Two large thyroid tumors: doctors advise urgency

@rockon79
My sister had thyroid cancer at 27 and had her full thyroid removed. They first did a lobectomy and when they found cancer, they decided to do a second surgery to remove the other lobe. She is now in her late 50s. I also had a nodule found in my right lobe when 52 and the biopsy was unable to confirm whether cancer or no cancer. They removed it and the nodule was 2.5 cm it was found to be benign but they did find a micro cancer. My left lobe is being monitored because it has a large macro calcification. Before surgery, I was having swallowing and speaking issues and believe it was tied to the large nodule.

Since your nodules are quite large (3.6-4.0cm), it might be good to have your full thyroid removed. When they do fine needle aspiration for biopsy, keep in mind that only the cells where the needle needle is placed get picked up but since your nodules are large, there could be cancer in other parts of the lobe nodule.

You could choose to only have one lobe removed but you may have to have a 2nd surgery to remove the other lobe if it eventually found to be cancerous or the nodule gets so big it causes you swallowing/breathing/speaking issues. More surgeries create more scar tissue which can cause problems. Also, keep in mind that even if you have only one lobe with the cancerous nodule out, you may still need thyroid medication. I needed thyroid medication because my one lobe did not produce enough and I became hypothyroid. I also have Hashimoto’s thyroiditis (immune system attacks my own thyroid gland). Did you get tested for this (TPO thyroid antibodies in bloodwork)? Did they determine if you are hyperthyroid or hypothyroid (low or high TSH)?

I would opt for a total removal. I was diagnosed with Thyroid cancer during a separate surgery for tongue cancer. Thyroid cancer was found in a lymph node removed during that first surgery. My thyroid had tested negative on several needle biopsies. But somehow the thyroid cancer had left the thyroid and spread to my lymph nodes. My point to you is, I would take it out before it has a chance to spread elsewhere.

Most of the information I have received recommend total removal, for the reason you mentioned. Some suggest, with the proper custom diagnosis and understanding of my personal makeup, family history and expert surgery that I might still keep some of my thyroid and function, which I would prefer, even if I would have to use thyroid supplements there after. Thank you for your input.

Thyroid and hypothyroid levels are entirely in the normal range. I do realize the problems of scar tissue, but I think that would be somewhat minimum with how they perform this surgery. Never the less I would prefer to keep as much of the thyroid as possible, even with the eventuality of another surgery. At this point I haven't been diagnosed with any other thyroid issues. Another plus (if there is one in our situation) is that even though the tumors were considered large, they caused no symptoms or problems. I do realize I will probably need thyroid supplementation after the removal, no matter how much they remove. Thanks for your input

Last fall 2024, I had a total thyroidectomy. My thyroid cancer had spread to my trachea, lymph nodes and was next to my voice box. I understand my condition is different from yours.
I chose a top cancer hospital, Memorial Sloan Kettering. I was fortunate to be advised by their top thyroid surgeon. The surgeon has done many hundreds of these operations. I agreed to his advice.
Also there are variants of PTC. Tall cell variant grows more quickly.
My advice is, if you have a good team, follow their advice. They have seen it all.

@ rockon79

The good news is that papillary thyroid is a very curable cancer. Both my ex husband and my daughter had it. I also have a few friends that had it as well.

I know it’s shocking to find this out, but there is no good reason to want to keep any of the cancerous thyroid. It would only increase chances for recurrence. I’m sure they’ll check to see if it has spread to any of your lymph nodes. Hang in there, we were told that if one had to have cancer, this one was a good one since it’s so easy to treat and cure. Best of luck.

Hi. I should clarify that MAYO is not in my area. That is why I went to MSK.

I have had an MRI, several ultra sounds and fine needle biopsies all in a period of 10 days after the thyroid tumors were discovered. That is worrying, but the consensus is (for some reason) that it hasn't spread yet. I am scheduled to get a cat scan in a couple of days, which should hopefully be more definitive. My GP is very well versed in this and has sent me out of area to consult with a ENT oncology surgeon he highly regards. Appointment in three days which again is very quick for this doc with a waiting list of months. I don't know the expertise of the local team he wants me to use as far as the follow up an further testing, but upon my GP's seems comfortable working with them. I do seriously take your point about MSK. The inconvenience (NYC don't like it) and follow up worry me though. At this point I am still making decisions. The situation is moving ever so quickly, allowing me to meet and hopefully evaluate the expertise I am depending on.

I agree. After my partial thyroid removal an 8.5 nodule appeared in 8 months. Went in for a biopsy and doctor said on the scan it was a ghost image Thank God. He said come back in a year.