Not sure if I should get 2nd opinion

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Not sure if I should get 2nd opinion

by Lovemycats on Sun Feb 03, 2019 04:49 AM

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Hello.  I had an ultrasound done and right lower thyroid nodule measured 1.5cm x 1.0cm d 0.9cm.  Very hypoechoic, wider than taller, lobulated margins and no echogenic foci.  Ti-rads category 5.  FNA said benign follicular lesion.  My cousin has had thyroid cancer 2x. Don't know what type.  My endocrinologist said to have another ultrasound in a year then if nothing changes, should not have to worry about it.  I also have lost over 60lbs in last 2 years unintentionally and have taken Synthroid over 20 years. Endocrinologist said I might be loosing weight because of menopause.  After doing some research I now question the FNA results.  I Have Found information that said results of follicular cells  found in a FNA can be hard to distinguish between cancer and non-cancer cells.  Should I go for a second opinion or see what happens at the follow up?  Anyone else with similar experience?  The Ti-rads score of 5 scared me but I guess it did not mean much.  Any advice or sharing of experience would be helpful and appreciated.  Thank you.

RE: Not sure if I should get 2nd opinion

by ToddlerFather on Sun Feb 03, 2019 08:31 PM

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You are trying to divide the nodule between benign and cancer, and there are many levels in between. 

Being follicular enables the possibility of something called NIFTP, which is a nodule that doesn't afford treatment according to recent guidelines. 

Your doctor is right on in pursuing one information that might define the diagnostic, which is having it steady or growing. So I don't feel the need for a 2nd opinion regarding that nodule.
As the music says, "Don't worry... be happy." 

OTOH, your overall endocrine situation looks for improvement; even if menopause is the cause, some hormone replacement, dietary change or both looks in order. 

RE: Not sure if I should get 2nd opinion

by butterfly501 on Mon Feb 04, 2019 12:54 AM

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On Feb 03, 2019 4:49 AM Lovemycats wrote:

Hello.  I had an ultrasound done and right lower thyroid nodule measured 1.5cm x 1.0cm d 0.9cm.  Very hypoechoic, wider than taller, lobulated margins and no echogenic foci.  Ti-rads category 5.  FNA said benign follicular lesion.  My cousin has had thyroid cancer 2x. Don't know what type.  My endocrinologist said to have another ultrasound in a year then if nothing changes, should not have to worry about it.  I also have lost over 60lbs in last 2 years unintentionally and have taken Synthroid over 20 years. Endocrinologist said I might be loosing weight because of menopause.  After doing some research I now question the FNA results.  I Have Found information that said results of follicular cells  found in a FNA can be hard to distinguish between cancer and non-cancer cells.  Should I go for a second opinion or see what happens at the follow up?  Anyone else with similar experience?  The Ti-rads score of 5 scared me but I guess it did not mean much.  Any advice or sharing of experience would be helpful and appreciated.  Thank you.

Yes, get a second opinion. 

RE: Not sure if I should get 2nd opinion

by Lovemycats on Tue Feb 05, 2019 03:19 AM

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Thank you for your quick response butterfly501.  Do you think I should get it to be on the safe side?  Or do you or someone you know have a similar experience?  I appreciate your advice.

RE: Not sure if I should get 2nd opinion

by Lovemycats on Tue Feb 05, 2019 03:26 AM

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Thank you for your information and advice ToddlerFather.  I looked up NIFTP and that sounds like the explanation my Dr.  had told me.  Until the border is broke it is not considered cancer.  Once broken, then cancer.  Thanks again for your input.

RE: Not sure if I should get 2nd opinion

by butterfly501 on Tue Feb 05, 2019 11:29 PM

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On Feb 05, 2019 3:19 AM Lovemycats wrote:

Thank you for your quick response butterfly501.  Do you think I should get it to be on the safe side?  Or do you or someone you know have a similar experience?  I appreciate your advice.

I got a second opinion. 

My thought is if you think you need a second opinion, then you should get a second opinion; for your own peace of mind.

RE: Not sure if I should get 2nd opinion

by NickT on Thu Feb 07, 2019 05:22 PM

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On Feb 03, 2019 4:49 AM Lovemycats wrote:

Hello.  I had an ultrasound done and right lower thyroid nodule measured 1.5cm x 1.0cm d 0.9cm.  Very hypoechoic, wider than taller, lobulated margins and no echogenic foci.  Ti-rads category 5.  FNA said benign follicular lesion.  My cousin has had thyroid cancer 2x. Don't know what type.  My endocrinologist said to have another ultrasound in a year then if nothing changes, should not have to worry about it.  I also have lost over 60lbs in last 2 years unintentionally and have taken Synthroid over 20 years. Endocrinologist said I might be loosing weight because of menopause.  After doing some research I now question the FNA results.  I Have Found information that said results of follicular cells  found in a FNA can be hard to distinguish between cancer and non-cancer cells.  Should I go for a second opinion or see what happens at the follow up?  Anyone else with similar experience?  The Ti-rads score of 5 scared me but I guess it did not mean much.  Any advice or sharing of experience would be helpful and appreciated.  Thank you.

While I'm not conversant with your particular diagnosis,

I believe as a rule a second opinion is always a good idea.  Fresh eyes can be helpful.

RE: Not sure if I should get 2nd opinion

by longliveliver on Thu Feb 07, 2019 06:26 PM

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Absolutely get a second opinion.  An unintentional loss of sixty pounds in two years is not a common result of menopause—in fact, I have never heard of such a thing.  If you need treatment you should get it asap.  See someone else, a doctor who is not in the same practice.

RE: Not sure if I should get 2nd opinion

by Sdurnell on Thu Feb 07, 2019 10:36 PM

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I'm not familiar with thyroid cancer, but getting another opinion is hardly ever a bad idea, especially when you harbor some doubts about the first one or recommendations for treatment.

I had FNA biopsy for head and neck cancer and it was inconclusive.  It was only after surgery that the pathology report came back as squamous cell carcinoma.

Best of luck to you.

RE: Not sure if I should get 2nd opinion

by ToddlerFather on Fri Feb 08, 2019 09:49 AM

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Just to note that there are two 2nd opinions involved here: one about weight loss, the other about nodule management. You might want to get for both, but most likely it will be from different professionals. 

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