Radiation or thyroidectomy?

I am confused when people write that they have a diagnosis before surgery because I was told that thyroid cancer cannot be diagnosed until they remove the thyroid/ lobe. I had read that radiation kills the thyroid…., it causes the thyroid to stop working, which is why they don’t use it for treatment after lobectomy. You would have to take medication for the rest of your life so what are the gains? You might want to ask what happens to the 4 parathyroid with radiation…. They are on the back of the thyroid and are very important. You might also want to inquire about the risks to the surrounding tissues if you have radiation…. Will salivary glands and vocal cords be affected? It seems like a lot of people have radiation therapy after removal for metastatic cancer but I always thought that was because the diagnosis was confirmed with surgery and it was done primarily to ensure all cancer cells were killed…..I don’t think I have ever read about anyone having radiation as an option instead of surgery. Good luck!

I was diagnosed with metastatic papalary thyroid carcinoma as well without surgery, just from a biopsy. I am seeking second and third opinions to see the best options for me.

I am curious about this because of false positives and false negatives with the needle biopsies. Based on what I have read, the Affirma testing (done with a needle biopsy) has the most accurate rate of predicting cancer, however it is still just a prediction until you have surgery. Sometimes I think it is related to the doctors wanting to take the most aggressive approach to protect themselves from missing cancer. The word “Metastatic “ makes people panic and opt for surgery….but is it an actual diagnosis or just a possibility on ONE test. It’s very hard to know what to do. I ended up with Hurthle cell carcinoma and had a lobectomy, however only after going to another hospital to be evaluated for Radiofrequency ablation (RFA) to shrink my large nodule and they did the Affirma testing. Affirma testing gave me a 50% chance of Hurthle cell carcinoma so I did not qualify for RFA and the nodule was large and growing, so I had lobectomy surgery. The pathology report from surgery confirmed Hurthle Cell Carcinoma. If you have a large nodule, you might qualify for RFA; it might be worth going for an evaluation by a doctor who does the procedure.. Good luck!

I had a biopsy of thyroid node which confirmed malignancy.

Maybe they told me it could not be diagnosed until surgery because of how the biopsy went….I don’t know….but if you are going to have an organ removed I tend to think you should be sure you actually need to.

I agree. You would have to have cancer cells outside the nodules or lymph nodes as I understand it to have radiation.

Hi - Yes - I have been told by 3 of the doctors I have seen that cancer cannot be diagnosed until after thyroid is removed. In this day and age when there have been so many advances it’s frustrating that this is the only option, especially when the decision to have it removed is a life alternating one.

I would get the total thyroidectomy, based on my experience. I had a tumor on thyroid and 21 cancerous lymph nodes that were removed . I believe surgery is the best option.

They can do a ultrasound guided biopsy to determine if cancer is present in thyroid and any nodes.

Yes, I totally agree. When there is a positive I would go with that. These are people who have studied for years. We have to put our faith somewhere. Otherwise, why bother to have the biopsy?