# Need quick advice on surgery tomorrow



## kidsabc (Feb 20, 2013)

Hi! I'm in Texas at MD Anderson. Diagnosed with papillary carcinoma and awaiting surgery tomorrow. Need quick advice. Love the surgeon and the hotel! Need an opinion.... Surgeon wants to only do a partial thyroid removal and NO radioactive and everything I read said whole thyroid and radioactive iodine for best chance of no recurrence and best prognosis. I know this guy is the head honcho, but now I feel confused... What are your thoughts?


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## joplin1975 (Jul 21, 2011)

How large is the troublesome nodule? What kind of pre-op testing have you had done?

I was put on an immediate track for a total and was told to expect RAI, but that the final decision would be made after surgery...when he and my Nuc med doc would have the full pathology results *and* after I had a radio iodine uptake scan to see if there was remaining thyroid tissue.

You'll find lots of people around here advocate for a total, but it's hard to say without more info.

And, hey, good luck tomorrow!


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## susieintexas (Mar 4, 2012)

I replied via PM but I wanted to add that I will be thinking about you. GL!


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## Lovlkn (Dec 20, 2009)

kidsabc said:


> Hi! I'm in Texas at MD Anderson. Diagnosed with papillary carcinoma and awaiting surgery tomorrow. Need quick advice. Love the surgeon and the hotel! Need an opinion.... Surgeon wants to only do a partial thyroid removal and NO radioactive and everything I read said whole thyroid and radioactive iodine for best chance of no recurrence and best prognosis. I know this guy is the head honcho, but now I feel confused... What are your thoughts?


I doubt you will change their mind with surgery tomorrow, however - if you want them to take the whole thing tell them before they roll you into the room.

If it were me - I would choose a daily replacement pill over the chance my existing 1/2 would remain cancer free and provide enough thyroid hormone for me.


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## kidsabc (Feb 20, 2013)

Thanks for your replies. I am so nervous and confused this morning. I have had an ultrasound of my neck which showed no suspicious lymph nodes so he said no need to remove any. The nodule was shown positive for papillary carcinoma based on the FNA and its on the left side and on isthmus 1.2 cm x .5 cm. Surgeon, Dr Claymon of MDAnderson saying take out left side and isthmus, leave right lobe because 50% chance won't need meds rest of life. No RAI. No PET body scan. No Tg levels. Just ultrasound follow up. My husband thinks this is awesome and the guy is the best in the world and I should do whatever he says. I'm nervous because its all so the OPPOSITE of everything I've read....

Need opinions ASAP as I'm meeting him to discuss. Surgeon says he will do whatever I'm most comfortable with. Lovlkn was confused about whether you we're voting full or partial?

Thanks guys!


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## joplin1975 (Jul 21, 2011)

My opinion is based only on my experience:

I had two ultrasounds AND a RAIU prior to my surgery. All three tests showed thee cancerous nodules on the left side of my thyroid, with a clear isthmus and right side. All three showed no suspicious lymph nodes.

Post-op, my surgeon said the nodules on the right side were large enough that he decided to do a central neck dissection too (removed 10 lymph nodes), "just to be on the safe side."

Post-op pathology showed that all three nodules on the left side were cancerous, as expected, but that I also had three microcarcinomas on the right side (unexpected) *and* three of the lymph nodes were positive for cancer as well.

I'm living an extremely full life now, post-op, and have no real issues with being on meds, etc. So, count me in as a vote for a total.


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## webster2 (May 19, 2011)

I'd vote for a total, just to avoid another surgery down the road...in say a year or twenty, as was my experience. Good Luck!


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## Octavia (Aug 1, 2011)

You have an interesting dilemma. I'll share my experience briefly. My FNA prior to surgery was inconclusive, so we did not know going into surgery whether I had cancer or not. So the surgeon took out only my right lobe.

Pathology came back a few days later showing cancer, so within a couple of weeks, I had a second surgery to take out the other half (non-cancerous), and I had an RAI treatment.

This surgeon may be making his recommendation based on the size of your tumor...is it very small? (Mine was 3.2 cm...not huge, but fairly large as thyroid nodules/tumors go. The bigger they are, the more likely it is that they have/will spread.)


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## kidsabc (Feb 20, 2013)

Hi everyone.... Just wanted to give you an update. I had surgery yesterday and discussed with the surgeon,his assistant and my husband for over an hour pre-op about total versus partial. I understood the risks associated with leaving half in but didn't grasp any benefits. They patiently explained that the quality of life with a total thyroid removal for woman is poorly affected by the loss of the 26 chemicals produced by this gland. While the medication replaces one or two, most find low energy, depression, etc and never feel right again. He also explained that the chance of recurrence for me having a completely encapsulated 9mm papillary microcarcinoma is less than 4% and the risk of RAI and total and parathyroid injury was much greater. So I elected for the partial and for trusting the best guys but I must admit I am still nervous! I will always worry.

The surgery hurt more than I expected and I am now at the hotel recovering. Would love to hear your thoughts and am thankful for all the well wishes!!!


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## webster2 (May 19, 2011)

I am glad to hear that you are recovering well. Did they suggest that you take thyroid replacement? After my partial, I was told to take replacement. I only did for one year. I wish I had listened. So, that's my only advice, if replacement was suggested, take it!

I do think you had a great doctor with sound advice.


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## susieintexas (Mar 4, 2012)

Yea! I am so glad. I have been thinking about you. It took me 10 days to feel 'normal' again and I had a large incision. Take it easy and stay on top of the pain.


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## Lovlkn (Dec 20, 2009)

> the quality of life with a total thyroid removal for woman is poorly affected by the loss of the 26 chemicals produced by this gland. While the medication replaces one or two, most find low energy, depression, etc and never feel right again.


I personally feel better without a thyroid than a diseased one.

Fingers crossed that you will not need a 2nd surgery.


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## joplin1975 (Jul 21, 2011)

I, too, am so glad you are doing well.

I also disagree about not feeling well after a total. I feel so good, so much better than I have on a decade. Everything from energy level to libido has improved.

But, that's not a if deal, just a minor quibble. I think you'll do just fine. Just stay on top of those follow up appointments and you'll be fine. 

Now go heal up!


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## Andros (Aug 26, 2009)

kidsabc said:


> Hi everyone.... Just wanted to give you an update. I had surgery yesterday and discussed with the surgeon,his assistant and my husband for over an hour pre-op about total versus partial. I understood the risks associated with leaving half in but didn't grasp any benefits. They patiently explained that the quality of life with a total thyroid removal for woman is poorly affected by the loss of the 26 chemicals produced by this gland. While the medication replaces one or two, most find low energy, depression, etc and never feel right again. He also explained that the chance of recurrence for me having a completely encapsulated 9mm papillary microcarcinoma is less than 4% and the risk of RAI and total and parathyroid injury was much greater. So I elected for the partial and for trusting the best guys but I must admit I am still nervous! I will always worry.
> 
> The surgery hurt more than I expected and I am now at the hotel recovering. Would love to hear your thoughts and am thankful for all the well wishes!!!


Glad to hear you are in recovery and make icing down your best frien for now.

Take good care of yourself; there is only one "you!"


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## Octavia (Aug 1, 2011)

Glad you had the discussion and arrived at a decision you were more comfortable with. Get lots of rest! :hugs:


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