I had a TT on 5/21/08 due to a 2.2cm papillary tumor. The pathology report confirmed the biopsy result (pap. ca.) with the only negative surprise being some microscopic extrathyroidal extension of the tumor (i.e. some cancer cells were found on the outside of the thyroid). There did not appear to be any lymph node involvement, and the one they took out was negative for cancer. Both my surgeon and endo have recommended a 100 mCi dose of RAI for remnant ablation due to i) the tumor being > 1.5cm and/or ii) the extrathyroidal extension (according to them, either one of these factors would warrant RAI). My endo is comfortable using Thyrogen for the remnant ablation dose, and I am cool with that.
My question is this: as I understand it, they are not going to do a WBS to see if the disease is metastatic prior to the ablation dose. Instead, they will do a WBS after the ablation dose to see if it has spread anywhere else. Based on my research, this presents 2 potential issues: 1) how do they know what the proper dose of RAI is if no one knows if it has spread and 2) how do they know using Thyrogen is a good idea if it is only indicated for non-metastatic disease?
Has anyone else had Thyrogen-assisted RAI for remnant ablation following surgery without a diagnostic tracer dose and WBS first? Thanks in advance.
Tim