Thyroid cancer and Hashimotos: Full or partial thyroid thyroidectomy?

I’m not sure if commenting will bump up this post but surgery is in a couple days and I’m really questioning that I’m only doing partial. Has anyone had Hashimotos and only had a partial removal?

I had PTC with follicular variant in 2016. I had for decades felt I had thyroid issues but no doctor would pursue it other than running TSH tests. In my path after surgery, I had chronic Hashis. My cancer was only on one side, but because the margins were close to the edge my surgeon took it all. I was glad after I saw my path report. Pros: you can control your medication levels to the point you could be more comfortable symptom wise. Cons: while they have come way down, I still show antibodies. I did have an ablation at the insistence of my endocrinologist. I am 100% dependant on thyroid replacement medication for life. I periodically get symptomatic when my thyroid levels are too suppressed. If you have time to consult with an endocrinologist who treats thyca, that is what I would suggest- to get one more opinion before surgery. You should have one lined up to follow you afterwards.

Thank you for your response. I am less worried about having another surgery in the future when if it hasn’t spread already, we could just prevent that now. And if it has spread, then we can do the radiated iodine so I could feel like we have it all.

I understand this isn’t a deadly cancer, but to me it’s a pretty big deal to have it and will feel anxiety knowing that it could be growing every year is hard to accept.

Yes, I felt the same. If I had to take levothyroxine anyway, it was better for me to know all my thyroid was removed, and cancer was all gone. As it was, they not only found one tumor, but two. And not just PTC, but follicular variant and the Hashi’s. I had read a lot of journal articles pro and con before my surgery. In the end, there is no perfect answer, only the best answer for you and what you can be comfortable with.

Thank you, trying to do the same with reading journal articles. Many of them say full, especially when they are particular to Hashimoto’s. I just got a message that I have an appointment with endocrinologist tomorrow, so looking forward to discussing these things with her prior to surgery. Hoping that will make me more comfortable with whatever I choose.

That is perfect timing! Write down all your questions ahead of time, take someone to listen and take notes if possible. It can be very overwhelming to go to these appointments by yourself! Good luck and I hope you go into surgery feeling confident with your care plan.

@lmmhqb, what did you learn from the endocrinologist? Did you have your surgery? What did you decided and how are you doing?

I met with my endocrinologist on Wednesday, she was very a tune to my concerns with the Hashimoto’s, we went over everything and all of the available data and it pretty much came down to I could argue that a partial or total removal were best. So I kind ofhad to choose. So I spoke to my surgeon and let him know that I want him to go into the surgery with the priority be in my left lobe, but if that went well to go ahead and take the rest of it. He was in agreement. Thursday I had a total thyroidectomy, went very well, there was a moment where they almost severed one of the nerves on my right side, but he caught it and did didn’t damage it thank goodness. But people with Hashimoto’s do have thyroids that are usually inflamed, and can be hard to get out, my doctor described Hashimotos thyroids can be “sticky.” so it’s a bit of an additional challenge for surgeons, so it’s good to get an experienced surgeon.

The ultimate reason why I decided to go total is because that allows for more ways to monitor for recurrence in the future. If you get a partial you can really only monitor via ultrasound, but with a total they can use thyroglobulin levels, ultrasound, CT with contrast and also I could get Radio iodine if pathology comes back and they think I should do that. I also wanted to avoid a second surgery. Meeting with the endocrinologist was key, though, I would not have had my surgery until I was able to do that, so I would advise anyone that is about to have their surgery. Make sure you meet with your endocrinologist beforehand.

No Endocronologist for me.

Because she tried to delay the thyroidectomy to 6 months after stroke when my surgeon and anaesthetist said a.s.a.p.
They did several tests like voice box, biopsies and i sailed through op at 4 months and 2 lymphs were already affected.

declared no rai or suppression. low risk and rai treatment can do a heap of damage to your blood - leukaemia, damage you para thyroidsm voice box, throat and osphagus etc.

trust your surgeon.

have total as above says easier to regulate your TSH, T3 amd T4.

Use Thyroglubin serum and antibodies as a guide for cancer return.

I am 5 years down track..

Surgeon used a blue dye up to op to show that way. Lots of items need clipping back.
Cheri JOY. (Tuckie)

All the very best.