On 5/29/2008
Leemg wrote:
I've
been told it has only been the last several years that they have
designated a sub type group of papillary cancers based on the fact the
cells may look different and behave differently. Tall cell is just one
sub type and it is named that because the cells are actually taller
than normal papillary cells. They are just learning and collecting
data on how it reacts. My endo claims it is still a papillary thyroid
cancer which is the most common and treatable and he claims they treat
it the same but I have discussed this with several other doctors who
treat thyroid cancer plus have done research on line and all indication
is that it tends to be more aggressive in nature and is further along
when first diagnosed which was the case with me, I'm stage 3. It is
not unusual for papillary thyroid cancer to metastisize to the neck,
actually it is very common. The problem again with tall cell, it acts
more agressively than its slower growing cousin, the common variety.
They have found, and again in my case, that it may or may not respond
to RAI and may not show up in the scans, again I am a case where it has
not. It is important to have blood tests to monitor your levels.
Again, I was told that the levels don't have to be as high to indicate
a problem brewing. Also, routine ultrasounds of the neck should be
done as thyroid cancer first spreads to the neck before moving to other
parts such as the lungs and bones. That is why I did not feel
comfortable knowing I had a positive lymph node in my neck and stayed
on top of it. Even the ultrasound did not pick up the additional two
lymph nodes found on pathology. And I read that it is not unusual to
find more lymph involvement when they actually remove them and do
pathology. Since you present with questionable swelling, I believe, in
the neck region I would push to have at least one biopsied to insure
that they are not cancerous in which case I would push to have a neck
dissection. Why allow it to do whatever if you can address it now is
what I say. I had breast cancer 4 years ago and I don't need to mess
with positive lymph nodes. Yes, sometimes you have to be your own
advocate. My endo is a nice guy and kept telling me I would be okay
and then he tells me about a 40 some year old male whole has spread and
is not doing well etc. I don't need any doctor telling me Oh, I'm
sorry I didn't think it would do that after the fact. In situations
such as this I always seek a second opinion and do as much research as
possible. When you have your appointment then you can address those
points, point by point. One doctor told me he appreciated that I was
so well informed. I believe they take you more seriously too. Today,
with HMO's and doctors having to move patients through to exist, it is
easy to become just another patient. My doctors know me as a person.
Good luck to you! (I'm from NJ)
You have
been very helpful with this information. I don't see my doctor for 5
months, so I might see my oncologist in-between for his opinion.. I
wonder if a PET scan would pick up anything missed by our WBS? I don't
know what kind of a scan we have in a WBS--do you? I also had another
cancer years ago, so I don't like to put any checkups off. Do you
happen to know what our TSH and thyroglobulin levels should be? They
told me today that mine tested positive at 1 and that my TSH was 46.
I'm not sure what any of this means with tall cell. I have family back
east (NY + NJ) and have considered Sloan-Kettering for a second
opinion. Thank, Tara