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Old 07-28-2012, 05:26 AM   #1
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What is the main reason they do surgery for a 4 cm nodule

My question is, my nodule is 3.9 and the doctor basically told me during my consultation that if it was 4 cm he would send me straight to surgery. So we did the FNAB and it shows benign. I questioned him why a 4cm nodule justifies surgery and my 3.9 is to follow up in 12 months with an ultrasound. His response "Why do you want surgery?"....I don't want surgery, I'm just concerned that it is a now or later situation and why wait 12 months.

I'm not even sure how to go about getting a 2nd opinion and I'm nervous that if I ask about surgery, it's just going to start a new host of problems. Also, concerned because while it came back benign, it sounds like there could be cancer cells lurking in there that they didn't biopsy.

I think I am just a bundle of nerves right now....

 
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Old 07-28-2012, 05:45 PM   #2
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Re: What is the main reason they do surgery for a 4 cm nodule

While I'm not 100% sure of the answer, I *think* surgery is done on larger nodules since an FNA doesn't get enough cells to rule out cancer....another reason could be if the nodule is compressing anything.

Why don't you consult an ENT?

That's the type of specialist you'd need anyway if you opted for surgery.

And, if you've already consulted with an ENT, I see no reason why you can't get a second opinion.

I wouldn't put words in the doctor's mouth about surgery - I'd see what he/she has to say about the nodule...
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Last edited by sammy64; 07-28-2012 at 05:49 PM.

 
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Old 07-29-2012, 05:26 AM   #3
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Re: What is the main reason they do surgery for a 4 cm nodule

My family doctor sent me to an endocrinologist so that is who I seen. I think I am frustrated because the doctor that I seen didn't even answer any of my questions. Im just concerned because I have read other stories that the biopsy showed benign but it was actually cancer.

 
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Old 07-29-2012, 06:37 AM   #4
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Re: What is the main reason they do surgery for a 4 cm nodule

I understand your frustration.

While an endocrinologist should be familiar with thyroid function, things that relate to the physical state of the thyroid are best left to an ENT.
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Old 07-29-2012, 10:20 AM   #5
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Re: What is the main reason they do surgery for a 4 cm nodule

Quote:
Originally Posted by asm505 View Post
I'm not even sure how to go about getting a 2nd opinion and I'm nervous that if I ask about surgery, it's just going to start a new host of problems. ...
I think I am just a bundle of nerves right now....
I sympathize with you. Doctors make me nuts, too.

How you go about getting another opinion depends on your insurance, I suppose. I'm not dependent on referrals, so I just call up the doctor's office of my choice and book an appointment. When the receptionist asks why you want to see the doctor, just say you need a second opinion about a thyroid nodule. Simple as that. You don't have to go in with a predetermined agenda. Just tell him/her that you're being told it can wait for a whole year without any monitoring but that you aren't completely comfortable with that advice [I wouldn't be, either.] and would like to know what his/her opinion about it is.

The issue with waiting too long is that - cancer or not - that nodule can grow way out of control and start wrapping itself around other structures in the neck or even grow under the collarbone into the chest.

I hope you can soon figure out exactly what it is you need. But I agree with Sammy that an endocrinologist is not the person to help you do that. You need the sage advice of an experienced ENT right now.

Good luck to you!
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Old 07-29-2012, 11:31 AM   #6
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Re: What is the main reason they do surgery for a 4 cm nodule

You will need copies of the ultrasound and the fna/cytology report to bring with you. You can call a local ENT, but you also might want to make an appointment with an ENT at a major teaching hospital --- I think Hershey in Lancaster has a really great hospital with good quality doctors. You can ask around---people you know and, ask your regular doctor for a good ent as well.

You have to take control over your health care---many of us have to these days. Nothing to fear.

 
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