1. < Thyroid Cancer

PTC and Hashimotos

Posted by lmmhqb @lmmhqb, 5 days ago

I have papillary thyroid cancer in my left node. No where else they can see. So recommended to have the left node and a few nearby lymph nodes removed and sent to pathology. They think that will be all I will need but if pathology come back different than they expect, they may have to go back in to remove more, but seems unlikely.

I have Hashimotos. I will still have half of my thyroid and therefore my Hashimotos will still be active. A full thyrodectimony would cure the Hashimotos. My Hashimotos symptoms are not extreme, I have 500-ish level antibodies and my thyroid has functioned pretty well without any medications so far but is trending towards hypothyroid. But the antibodies likely keep the tissue consistently inflamed and may be related to some mental health struggles I’ve had for 8 years like anxiety, mood swings, and fatigue. I always attributed it to having two young kids, but the more I think about it, they could be thyroid symptoms. And inflammation can create an environment for cancer I have heard.

My doctor does not expect the remaining right half to produce enough for my body so I will be medicated post surgery most likely.

What is your take on full vs. partial thyroid removal when Hashimotos is a factor? The remaining side won’t be functioning properly so medication is needed no matter which surgery I get. But does the risk of doing a full outweigh the cost of forever having Hashimotos?

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lmmhqb | @lmmhqb | 1 day ago

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?

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ascott510 | @ascott510 | 12 hours ago

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.

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1 reply
lmmhqb | @lmmhqb | 11 hours ago
In reply to @ascott510 "I had PTC with follicular variant in 2016. I had for decades felt I had thyroid..." + (show)
@ascott510

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.

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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.

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ascott510 | @ascott510 | 8 hours ago

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.

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1 reply
lmmhqb | @lmmhqb | 7 hours ago
In reply to @ascott510 "Yes, I felt the same. If I had to take levothyroxine anyway, it was better for..." + (show)
@ascott510

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.

Jump to this post

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.

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ascott510 | @ascott510 | 6 hours ago

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.

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