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Old 11-13-2012, 10:02 AM   #1
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Why surgery?

I've read that many thyroid cancers don't even require surgery if they are confined to the thyroid nodules. You can just watch and wait. So why all the surgeries?
My question is, how do they know it's encapsulated or confined to the nodules? I've had 3 US for my nodules in last 13 years, all are quite different but nodules keep growing. I don't believe I have cancer but if I did, no problem for 13 years. I asked naturopath how I would know if I'm having signs/symptoms and she said dunno, is too general a question.
Anyone else in this situation?
I've been to 2 internists, 1 ENT and 2 naturopaths. All tell me my blood work is just fine, no hashi's or hypot/hypert. None think this is an issue for me so I guess I don't either (other than choking all the time), am just curious.

 
Old 11-14-2012, 01:47 PM   #2
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Re: Why surgery?

What size are your nodules? Have you had an fna---needle aspiration of the larger ones? I had no symptoms, and my blood work was normal and i had thyroid cancer. This is how it is with thyroid cancer.

You do seem to have a "choking" sensation "all the time"? Surgery would obviously get rid of that symptom. You could try thyroid medication for 3-6 months to see if the nodules shrink with suppression of your tsh. If they don't, then surgery is likely the answer. The only way to know if it's "encapsulated" is by removal of the lobe and a pathology.

 
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Old 11-14-2012, 04:58 PM   #3
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Re: Why surgery?

Hmm, thanks Reese. I'm so confused about all this. What I read here is so different than docs are treating me.
As of 6mos ago, my largest nodule is 2cm, numerous others at about 1-1.5cm and some smaller than that about 8mm. I have 8 total that I counted. Some have calcification which I understand doesn't mean much and all are solid/hypoechoic (not sure of spelling). I had inconclusive FNA on 1 of the nodules 13years ago and nothing since but 2 ultrasounds. ENT said don't need FNA but he couldn't tell me I don't have cancer and choking sensation (especially when I lay in bed) is just heartburn. He didn't even want to bother reading ultrasound and said to see internist in another year. I take prilosec now and no difference with choking. I've given up on doctors but this still nags at me occasionally. I know at 53yrs old, I've likely had these most of my life so guess it's no emergency.

 
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Old 01-15-2013, 07:03 PM   #4
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Re: Why surgery?

I have a nodule suspicious for follicular neoplasm that I am monitoring. It was recommended by one doctor to remove right away then a second doctor didn't seem as worried about it and is ok with close monitoring of it. I think if you go to different doctors you end up with different opinions. I am against surgery unless it is a last resort. Way too risky.

 
Old 01-16-2013, 04:58 AM   #5
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Re: Why surgery?

I had a lump on right side below the Adam Apple. I am 61 years old. On examination Doctor advised to go for a FNA and Thyroid scan

The FNAC report said -Possibibilty of follicular neoplasm can not be excluded

Thyroid Scan report said =Cold thyroid nodule involving the upper pole of right lobe with equivocal vascularity. the left lobe is of normal size with uniform radionuclide distribution. Suggested FNAC correlations
After two months another FNA done whish says-OVER ALL FEATURES ARE OF FOLLICULAR LESION WITH FOLLOWING DIFFERENTIAL IN DESCENDING ORDER.
OPINION: 1 ADENOMATOUS HYPERPLASIA IN A NODULAR GOITRE
2. FOLLICULAR NEOPLASM.
ADVISE: HISTO PATHOLOGICAL CORRELATION TO DIFFERENTIATE THE SAME.

THE Ultrasound report said : ABOVE DESCRIBED ULTRASOUND FEATURES OF THE SOLID NODULE ARE HIGHLY SUGGESTIVE OF A BENIGN MASS LESION, MOST LIKELY TO BE AN ADENOMATOUS NODULE.

Thyroid profile is within range... all else is near normal .

Wish to know, basis above report if sugery is paramount .... or observe and go for the checkup ie FNA or detailed examination say every 6 months ...

 
Old 01-17-2013, 09:40 PM   #6
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Re: Why surgery?

I will offer my opinion but I am not a doctor. An adenomatous hyperplasia is a benign growth and is not serious which is your most likely case but it sounds like there is a possibility of a follicular neoplasm. It doesn't sound like the risk for follicular neoplasm is significant but that is something to ask your doctor. I would also take into account the size of the nodule. It is safer to watch a small nodule when compared to a larger one.

I would also not have surgery unless a second independent doctor (one from a different hospital or clinic that you find on your own) advises it also. The surgery carries some big risk with one of them being permanent damage to your vocal cord nerves which can affect breathing, swallowing, and talking. I had a spine surgery that permanently damaged that nerve and I don't think the surgery was worth it. If you do decide for surgery make sure the surgeon has done over 1000 thyroidectomies.

 
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