Tt In 2 Weeks, How Do They Know If It Spread To Lymph Nodes &Ct With Contrast

Hello,

 

I am having a TT in two weeks for Pap Cancer.  I had an ultrasound of my neck for suspiscous nodes, but it looked fine. Now, they want me to have a CT with Contrast before my TT.  I asked for an MRI instead but they said no.  I want to minimize any radiation I am going to have to get and also all my thryoid cancer books say that a CT with Contrast interferes with the RAI treatment after because a CT with Contrast had iodine in it, so when you do the RAI, the uptake will be minimal because you will still have lots of iodine from the Contrast.  I tried to talk to my surgeon about it, but he said it was not a big deal and was fine.  I also really don't want radiation to my neck, I already have cancer, do NOT need to risk another one down the line.  I have read that MRI can be used.  He says he wants to do this to see if it has spread to lymph nodes before surgery so he can take them out. I understand that, but many people I have talked to that had a TT never had a CT before.  What do you think>?

 

On 2/11/2007 11laura11 wrote:

Hello,

 

I am having a TT in two weeks for Pap Cancer.  I had an ultrasound of my neck for suspiscous nodes, but it looked fine. Now, they want me to have a CT with Contrast before my TT.  I asked for an MRI instead but they said no.  I want to minimize any radiation I am going to have to get and also all my thryoid cancer books say that a CT with Contrast interferes with the RAI treatment after because a CT with Contrast had iodine in it, so when you do the RAI, the uptake will be minimal because you will still have lots of iodine from the Contrast.  I tried to talk to my surgeon about it, but he said it was not a big deal and was fine.  I also really don't want radiation to my neck, I already have cancer, do NOT need to risk another one down the line.  I have read that MRI can be used.  He says he wants to do this to see if it has spread to lymph nodes before surgery so he can take them out. I understand that, but many people I have talked to that had a TT never had a CT before.  What do you think>?

I had my TT on December 13, 2006, for papillary cancer.  The nodules were discovered during a carotid artery ultrasound.  I did not have any other scans done prior to surgery to look for lymph node involvement.  My nodules were small (

If you are really adamant about not having the CT then I would suggest you seek a second opinion (or third).  I would guess if you are having to argue with your surgeon about this then there will be future arguments about other issues, too.  At least a second opinion would give you some basis from which to judge your current surgeon's course of action.  I went for a second opinion and was glad I did because it probably spared me from a second surgery the first surgeon would have done! 

Sorry, part of my paragraph above was deleted for some reason.  It didn't make much sense without it:

I had my TT on December 13, 2006, for papillary cancer.  The nodules were discovered during a carotid artery ultrasound.  I did not have any other scans done prior to surgery to look for lymph node involvement.  My nodules were small (1.5cm each), so I would wonder if they were less concerned about lymph node involvement.  Maybe that is your case, also?  I do know they can tell if nearby lymph nodes are involved during surgery, and would assume they can also make an educated guess about involvement of other lymph nodes further up the neck.  Someone else here can correct me on this.

I had CT with contrast (neck and chest) and ultrasound with fine needle aspiration on the same day; I think my GP didn't know and the radiologist was out to lunch on that day.  Because of the iodinated contrast, I had to wait and extra couple months for RAI so that my iodine levels were low again.  Perhaps they could do a non-contrast CT?  Would the delay of a couple months affect the outcome?  Maybe not.  I don't know; I guess it depends on the type of contrast.  I would talk to your endocrinologist about it.  You should have an endocrinologist because they will manage your thyroid cancer in the long-term and know more about this stuff compared to surgeons (in general). 

Oh, and I bet they want to do CT rather than MRI because CT is cheaper.

I am having a TT next month for papillary cancer and my surgeon told me that if anyone suggests I need a CT scan to tell them no way.  I can't remember the reason why not, but I am sure he knows what he's talking about as he is a highly respected surgeon in a major medical center.