CT Scan Results

To determine the treatment options I had an ultrasound of my thyroid and a CT scan of my neck and chest today. After the two tests, I saw Dr. Milas for the reports and the blood work I had done last week and the reading of my slides from the MD Anderson/Orlando pathologists.

 

What’s The Treatment For Recurrent Thyroid cancer?

Many of you already know the diagnosis is recurrent thyroid cancer. Specifically, I have metastatic papillary thyroid carcinoma. Let the Googling begin. It’s the best kind of thyroid cancer to have. I have a “mass” (scary word) on the left side of my trachea within the thyroid cavity. I also have several (at least 15) abnormal lymph nodes.

 

Radioactive Iodine

The treatment is surgery and then Radioactive Iodine. When I had my surgery 9 years ago it was followed by Radioactive Iodine treatment. How can I have thyroid cancer and not have a thyroid? The cancer cells “escaped” the thyroid so to speak and moved to another area. Thankfully they are very slow-growing cells. Studies show that life expectancy won’t be altered for people who are diagnosed with thyroid cancer prior to age 45, i.e. they won’t die from this. I was first diagnosed at the age of 34. Obviously the radioactive iodine did not kill all of the cancer cells the first time. I will have the Radioactive Iodine again this time but it sounds like we will be discussing additional treatment after surgery.

 

Radical Neck Dissection Not Chemo

Chemo is not an effective treatment of thyroid cancer unless it has moved to the bones or lungs or other parts of the body that are responsive to chemo. The surgery option is a radical neck dissection and comes with risks, lots of risks. It is an extensive surgery that could take anywhere from 6 – 13 hours. My scar will go from one side of my neck to the other and slightly up each side. It sounds like a large smile on my neck. The Dr will make the scar as perfect as he can. If I am not happy with it after 6 months he will bring me in and make it as perfect as he can. I’m truly not worried about my scar. It will be earned by the time I’m done with this.

There is a 10% chance (vs 1%) that my vocal cords could be damaged because this is my second surgery in the same area. There is a 20% chance that my parathyroid glands will be damaged. In that case, I will have low calcium which will have to be managed. In addition, there could be damage to my trapezoid nerves and I won’t be able to lift my arms over my head. Another nerve at risk is the one that controls my tongue. Some might say that’s already affected. Then of course all of the regular surgery risks, infection, death, you know, etc.

 

Lymph Node Removal

We asked about how the body reacts with lymph node removal. The body will adjust.  My body will still fight infection after.  What is the recovery time for the surgery?  Actually, I asked when I could exercise again. I liked the answer, 2-3 weeks. He wants me to live life normally until the surgery. Continue to exercise, continue to have a glass of wine at night. The wine comment was unsolicited advice that I was grateful to hear.

 

Will It Come Back Again?

What about the cancer returning?  There is no crystal ball. I have worried that cancer would reappear in my body for the past 7 years.  I will probably always expect that it will be back but will be praying that it doesn’t come back. He did say that I am at higher risk for recurrence because it is in the thyroid cavity as well as both sides of my neck.  Comforting, right?

 

Second Opinion?

We asked about a second opinion and he encouraged us to seek one. The next question was, who would you send your wife to for the surgery? The answer, Dr. Gary Clayman at MD Anderson in Houston. Doesn’t sound objective initially, however, Dr. Milas’ sister is an endocrine surgeon at Cleveland Clinic and does these surgeries. He didn’t say her. I think that’s an objective opinion. I will do more research on this but they will call to get the ball rolling on a second opinion.

 

Ready To Move Forward With Surgery

OK – How do I feel about all of this emotionally?  I am not surprised by the news today.  It is what I had expected to hear.  I’m ready to get going.  It’s a big surgery.  I want the cancer out of my body.  I want to move forward.    I’m tired tonight.  Lots to process.