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6 cm nodule-go to surgery?


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#1 Danny70

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Posted 25 March 2018 - 08:38 PM

Hello. I have a 6cm solid nodule that showed on an ultrasound. I have a consultation about having a biopsy but I was wondering if I should go straight to surgery. I watched a UCLA video and they said over 4 cm should be strongly considered even if it's benign. If I'm going to need surgery anyway, I would prefer to get it over with and not go through a biopsy. Thanks.



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#2 Lovlkn

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Posted 26 March 2018 - 08:43 AM

If it were me I would go straight to a surgeon for removal. Your issue will be difficulty stabilizing with 1/2 a thyroid post surgery.

Something to discuss with your surgeon.

Find a surgeon who performs 4-5 thyroid surgeries weekly as experience is a good thing
Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#3 joplin1975

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Posted 26 March 2018 - 11:11 AM

Yup - agreed. Go straight to surgery. And ask them to remove the entire thyroid.
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#4 Danny70

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Posted 27 March 2018 - 12:32 AM

Thanks. I'm going to cancel the biopsy appt and set up a consultation with a surgeon who does a lot of these surgeries.



#5 joplin1975

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Posted 27 March 2018 - 12:10 PM

Good luck - if you have any questions about surgery, please let us know.
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#6 Danny70

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Posted 04 April 2018 - 04:10 PM

I'm probably going to have a 5-6 week wait for an appointment with the experienced thyroid surgeon. I live in a small state where there aren't a lot of experts in this area so I'm thinking I should just wait instead of trying to see someone else. I'm not having any symptoms despite the size of the nodule.



#7 joplin1975

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Posted 04 April 2018 - 05:18 PM

Go with an experienced surgeon, assuming the symptoms are manageable. It will be worth the wait. 


Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#8 jenny v

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Posted 07 April 2018 - 05:50 PM

Definitely agree, wait for the good surgeon!


Thyroid problems since 2002
Diagnosed with Graves Disease 2002 and Hashimoto's Disease April 2012
TT on October 10, 2013
Currently on 90mg Westhroid and 50mcg Cytomel


Information exchanged on these boards should not be construed as medical advice. We ARE NOT doctors. Please seek a qualified physician to answer your questions before acting on any information found here.

#9 Danny70

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Posted 28 May 2018 - 09:16 PM

I'm back. I'm having surgery on Wednesday. I should be able to leave the hospital Thursday morning and was planning on staying with my parents until Friday and having them drive me back home. I live by myself so is it okay for me to be by myself two days after surgery? Is it common to have really bad symptoms? My parents don't mind me staying longer but I have awful insomnia and have a bed at home that allows me to sleep good and I know I'll be exhausted by Friday. I live a half mile from a hospital and am stocked up with soft foods, Thanks. 



#10 joplin1975

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Posted 28 May 2018 - 10:52 PM

I was alone during the day 12 hours after surgery. I didn't need help. I may have felt crummy but I didn't need help. You will likely be exhausted after surgery!
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#11 Lovlkn

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Posted 29 May 2018 - 12:56 PM

I went home form the hospital and cooked dinner for my family - 

 

When are they starting you on thyroid hormone replacement? 

 

It's a good idea to have the bottle on hand vs getting filled after surgery or maybe your parents can get it filled before you go to your house.  I did not do that and by day 3 felt nailed to floor so they called it in - hubby went and got it.  You really should not drive as long as you are taking narcotics.


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#12 Danny70

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Posted 29 May 2018 - 04:27 PM

I'm not sure when I'm starting thyroid replacement. I'll have my parents pick up whatever medication I might need before I go home. I have a pharmacy within a mile of where I live.



#13 Lovlkn

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Posted 30 May 2018 - 01:07 PM

You might want to clarify who will be providing your replacement hormone prescription post surgery.  People start hormone replacement anywhere from the day after to a week after surgery.  Personally - I think 2-3 days is a good start point as any hormone spilled during removal has time to burn off.

 

You might also figure our what dose you should be asking for.  Figure 1.7 mcg per kilogram of body weight for a start dose.

 

Many doctors start with 100mcg and if you weigh more than 129.63lbs it won;t be enough.


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#14 Danny70

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Posted 01 June 2018 - 02:27 PM

I had a partial thyroidectomy on Wednesday morning and am back home now and feeling fine. My surgeon did perform a FNA/ultrasound on my large nodule (6cm) on the right side a month ago and it came back negative for cancer and didn't see anything on the left side. I mentioned that if there was any doubt I would like to have a total but he didn't see any cancer during surgery and thinks it's just a large nodule. I will know for sure when I meet with him again next week and find out test result of nodule that was removed. I was sent home with TUMS and told to take 3 and call his office if I have any symptoms. What should I ask at the appt? Thanks.   



#15 joplin1975

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Posted 01 June 2018 - 02:46 PM

Glad you are through the appointment and feeling well. 

 

Did you start on thyroid meds yet? If not, I would ask about that: when will the blood tests will be, what tests they will run, and who will prescribe the meds.

 

Also, ask for a copy of your pathology report. 


Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#16 Danny70

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Posted 01 June 2018 - 08:50 PM

I haven't started on thyroid medicine yet. I will ask these questions and get a copy of the pathology report. My appointment is on Tuesday with the surgeon and a nurse practitioner. Someone where I work had had a total thyroid removal with the same surgeon and she says she works with the nurse practitioner more during her checkups to check her levels. My surgeon does a high volume of thyroid surgeries and is 65 so I'm not sure if I would be seeing him at every appt and I would guess he might be getting close to retirement.  






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