Small study showed high accuracy but hurdles remain, two experts said
by hillaryedrn on Tue Dec 22, 2009 11:29 PM
My pathology report states, "Colloid, follicular cells with hurthle cell changes consistent with nodular goiter." The MD who did the biopsy says it is benign, but I'm still wondering with my history of father AND grandfather with thyroid cancer and me having multi-nodular disease, should I press for them to remove it anyway or am I overreacting?
by Ronni778 on Wed Dec 23, 2009 02:02 AM
I am glad you got your results before Christmas. Only you can decide the path that will make you most comfortable. You have to be at peace with your decision.
Personally, I would start by asking for a second opinion of the biopsy results from a medical center with a good reputation for dealing with thyca. Pathologists can disagree and I have first hand experience with a false negative after my total thyroidectomy. Long story short, the biopsy pathologist and the surgery pathologist (2 different doctors) described seeing the same cellular changes with the biopsy saying it was cancer and the surgery saying it wasn't. This made me very uneasy so I asked for a second opinion from John Hopkins. My insurance paid for it - most of them will. John Hopkins said it was cancer also. It scares me to think of what might have happened had I not followed my instinct and asked for that second opinion. I certainly would not have had the rai and close follow-up needed to watch for recurrence.
Are you having any other problems with your thyroid? What caused you to have the biopsy in the first place?
If it were me, I think if the second opinion came back negative, I would find an endo who was willing to check me every six months with ultrasound and biopsy again any time there were changes in the nodules. Thyca is such a slow growing cancer, it's not likely that it would become an issue quickly if cancer were to develop. While not necessarily the worst surgery one could experience, neither is a total thyroidectomy a walk in the park. The medication adjustment process takes quite a bit of time and I have spent much of the last year dealing with fatigue and other issues. I would not want to go through surgery unless it were absolutely necessay.
I wish you the best as you make the right decision for you. Happy Holidays!
by Tavish on Wed Dec 23, 2009 03:43 AM
Second opinions are a good thing.
Consider taking your slides to a cancer center or major univeristy hospital, and have a new report. Then take the 2 reports to another doctor for a second opinion about treatment recommendations. And ask them what they would do if it were them or their family members.
Whatever you do, feel confident in your decisions and take control. With the thyroid, it may also be ok to take a watch and wait approach, and re-evaluate at a future date.
by hillaryedrn on Wed Dec 23, 2009 10:16 AM
Thanks for the replies!
Ronni, the nodules were initially found during a routine physical where they did an ultrasound of my thyroid. I have a history of thyroid cancer in my paternal grandfather and my father. I guess my family history is making me concerned more than anything else. That and I've heard that hurthle cell usually can't be diagnosed as benign or malignant by fna which is what I had.
by justdiagnosed on Fri Jan 08, 2010 06:49 AM
Don't ever think you are over reacting! And don't let a Dr. tell you that you are either. Sometimes we just know our bodies are not right. I just knew after a needle biopsy of a goiter on my thyroid was negative, that there was something not right. I persued it, even though several Dr's told me that I was fine and only to worry if it grew. I finally found a great Dr who listened to me. The tumor was removed and while I was under anesthesia they did a frozen section - still no cancer. The surgeon sent the tumor to a lab to be fully sectioned just in case - papillary thyroid carcinoma. Trust your instincts.
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