# Does anyone have any information on thyroid nodules and length of time observing them



## 49countrygirl (Jan 21, 2013)

Thanks to everyone for all of the wonderful information that you have posted on this site. :hugs: I have been looking for more information on thyroid nodules and how long doctors suggest a watch and wait plan. Mine just happened to be found 12 years ago on an mri for something other than thyroid. It was 1.2 cm at that time, I had an RAIU scan, ultrasound every 6 months for 2 years, and an fna of the nodule. I followed up on this for 2 years, and they called it a benign looking nodule. Fast forward 10 years, and I have a feeling of something in my throat. Now I have 3 nodules, 2 are smaller (less that 1 cm) and the other one was 2.0 cm. I have went through the same tests, and have been placed on synthroid for a year and a half. (They say Hashis, and a non-toxic multinodular goiter, benign appearing nodules.) The largest nodule has now decreased to 1.6cm & the other two smaller ones have shrank by a mm or so. My doctor still didn't think I needed surgery, but I went for a second opinion. My dear Grandma had thyroid cancer, but not sure what type. She did great!
The endo said she felt that it was a 30% chance of malignancy, and that really got my attention! I am now scheduled for a tt the end of February. Has anyone had any similar experiences? Thanks so much for any advice.


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## Octavia (Aug 1, 2011)

My answer is not based on any scientific studies, so take it with a grain of salt. 

My hunch is that TIME itself is not as important as SIZE and GROWTH when it comes to watching a nodule. A nodule could be watched forever if it's not growing and not causing discomfort/problems...I believe. A large portion of the population has nodules, most of which do not create problems.

Curious to see what others say...


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## 49countrygirl (Jan 21, 2013)

Thanks for your response. I didn't see it until tonight. (I had posted the same thread on another discussion board.) I have now had another fna with a new endo just last week, and the report came back benign, and that it is a colloid nodule. But, the ultrasound showed a small calcification. I am planning on cancelling the surgery and continuing the watch and wait I guess. Do you know anything about calcifications showing up with colloid nodules? Thanks so much for reading this. I really appreciate all information. :hugs:


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## I DClaire (Jul 31, 2011)

My experience is a little bit different. I suddenly had symptoms about three years ago (elevated blood pressure, heart racing) and a blood test indicated hyperthyroidism. My doctor said she'd watch it and every six months for the next couple of years I had ultrasound tests and nuclear scans. Every test revealed old nodules growing and new ones developing.

When the oldest nodules became big enough to do FNA, I didn't feel comfortable with that. I was afraid because I really didn't trust the test...and time would prove I was right. I asked my endocrinologist wasn't the time going to come, because of how quickly the nodules were developing AND I was having problems with the drug I was being given, that I'd have to have surgery and she said yes, there was no reason to think my situation would improve.

I had a total thyroidectomy. In spite of all the tests, my thyroid was 3-4 times bigger than expected, and filled with cysts and nodules...and a very tiny papillary cancer, so small that I did not have to undergo any further treatment for cancer but I will be monitored for 5 years.

My thyroid disease seemed to come out of nowhere and was obviously quite aggressive. I do not believe FNA would have ever found the little cancer inside my thyroid. Plus, due to the unanticipated size of my thyroid, all four parathyroids were injured during surgery leading to five extra days in the hospital having my calcium levels checked around the clock.


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## joplin1975 (Jul 21, 2011)

Calcifications are one of those things we consider red flags: calcification, hyper vascular, solid (rather than cystic).

Given that you are carefully watching this, I don't think there's any real danger...just keep in mind that a nodule with calcification should be watched with extra caution.


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## 49countrygirl (Jan 21, 2013)

Thanks so much for your responses! To think that the tests don't necessarily show the actual size of things is kind of scary. It's great IDclaire that you didn't have to have any further treatment and that you found it early.  Thank you Joplin for your response on the calcification, I hope that you are doing really well too. 
I feel that I will eventually end up have a tt done because the nodules aren't going away although they haven't changed in size much at all over a long period of time. Are calcifications a normal finding with some colloid nodules? My endo didn't seem to be too concerned, just to follow up every six months. My ear/nose/throat surgeon who also specializes in oncology also agreed with that, and for a surgeon I thought that sounded promising. I went to another endo who thought there was a 30% chance of cancer but didn't recommend an fna or an updated ultrasound. She scared me, and then I went for another opinion. That endo recommended the fna and she did the procedure herself, and called me with the results the next day. I was very impressed with her. 
There is sooo much information on the internet. Is a fna more conclusive than an ultrasound? What is the most reliable web site out there for thyroid information?


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## joplin1975 (Jul 21, 2011)

Ultrasounds are a good starting point, but they have lots of limitations. My own example is that my u/s underestimated the size of all three large nodules (left side) and didn't pick up the three smaller nodules on the right side. It's a good, non-invasive tool, but it's not perfect and it cannot be used to distinguish between cancerous and non-cancerous nodules.

FNAs are significantly more reliable, but they aren't perfect either. Remember that the needle is very small, so if you have cancerous cells, the needle has to hit those cells in order for you to get conclusive results. And, you can always get inconclusive results, for a variety of reasons. But, outside of surgery, it's your best option.

This is a slightly older article, but I found it to be helpful: http://www.aafp.org/afp/2003/0201/p559.html


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## 49countrygirl (Jan 21, 2013)

Thank you Joplin for your reply. I checked our your link too and it was very helpful. If you don't mind me asking...have you had an fna before? I made my decision today to go ahead with the surgery next week. I am so tired of the watch and wait approach and the worrying about it is taking its toll. Thanks again for your help. God bless.


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## joplin1975 (Jul 21, 2011)

Yes, I had a FNA before surgery - I'm a big baby and wanted to avoid surgery at all costs.  Turns out, it was papillary cancer so despite my best efforts, I headed off to surgery. I would rather have been doing 101 other things than be in the hospital, but all in all, it was pretty easy. So, good luck with your procedure and don't forget to let us know how you make out!


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