1. < Thyroid Cancer

Total thyroidectomy or lobectomy?

Posted by gillsden @gillsden, Aug 15 8:22pm

Hi All - I posted a couple of months ago after receiving notice that genetic testing was showing a 70% chance of cancer in my right lobe. Two doctors recommended full thyroidectomy and a third doctor recommends taking only the right side, making a strong argument as to why the left side should remain. I'm scheduled for a total thyroidectomy in two weeks based on the first two opinions. Now I am unsure what I should do. (I am 63 years old.) I have small nodules on the left side, but not even big enough to be biopsied at this point. Has anyone been faced with this decision? Any advice or comments you have I would appreciate you sharing them with me. This group has been very informative. Thank you!

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koh | @koh | Aug 16 6:05am

Hi, Since thyroid cancer is usually self contained, I don’t know why doctors recommend a full thyroidectomy when a possible issue has been identified in one lobe. I was told that nodules are very common and it’s only a problem if they start growing rapidly, so it does not make sense to remove the other lobe. By keeping one lobe you might not have to take Synthroid, which can be extremely challenging to get regulated on and can include a lot of side effects for some people (me). Although I had to start taking thyroid medicine after lobectomy, the dose seems to be lower since half of my thyroid still works. It seems to me that removing an entire organ for a problem in half is only appropriate if the cancer is the aggressive metastatic type….. otherwise it seems like overkill. In my opinion, keeping half of your thyroid will give you the possibility of not having to deal with taking thyroid medication and definitely worth it! I am curious if total thyroidectomy is the “ old way” of dealing with thyroid nodules that might be cancerous and often used as a default. ….it will take care of the potential for cancer but the patient has to deal with medication issues. It’s a tough decision for you but maybe you should consider what type of cancer you MIGHT have and how aggressive it is. Good luck!

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2 replies
cdngal59 | @cdngal59 | Aug 16 10:20am

I went thru something similar recently. (june surgery) Had 95% chance of cancer in left lobe. Doctor recommended taking both sides out, I only wanted left out. I have been on thyroid meds for the last 7 years due to underactive thyroid. Dr said that there was a probability of cancer in the other remaining lobe at some time & I would have to go thru same surgery, cost & recovery. My right showed no signs of problems in ultrasound. Pathology report after surgery: cancer in left as suspected. Had hashimoto's in both so therefore the right side was barely working. I am a 64 year old female, have experienced 15 lbs of weight gain in the last 3 years, fatigue, more joint pain & unexplained aches & pains. No aches and pains since and fatigue is only around while trying to find the optimal dosage of my armor thyroid . I feel great and have no regrets. Cancer was contained. scheduled to have ultrasound of my lymph nodes next year ( will be a yearly event) and no radioactive iodene treatment needed. Hope this helps.

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gillsden | @gillsden | Aug 16 12:40pm

Hi - wow almost mirror symptoms. I even started weight watchers because I am so upset about the weight gain but haven’t lost a pound. Did you go ahead with removing the whole thyroid? I am glad to hear you are doing well. Thank you for sharing!

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1 reply
fossfactor | @fossfactor | Aug 16 10:10pm

I only took the left side where my nodules were.

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fossfactor | @fossfactor | Aug 17 8:24am
In reply to @koh "Hi, Since thyroid cancer is usually self contained, I don’t know why doctors recommend a full..." + (show)
@koh

Hi, Since thyroid cancer is usually self contained, I don’t know why doctors recommend a full thyroidectomy when a possible issue has been identified in one lobe. I was told that nodules are very common and it’s only a problem if they start growing rapidly, so it does not make sense to remove the other lobe. By keeping one lobe you might not have to take Synthroid, which can be extremely challenging to get regulated on and can include a lot of side effects for some people (me). Although I had to start taking thyroid medicine after lobectomy, the dose seems to be lower since half of my thyroid still works. It seems to me that removing an entire organ for a problem in half is only appropriate if the cancer is the aggressive metastatic type….. otherwise it seems like overkill. In my opinion, keeping half of your thyroid will give you the possibility of not having to deal with taking thyroid medication and definitely worth it! I am curious if total thyroidectomy is the “ old way” of dealing with thyroid nodules that might be cancerous and often used as a default. ….it will take care of the potential for cancer but the patient has to deal with medication issues. It’s a tough decision for you but maybe you should consider what type of cancer you MIGHT have and how aggressive it is. Good luck!

Jump to this post

I have been on thyroid medication for many years and I am on the same dose after having half of my thyroid removed. I agree with taking only what is necessary.

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1 reply
gillsden | @gillsden | Aug 17 9:04am
In reply to @fossfactor "I have been on thyroid medication for many years and I am on the same dose..." + (show)
@fossfactor

I have been on thyroid medication for many years and I am on the same dose after having half of my thyroid removed. I agree with taking only what is necessary.

Jump to this post

That’s great to hear. Thank you so much for sharing.

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cdngal59 | @cdngal59 | Aug 17 11:18am
In reply to @gillsden "Hi - wow almost mirror symptoms. I even started weight watchers because I am so upset..." + (show)
@gillsden

Hi - wow almost mirror symptoms. I even started weight watchers because I am so upset about the weight gain but haven’t lost a pound. Did you go ahead with removing the whole thyroid? I am glad to hear you are doing well. Thank you for sharing!

Jump to this post

I went ahead and removed both left and right.scar is barely noticeable at all .Didn't want to continue to 2nd guess myself or doctors..and worry about possibly getting cancer in the remaining lobe.Since I was already on Armour thyroid, have increased the dosage twice trying to find the ideal #.It'll take some time, but okay with it.my calcium levels have been low, so chewing on a couple of tums daily also..Have more energy & motivation.been walking an average of 12k steps a day again and back to the gym..

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gillsden | @gillsden | Aug 21 6:42am
In reply to @koh "Hi, Since thyroid cancer is usually self contained, I don’t know why doctors recommend a full..." + (show)
@koh

Hi, Since thyroid cancer is usually self contained, I don’t know why doctors recommend a full thyroidectomy when a possible issue has been identified in one lobe. I was told that nodules are very common and it’s only a problem if they start growing rapidly, so it does not make sense to remove the other lobe. By keeping one lobe you might not have to take Synthroid, which can be extremely challenging to get regulated on and can include a lot of side effects for some people (me). Although I had to start taking thyroid medicine after lobectomy, the dose seems to be lower since half of my thyroid still works. It seems to me that removing an entire organ for a problem in half is only appropriate if the cancer is the aggressive metastatic type….. otherwise it seems like overkill. In my opinion, keeping half of your thyroid will give you the possibility of not having to deal with taking thyroid medication and definitely worth it! I am curious if total thyroidectomy is the “ old way” of dealing with thyroid nodules that might be cancerous and often used as a default. ….it will take care of the potential for cancer but the patient has to deal with medication issues. It’s a tough decision for you but maybe you should consider what type of cancer you MIGHT have and how aggressive it is. Good luck!

Jump to this post

Hi - Thank you for your response. It prompted me to do further research based on the molecular testing report which states low-risk follicular-patterned cancer. I appreciate your help. Take care!

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zygote | @zygote | Aug 23 3:51pm

I had 1/2 of my thryoid removed based on the frozen sections during surgery. (no cancer) At my follow up final path was a large (4.5cm) follicular cancer, so I had to go back to have the other side removed which showed atypical cells but not cancer. I think I would have worried all the time if I had cancer if I did't have both sides out. Going in 2x was not anything I expected. My sister had multinodular thryoid and went ahead and had it out. No cancer. But she was having so many FNAs, she went ahead with removal and she is glad. Me, still trying consistently lower doses of levothryoxine to get my TSH in range.
It's a tough decision for you. Good luck!

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gillsden | @gillsden | Aug 23 4:36pm

Thank you so much for sharing! Be well.

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