What can be done about positive margins after thyroid lobectomy?

Posted by mift24 @mift24, Jan 12 1:10am

I'm posting this question on behalf of a loved one. Words alone cannot describe
the sadness I feel. Specially when the person you care about is presented with this diagnosis during a milestone in their life we should all get to experience with joy; being newly married, first home and ect. My question is what can be done about positive margins after a lobectomy. As of now, they are waiting for a completion thyroidectomy, but it's not set until april which to me is very worrisome to wait that long. Will a completion thyroidectomy bring about negative margins or does the surgical site of the positive area need to be re-excisioned? Has anyone's Dr. done the later to achieve negative margins? Their TSH raised at 4 weeks after lobectomy to 3.99 I'm concerned this will aggravate the cancer cells left behind to spread due to the TSH hormone being put out. Dr/surgeon is suppose to consult with others regarding treatment plan. Loved one is a sitting duck in the meantime with no answers about TSH yet or knowing plan that will take place.

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Colleen Young, Connect Director | @colleenyoung | 2 days ago

@mift24, I can see you are very worried for your loved one - understandably so. You are asking the right questions that I hope the surgeon can answer for you and your loved one. I'm not a doctor, but it sounds to me that a complete thyroidectomy has been scheduled because the negative margins indicate the need for complete removal to stop the spread and reduce the risk of recurrence.

Can you ask for a consult with the surgeon to a) express your concern about the wait period and b) to understand the liklihood of getting positive margins with a complete thyroidectomy?

kmlnj | @kmlnj | 1 day ago

So sorry you are going through this during a time that should be filled with blessings.
First, it is important to be in the care of a medical team highly experienced in thyroid cancer. (People on this forum are from all over the country, so I don't assume.)
Second, it may be important to know if your partner has a variant of Papillary TC. I have tall cell variant, that is more aggressive.
Third, sometimes cancer has progressed outside the thyroid. In my case it was wrapped around my trachea. The surgeon removed the most he could, but some remains. Therefore, I will undergo external beam radiation 5 days/6 weeks, plus some chemotherapy enhancements. This treatment is standard now for a mass/tumor left behind post surgery.
I wish you well --- make sure you are in good hands with an experienced team.
Don't worry. Worry is exhausting and accomplishes nothing.