Question about Father's High TSH and Large Nodule

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Hi Zent,
In my opinion, it sounds like your father’s doctor wants to see how quickly nodule grows/ shrinks while taking Thyroxine. I was told that one treatment for large nodules is to take thyroxine to see if it will shrink. As for waiting 2 months for biopsy…..I was told that thyroid cancer tends to grow very slowly and usually stays contained in the thyroid gland, so 2 months to see if the nodule shrinks seems like a good option….. you don’t want to rush for surgery if the situation can be managed with medication. I was told that biopsies are only as accurate as the specific location that the cells are drawn from and are only considered a “ prediction” for thyroid cancer…… there are a lot of false positives so you don’t want to rush into surgery. I found out about Affirma testing that has a very high accuracy rate for predicting thyroid cancer. If your father has a needle biopsy, you might want to ask to have the cells sent for Affirma testing. After years of hearing my nodule was soft so not cancerous, the Affirma testing gave me a high probability that I had Hurthle Cell Carcinoma; and they were right!
All of the testing is helpful for making decisions, however, removing the thyroid and getting regulated on medication is not always as easy as people think. The side effects of medication can be quite difficult; and finding the right dose and the right medicine can be extremely challenging.
It’s always good to be proactive, however I think the thyroid is unique in that cancer cannot be definitively diagnosed until you actually have surgery. I hope the Thyroxine shrinks the nodule and his blood stays in normal range. Good luck!

Hello Lynne,
Hope you are doing well. Thank you so much for your previous answers, best wishes and hugs for my father!

If you don't mind, I have an update and a few questions:

Free T3 & T4 and TSH tests were done today, and the results are below:

F T3 - Triiodothyronine (ECLIA) :
2.57 pg/ mL [2.40-4.20]ng/ml

F T4 - Thyroxine (ECLIA) :
1.27 ng/ dL [0.80-2.30]micg/dl

Thyroid Stimulating Hormone (ECLIA):
0.702 μIU/mL [0.340-4.250]

Father so far is doing ok without any symptoms of change in voice, shortness of breath or difficulty in swallowing.

Questions:

1) Are these results good? Can anything be inferred about the state of the 6 cm nodule from these results?

2) Should I request the surgeon for a Neck Ultrasound in May? The last one was done in last week of February 2024.

Thank you always for your answers!

Zent

I'm so glad that your father is stable still! That's great news.
With the tests like these, I can't provide medical input, but its important
to remember a medical professional would need to compare these results , 1) with the previous results 2) and link it to the objectives in treatment he is recieving .
I'd be asking the doctor what objective do they have, does he see what he was hoping for in these results,
such as an appropriate change in numbers given the treatment/medication , or are there some
concerning results ? If so , why are they concerning?
I've been told in the past which numbers need to be as low as possible , yet still in normal range, etc. Every case is a little different. I'd be encouraged though by the fact that he has no increasing symptoms. That's wonderful.
I would ask the doctors if they think an ultrasound is necessary, but it's possible that because other results are indicating no change they could wait a few months on it. Usually 6 months to a year had been the marker for me. No harm in asking them though! Way to be a good advocate!

Hello Lynn,
Thank you so much for your very helpful response!! I will ask father's surgeon the questions you have suggested.
Will update. Wishing you the best of health!

Regards,
Zent

Sending hugs!