I have had a few people who have had this done say that I most likely won'
t need the I-131 after my thyroid cancer is removed. My primary says I will which makes me feel a little more secure about getting rid of the cancer. Another doctor said no, Can someone go into more detail on this and give me your opinion.
As far as I know, most ***** patients get RAI after surgery to be absolutely positive no more thyroid tissue can exist afterward. RAI is very similar to regular chemotherapy you hear about for canver. It kills off cancer cells quickly. Im not a doctor but I think that the positive's you have from knowing you totally destroyed the cancer for sure is worth the tiny risk involved in getting RAI. With surgery, no matter how good the doc is, they do leave behind some thyroid cells. If some of those cells happen to contain cancer cells, they can of course spread to the lymph nodes, lungs, etc. Nuking any remaining tissue will obliterate any remaining cells.
Once your thyroid is removed, RAI should have very few negative effects on you. Most of the problems with RAI stem from too much thyroid tissue dying off too quickly, which you no longer have to worry about. I think if it were me and I had the choice, I would opt for the RAI and know I will probably never have to mention the "C" word again in my life....its just a precaution.
Yeah, I think there are some different professional opinions out there.
My surgeon believes very strongly that everyone that has any thyroid cancer should have RAI, but some endocrinologists only recommend it if the thyroid cancer invaded, or if the nodule was a certain size or larger.
There was no controversy in my case because my nodule was 3.5 cm, and there was some "vascular invasion." I hope your surgery goes well and you recover quickly!
The dr. I got a second from said he doubts it with the I-131. My one mass is 4cm and is very vascular. When I asked him about the vascular part he said they are all vascular. Though I had to go to a specialist for my biopsy because my ent wouldn't attempt it because it was very vascular. I thought that vascular meant a blood supply for the tumor? Please fill me in.
I think he might mean that that area of the neck---the thyroid is a very "vascular" or veiny area, and that it doesn't necessarily mean it invaded?
After my surgery, when my thyroid was removed, and I guess veins were removed, the pathology report said "vascular invasion"---which I think means that the actual cancer spread into those veins there.
I don't know what kind of doctor you second opinion was---You may want to get an endocrinologists opinion---if that doctor wasn't one, in terms of treatment of RAI after the surgery. Usually an oncologist or radiation oncologist, or endocronologist can help make that decision after the pathalogy report from the surgery.
I hope you get the medical opinions and choose the route that you feel most comfortable with. Remember---even if you don't have RAI 6 weeks right after the surgery---you can still have it done a few months later.
If there was vascular invasion it would indicate that your cancer was follicular. Papillary normally doesn't have vascular invasion, but can have lymph node mets. I would recommend you having 1-131 if indeed you have follicular as it means that the cancer cells may have traveled into your bloodstream and could then spread to other parts of your body. (unlikely if it was caught early, but I'd rather be safe than sorry). A mass size of 4.0 cm is large and if follicular or not, I think your safest bet would be to have the RAI.
Follicular Cancer 2.5 cm dia. 2/20/04