# Just diagnosed with PTC



## Kacot (Feb 8, 2013)

Hi, I was just diagnosed this week with PTC. Here is my story. About ten years ago my ob/gyn mentioned that my thyroid looked enlarged. Two years later I had an ultrasound and was found to have 3 small nodules, I was never told the size. They said they were of no concern but to keep a watch. At every annual the obgyn would exclaim at the size of my thyroid. I never really notice it and felt that I had no symptoms. Blood work had also been done and I was told it was within normal range. In the winter of 2006 and started to have random outbreaks of severe uticaria that lasted almost a full year and rhen just disappeared. 2010 I had blood work again, tsh .36 ref range (.49-4.67) t4 free? .86 ref range .61-1.12)
Also had another US and it showed no change. So nothing was done. This year at my annual my PA did blood work again tsh .42 ref range .49-4.67. No t4 shown. We also did another US. It took several weeks to hear back, but when I did the PA said the radiologist reported a change, I had a 4 th nodule, however he told the PA he didn't feel it was anything to be concerned with and to just watch it. The PA told me she felt I should be seen by an Endo. 10 days ago I saw the endo, who did another US, and ended up to a FNA on one of the nodules. He called me up five days later to tell me it came back PTC and he referred me to a surgeon. The nodule is 1.5 and solid. I met with the surgeon the next day, in a foggy haze. He examined me and explained that he would perform a total thyroidectomy , along with removal do the lymph nodes around it! He said that they usually dont do RAI ablation anymore, but i am confused. is that the same as a whole scan? if they dont do that how do they know there is mo remaining cancer? i assume post surgery i will get path results that will tell us more. Whew it has been a blur of a couple of days.i am the type of person that likes to be in control and rarely thinks of myself first. We own a small family restaurant that luckily is closed for the season until til march, but still! My mother is in the early stages of Alzheimer's and my dad will be 90 next month and is starting infusion treatment this week for pemphigus! Needless to say I have to figure out how to lighten my load! I say that I have had no symptoms, but in hindsight I am wounding if the urticaria was related? Also my voice has become hoarse and I suffer from night time hand numbness and pain. Any thoughts would be greatly appreciated. I am scheduled for the TT surgery on 2/21. Thank you!


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## joplin1975 (Jul 21, 2011)

Uh. Well, first, welcome!

Second, RAI is still quite commonly used. Some don't receive it if their tumor is exceptionally small and well contained, but I think the majority have it.

The whole body scan is done with a small dose of radioactive iodine, however it's a smaller dose and different isotope from the RAI ablation process. Usually, you get the "tracer" dose, have the scan, and then the doctors decide if and how much of a "treatment" dose that kills off any residual thyroid cells.

Would your surgeon be deciding about RAI definitivly or will you referred out to radiology/Nuc Med for a whole body scan?


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## Abcdefg (Mar 16, 2012)

Sorry you've joined the club . But I'm happy they finally did more than just monitor your nodules. it's very likely they've caught it early and surgery will get hopefully all of it. The neck dissection is actually ( to me) a relief, as that will somewhat assure you that any possible nodes are taken out. Don't let them blow you off. 
RAI: maybe maybe not. A lot depends on the tumor boards and Rad Oncs. You probably won't know either way until after your Path comes back.


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## Kacot (Feb 8, 2013)

Thank you, I guess there is still a lot for me to learn and these boards help a lot. I am scheduled for a lateral ultrasound the day before surgery, I don't really know what that is for, but assume many it is to check the lymph nodes? I am compiling a list of questions to ask at that appointment.


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## joplin1975 (Jul 21, 2011)

Yes, it is to take a look at those nodes. I had one too. 

Make sure you ask about that RAI. I had a TT and a central neck dissection (removal of ten nodes) - three of which were positive for cancer but the other seven were clear - and in my post-op scan, there was significant uptake in the neck area. I think, speaking very generally, if you are a candidate for a neck dissection, you're usually a prime candidate for RAI.


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## Andros (Aug 26, 2009)

Kacot said:


> Hi, I was just diagnosed this week with PTC. Here is my story. About ten years ago my ob/gyn mentioned that my thyroid looked enlarged. Two years later I had an ultrasound and was found to have 3 small nodules, I was never told the size. They said they were of no concern but to keep a watch. At every annual the obgyn would exclaim at the size of my thyroid. I never really notice it and felt that I had no symptoms. Blood work had also been done and I was told it was within normal range. In the winter of 2006 and started to have random outbreaks of severe uticaria that lasted almost a full year and rhen just disappeared. 2010 I had blood work again, tsh .36 ref range (.49-4.67) t4 free? .86 ref range .61-1.12)
> Also had another US and it showed no change. So nothing was done. This year at my annual my PA did blood work again tsh .42 ref range .49-4.67. No t4 shown. We also did another US. It took several weeks to hear back, but when I did the PA said the radiologist reported a change, I had a 4 th nodule, however he told the PA he didn't feel it was anything to be concerned with and to just watch it. The PA told me she felt I should be seen by an Endo. 10 days ago I saw the endo, who did another US, and ended up to a FNA on one of the nodules. He called me up five days later to tell me it came back PTC and he referred me to a surgeon. The nodule is 1.5 and solid. I met with the surgeon the next day, in a foggy haze. He examined me and explained that he would perform a total thyroidectomy , along with removal do the lymph nodes around it! He said that they usually dont do RAI ablation anymore, but i am confused. is that the same as a whole scan? if they dont do that how do they know there is mo remaining cancer? i assume post surgery i will get path results that will tell us more. Whew it has been a blur of a couple of days.i am the type of person that likes to be in control and rarely thinks of myself first. We own a small family restaurant that luckily is closed for the season until til march, but still! My mother is in the early stages of Alzheimer's and my dad will be 90 next month and is starting infusion treatment this week for pemphigus! Needless to say I have to figure out how to lighten my load! I say that I have had no symptoms, but in hindsight I am wounding if the urticaria was related? Also my voice has become hoarse and I suffer from night time hand numbness and pain. Any thoughts would be greatly appreciated. I am scheduled for the TT surgery on 2/21. Thank you!


What a shame this has happened. The good news is that your surgeon sounds really really good. You have a full plate. That makes me glad you are here because aside from support and info, we may even make you laugh a little.


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