A decision must be made soon.

JohnJ · New User Joined: 30 Jan 2010 Posts: 3 Location: Brisbane

Firstly, please let me apologise if my concerns seem small, for compared to what I've read, I guess they are. Others are enduring terrible things and I feel as fit as a fiddle.

I'm a 48 yo male, who except for age would fall into the low risk category.

For the last 13 odd years, there has been a large, solid lump on the front of my throat. While for most people this would have been a concern, in the course of my job then I had managed to stab myself in the throat with a pen and I thought it was a reaction to the trauma. (Moral : Do not lift boxes with a pen tucked into the neck of your T shirt. Accidents hurt.)

Some 4 months ago I became concerned about a swelling on the right hand side of my neck. After a CT scan it found to be a goiter like object severely interfering with the trachea and windpipe. An FNA was performed and nothing abnormal was found.

On the 22nd of January I went in for surgery to remove both the goiter/cyst and the big, ball like lump. While there, they decided to remove the right hand part of the thyroid as it was red and inflamed.

Yesterday I went to get the stitches out and one of the surgical team wanted to talk to me.

They want to take the rest of the thyroid out.

The cyst was tested and was clear, there was no sign of problems in the thyroidal tissue itself, but the big, cystic ball thingy was an encapsulated papillory tumor. There was no sign of capsular or vascular invasion. (I read the report on the desk) I was told a thyroidectomy was "standard procedure".

I need to know [i]why[/i].

For 13 years this thing has been in my neck and I've looked at it every day. I can't help but think that if it was going to spread or do anything, it would have done so by now. But there's nothing. No evidence of anything anywhere.

I feel like they're just "playing safe" and that the argument is similar to a dentist saying [i]"I've found a cavity in a tooth, so I want to take out all your teeth to prevent further cavities."[/i]

Frankly I'm still shocked, confused and more than a little bit scared by the thought of what may be coming. But I'm going to have to decide soon what is going to happen.

I know what the surgeon will recommend, one did that yesterday, but even he couldn't tell me why. Since the one they found was unilocal, he couldn't even give me an estimate of the chances of recurrence if I didn't have the second operation.

To make an informed decision, I need information. Can someone please point me in the right direction?

Thank you. Again I apologise if this all seems like small potatoes compared to what others have gone through, my only excuse is that it is looming very large in my future at the moment.
_________________
"In the beginning was the word"

"Oops"

brainman · Posted: Sat Jan 30, 2010 9:46 am Post subject: Re: A decision must be made soon.

Hi John. I am so sorry about your tumor. I have two thoughts:

1. Have they actually said that it is a cancerous (malignant) tumor? If not, you want to ask them. If it is not malignant, that is the reason it has not spread.

2. I am wondering if your accident and this tumor are even related to each other. It is not common for an accident to devolve into a tumor (malignant or benign). It could cause scar tissue and that might be what you have felt over the last 13 years.

Your medical team may have already answered these two issues to you. But since you did not specifically tell us about these two, it is impossible to advise you about what comes next. Let us know what you find out.

You are in my thoughts and prayers.
_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Twitter: @JimHawkins54
FaceBook: http://www.facebook.com/James.Hawking54?ref=profile

JohnJ · New User Joined: 30 Jan 2010 Posts: 3 Location: Brisbane

Hi brainman, thanks for the reply.

In reverse order:

2. The accident was coincidental to the lump. Because they happened around the same time I wrongly ascribed the lump to the accident and therefore didn't worry about it. My mistake.

1. The term used was "fully encapsulated papillary thyroid carcinoma". Malignancy wasn't mentioned.

You see, this is where I'm having problems. It was all "Well, this is what we found, and therefore it's standard procedure to do that." Nothing about risks to me, aside from general surgical risks.

From my reading, encapsulated ones are either unifocal or multifocal. Since mine shows no signs anywhere else after 13 years I can only think that it is unifocal.

If that is the case, then they've already got the thing out as well as the surrounding thyroid tissue. They've got it, there is no sign elsewhere, why cut more? I don't understand.

The damn thing wasn't even inside the thyroid but attached to the back of it. On the CT it showed up as hard as bone.

From the Drs comments and body language, it wasn't particularly dangerous. The path report showed no invasion anywhere. So why do they want what I can only call an extreme solution? I don't understand.

Especially since Rivera et al 2009 says: "None of SCAM EPTC recurred, including 30 patients treated by lobectomy without radioactive iodine (RAI) therapy (median follow-up: 8.9 years)."

I'm hoping someone here can shed some light.
_________________
"In the beginning was the word"

"Oops"

brainman · Posted: Sat Jan 30, 2010 5:39 pm Post subject: Re: A decision must be made soon.

Thanks for clarifying that. A carcinomal Is a malignant tumor, i.e. cancer. I also understand how you associated the lump with the accident because they happened at about the same time. I think I would have assumed the same thing you did.

I am not sure why they want to remove more tissue. It might be that they are concerned about getting clear margins. That information is usually a part of the pathology report (I assume that is what you saw?).

I think you might be right.... although not quite like wanting to remove all teeth because of a cavity in one (cavities cannot spread to other teeth), they are most likely just wanting to be safe. Rather safe than sorry.

The good news (great news) is that your type of cancer has a wonderful prognosis. If the tumor is removed, the is almost a 100% chance of living more than 10 years. I would want to talk with my doctor to fully understand his reasoning but most likely I would go on and agree to have both sides totally removed now rather than worry about it returning later. The other good news is that it rarely spreads to other organs.

You are in my thoughts and prayers as you try to figure out what to do next.
_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Twitter: @JimHawkins54
FaceBook: http://www.facebook.com/James.Hawking54?ref=profile

	Cancer Forums Forum Index -> Head and Neck Cancer/ Thyroid Cancer Forum	All times are GMT - 5 Hours
Page 1 of 1

A website for discussions about any type of cancer, including lung cancer, breast cancer, prostate cancer, laryngeal cancer, leukemia, lymphoma, multiple myeloma and others