer is not aggressiver but is a lifelong going to doctors, hospitals, scans, etc.

Please, please let her know it is important she takes her pills, thats the main reason her TSH level will remain low.

Take care
Patricia  
Avatar universal
sure seems as tho' you know an awful lot about the thyroid!!
Wish I could talk with you....
thyroid nodules
iodine uptake: NORMAL
however, radiologist's impression:  please refer to recent thyroid ultrasound report which did demonstrate bilateral thyroid nodules.  No Focal hot or cold nodule is seen.
Karen
***@****
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