Thursday, July 2, 2009

A month to go.

OK, so surgery date is still set, and is seeming like more & more a reality. July 30th is when all the excitement goes down! I have a pre-surgery meeting with the anesthesiologist and crew on July 22nd.

I had my 2nd-opinion-meeting a couple weeks back, and it was helpful. I liked the doctor's attitude - she was a very take-charge lady, and seemed intent on learning as much about me (i.e. my concerns and my medical status and history) as she could during our meeting (which was about a half hour.) Not entirely unexpectedly, she was very pro-removal of the thyroid. She says that the damage I could be doing by leaving it in is far worse than any inconvenience that would come from having it removed. While that's a valid opinion, it'd be harder to accept if it weren't also for the fact that the odds are apparently very high that my latest biopsy was correct, and I do most likely have thyroid cancer. (I've been hoping that perhaps it was a false positive.) As the doctor put it, your average thyroid nodule has only about a 5% chance of being cancerous. BUT, once a biopsy comes back indicating cancer, the stats are flipped, and now you only have about a 5% chance of not having cancer. Rough. Strangely, it's not the thought of having cancer that worries me so much (I am taking to heart all the reports that thyroid cancer is slow-moving and not terribly invasive when caught early on) it's all the other stuff - the living without a thyroid, the radiation treatment, you know - that I've just been wanting to be able to avoid.
But the doctor I saw (her name is Dr. Peng and she's an endocrinologist) was pretty convincing that surgery was a good idea. She made sure to point out out that they couldn't make me do anything, and that it was my body/my choice (yes!), but that if it were her sister, she wouldn't hesitate to give the same advice. She also volunteered plenty of information before I even got a chance to ask, which was comforting. Especially as regards the radiation treatment: Lots of people (myself included) worry about the effects it may have on the ability to have healthy kids, and she says no studies have shown ill effects. Doctors ask that their female patients wait at least six months before they conceive, but apparently this is more due to the risk of hypothyroidism than any damage caused by radiation. Hypothyroidism during pregnancy has been shown to have an adverse effect on the IQ of the child, and there is a strong likelihood that patients will be hypo during the first few months after treatment, as thyroid hormone supplements are adjusted to the correct dosage. According to Dr. Peng the radiation doesn't stick around in the body long enough to cause permanent damage to anything, except the cancer cells it kills on contact. This falls into the realm of "Stuff I can only trust my doctor to know" and since I haven't heard any evidence to contradict her, I'm accepting this information as truth. Pregnancy certainly isn't at the top of my to-do list right now, but I've always wanted kids, so this was (and is) an important thing to me.

I'm still toying with the possibility of going in for a second biopsy, but interestingly Dr. Peng cautioned against this. She says that the new biopsy could come back clean (non-cancerous) but that could be an incorrect result (since every test result has some possibility of being wrong - after all, that's why I'm thinking of doing another biopsy) and if I choose to believe this 2nd biopsy and it's incorrect, I will be allowing the cancer a chance to grow. I suppose the only way to guard against this possibility is to do an exhaustive series of biopsies, and I don't think I'm up for that. Should I be? I don't know! If I do a 2nd biopsy and it does come back showing cancer, I will at least be that much more confident that surgery is a good idea, but then again I think I already know that the results I have right now are probably correct.


  1. If the suspected nodule is smaller then 2 cm, it called stage one cancer, and the probability of false positive is more then 5%

  2. Thanks - however, my nodule is relatively large, at around 3cm.

  3. Even it is so large, based on 2008 clinical guide false positive is about 15 %. Best of luck!!!!!!!!!!