# Ruling out cancer with Hashimoto's



## Vogel (Nov 2, 2014)

October 2014 I was diagnosed with Hashimoto's and had an ultrasound performed because my thyroid is enlarged (evenly, and hard, which I am told is typical of Hashimoto's).

On my ultrasound there was a 7mm nodule found right smack dab in the middle of my thyroid. I will be requesting the results in my next visit, to see exactly what was written, but she was not concerned about it at all. I remember she remarked "lots and lots of inflammation" which is no surprise. I asked about the nodule during my most recent exam. The PA felt my thyroid and said she could not feel the nodule and in her expertise she can feel them when they are at least 1cm. I will have a follow up ultrasound in October.

My questions/concerns:


Can the inflammation obstruct other abnormalities (nodules, cysts)?
If the nodule hasn't grown in a year, should I push to continue to rule out cancer?
I'm having trouble finding a good resource for understanding ultrasounds, any suggestions?
What would you do/what have you done? Looking for general advice or anecdotes to start my brainstorming.

In case someone asks: My medication currently seems to be doing the trick, finally and thankfully. The last time we ran antibodies was in March. TPOAb was >1000 and TgAg was 1380. My tests at the beginning of June showed TSH was great (1.12) and though I don't have my exact FT4 and FT3 values at this moment, I know my FT4 was mid-range to 3/4 and my FT3 was just below mid-range. Because of lingering symptoms, and not wanting to over inflate my T4, I opted to start taking T3 last month. I'll see how the labs are in 3 weeks, but between adding the T3 and improving my Vitamin D deficiency, I feel pretty damn good. No other lows on the lab results - iron is great, RBC counts, ferritin, B12, calcium, and so on.


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## joplin1975 (Jul 21, 2011)

To rule out cancer, you need a biopsy. In order to biopsy, the general rule of thumb is that anything under 1cm is too small. Once the nodules hit that 1cm mark, they will biopsy.

Your lab work raises a lot of red flags. You may be able to find someone willing to try to biopsy the nodule, if you are bothered by it. However, thyroid cancer is a very slow growing disease. The general feeing is that you aren't changing your prognosis by waiting until (or if) it hits that 1cm mark.


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## Andros (Aug 26, 2009)

Hashimoto's cancer risk
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575056/
(Copy and paste into your browser)

Graves' and Hashi's cancer
http://www.thyroidmanager.org/Chapter18/18-cancothr.htm
(Copy and paste into your browser)

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf

Another Thyroglobulin and cancer
http://www.mdlinx.com/endocrinology/newsl-article.cfm/3305021/ZZ5052128790304906121963/?news_id=811&newsdt=092010&subspec_id=419
Nodules
Nodules http://www.aafp.org/afp/2003/0201/p559.html
(Copy and paste into your browser)

calcified nodules
http://www.ncbi.nlm.nih.gov/pubmed/12112538
(Copy and paste into your browser)

Nodules http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665239/
(Copy and paste into your browser)

TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html
(Copy and paste into your browser)

Providing some info for you and you may wish to see an ENT about all of this.

Lots of info; maybe too much but the sources are credible.

Hugs,


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## Vogel (Nov 2, 2014)

joplin1975 said:


> Your lab work raises a lot of red flags. You may be able to find someone willing to try to biopsy the nodule, if you are bothered by it. However, thyroid cancer is a very slow growing disease. The general feeing is that you aren't changing your prognosis by waiting until (or if) it hits that 1cm mark.


Thank you for re-affirming this information. I am bothered by it, because I don't like the unknown, but I do not have anxiety because of the size and how slow growing thyroid cancers can be. I will ask my endo if she is willing to attempt a FNA after we have results of the next ultrasound.



Andros said:


> Providing some info for you and you may wish to see an ENT about all of this.
> 
> Lots of info; maybe too much but the sources are credible.
> 
> Hugs,


Thank you for sharing this info - can never have too much! I read some of the links previously while searching for similar posts. I think I may see an ENT if my next ultrasounds shows the single nodule holding at the same size or larger.

I understand my TgAg is high, and can indicate thyroid cancer, but my impression was it is mostly significant post-TT. I understand you can have multiple problems at once, but since I have Hashimoto's I'm just not terribly concerned about the antibodies representing cancer at this time. Perhaps I'm missing a key piece to the puzzle, but without any typical symptoms of thyroid cancer I guess I'm not as anxious as I was previously. Coupled with my enlarged thyroid being "classic Hashimoto's thyroiditis" per my endo I'm OK with the usual "wait and see."

Thanks again to you both!


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