Well...
I think your doctor is jumping the gun a bit.
First, unless you are certain you want the thyroid out, you should have a biopsy before surgery. None of your nodules even meet the criteria for biopsy (although it's close). I'd ask why he's skipping the biopsy.
Second, many many people go into surgery not knowing for sure if their nodules are cancerous. That's normal. And yes, your u/s does show some concerning characteristics. However, he should be ordering a boatload of more tests to give you as much information as possible, most pressing would be thyroid antibodies. TPO and TSI would point to autoimmune thyroid issues and Tg/TgAB would help indicate if it's thyroid cancer. You could also have a radioiodine uptake scan which can tell you how well (or not) those nodules are functioning. It can also point to cancer vs no cancer. Finally, the most important thyroid function test is free t3 and you don't have that...if your doctor won't test that, it'll be really difficult to regulate meds after surgery.
To be clear, 40 is the seemingly magic number for thyroid cancer. If they find a cancerous nodule and you are 40 or over, it tends to be more aggressive and they treat it with more urgency.
Finally, I'll say two more things: 1) there's a push now to take a watch and wait approach with thyroid cancer. Research has shown that cancerous nodules under 1 cm that have not extended beyond the margins of the thyroid capsule don't always require treatment (although they do require monitoring) and 2) the biggest factor in successful recovery from surgery is finding a "high volume" surgeon. Do you have that? What kind of questions did you ask? What is his background? How many thyroid surgeries does he do annually? How does he close the wound? Will he do a frozen section exam during surgery? What is his complication rate? Etc etc...
I tend to be pro-surgery and you may need it, but I'm not convinced you have all the information you need to make an informed decision. I'll try to find the watch and wait article from the ATA.
I think your doctor is jumping the gun a bit.
First, unless you are certain you want the thyroid out, you should have a biopsy before surgery. None of your nodules even meet the criteria for biopsy (although it's close). I'd ask why he's skipping the biopsy.
Second, many many people go into surgery not knowing for sure if their nodules are cancerous. That's normal. And yes, your u/s does show some concerning characteristics. However, he should be ordering a boatload of more tests to give you as much information as possible, most pressing would be thyroid antibodies. TPO and TSI would point to autoimmune thyroid issues and Tg/TgAB would help indicate if it's thyroid cancer. You could also have a radioiodine uptake scan which can tell you how well (or not) those nodules are functioning. It can also point to cancer vs no cancer. Finally, the most important thyroid function test is free t3 and you don't have that...if your doctor won't test that, it'll be really difficult to regulate meds after surgery.
To be clear, 40 is the seemingly magic number for thyroid cancer. If they find a cancerous nodule and you are 40 or over, it tends to be more aggressive and they treat it with more urgency.
Finally, I'll say two more things: 1) there's a push now to take a watch and wait approach with thyroid cancer. Research has shown that cancerous nodules under 1 cm that have not extended beyond the margins of the thyroid capsule don't always require treatment (although they do require monitoring) and 2) the biggest factor in successful recovery from surgery is finding a "high volume" surgeon. Do you have that? What kind of questions did you ask? What is his background? How many thyroid surgeries does he do annually? How does he close the wound? Will he do a frozen section exam during surgery? What is his complication rate? Etc etc...
I tend to be pro-surgery and you may need it, but I'm not convinced you have all the information you need to make an informed decision. I'll try to find the watch and wait article from the ATA.
