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Discussion Starter · #1 ·
I had a physical exam on 2/27/15. During the foregoing, a CT scan was done which led to an incidental finding of a 2 cm nodule in the right lobe of my thyroid. Fast forward...... Ultrasound guided FNA biopsy = indeterminate - atypia of undetermined significance; biopsy shipped to Afirma for GEC testing = suspicious for malignancy and, thankfully, negative for MTC. The microscopic description reflects the following: The cyctologic preparations are mildly cellular and show some clusters of follicular cells in crowded and micro follicular groups with nuclear enlargement and some colloid.

So, I have met with a surgeon and am scheduled to have surgery on 4/16/15. Basically, I need to decide if I want half the thyroid out (running the risk of a second surgery if the final pathology shows cancer) or the whole thing (pill for the rest of my life and would likely regret this decision if the nodule ends up being benign). Thoughts????? Finally, if it ends up being cancer why can't I keep the left lobe in since there is nothing showing in it?

Thank you in advance for your perspective. Very tough call for me.....
 

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or the whole thing (pill for the rest of my life and would likely regret this decision if the nodule ends up being benign)
You have nodules - many times nodules become cancer, sometimes they do not.

You obviously were having enough issue to have an ultrasound of your thyroid, do you really think it will go away if you only have 1/2 removed? I don't.

I personally would have the whole thing out - why live the rest of your life wondering "if" it might be cancer later down the road.

Also - nodules impact the performance of your thyroid. As long as they are there - they will ebb and flow on thyroid hormone production. Do you really want to live the rest of your life with the ups and downs of thyroid disfunction?

I don't think you would "regret" if you really think about it.
 
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Get the whole thing out.

Doctors will tell you that you won't need to be on meds with a partial, but the reality is that most people who have had half or some of their thyroid removed do need meds. The risk of having a second surgery combined with the likelihood that you will need meds combined with the likelihood that having a remaining portion left in could make regulating your meds harder all = a total thyroidectomy.
 
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You're right. It is a tough call. If you had Graves or Hashimoto's disease, I would without a doubt suggest a total thyroidectomy. But you didn't mention either of those.

My opinion? Flip a coin. I am one of the people who had to have that second surgery because pathology from my first one came back as cancer. Prior to that, my FNA biopsy results were inconclusive. It stunk having to go back for a second surgery, but it was not the end of the world. Hindsight being 20/20, I wish I would have chosen a total thyroidectomy the first time around, but at the time, I thought a partial was the right decision.
 
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Discussion Starter · #5 ·
Thank you all for taking the time to respond. I really appreciate it.

Octavia, was your biopsy examined by Afirma with the GEC testing or was your surgery before this technology was introduced? Secondly, I do not have Graves or Hashimoto's disease. The reality is I probably would not have none about the nodule for a long time but for the CT scan as I feel very good.

I am leaning towards taking 1/2 out as you did..... I wish I had some more clarity.
 

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No, I just had the "standard" biopsy examination. It was not sent for Afirma testing. I did not know about Afirma testing at the time, and neither ENT I went to mentioned it, so I was completely unaware of that option.

A good friend of mine recently had a partial thyroidectomy. She lucked out...no cancer, and so far so good on her labwork without any replacement medication. I don't know how typical her results are.

Here's an idea that may help you decide one way or the other: how about getting a tested for thyroid antibodies, just to be sure your body isn't attacking your thyroid? If you test positive for antibodies, especially if you test EXTREMELY positive for antibodies, that would be a good indicator to me that you should more strongly consider a total thyroidectomy.
 

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My two surgeries were 20 years apart. I would go for the total. JMHO
 

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The voice of experience speaks! Why worry about the other half? Git 'er dun and that's that. You will sleep better and you will feel better.

Welcome and many hugs to you!
 

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I had a partial and then repeat surgery to remove the other half when it turned out to be malignant.

In my case, we really didn't expect it to be cancer (no Afirma here in UK, at least as far as I'm aware)

I felt really bad with only half a thyroid and was relieved when they took the rest. Wish I'd done it all in one go - would definitely have done so if I'd known there was a realistic chance of it being thyca.

Also, after the second surgery I had voice issues, which may have been partially due to having two surgeries within 6 weeks - I don't know, but it does make you wonder.
 

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Also, after the second surgery I had voice issues, which may have been partially due to having two surgeries within 6 weeks - I don't know, but it does make you wonder.
That's an excellent point.

I felt great after my first surgery. But my voice/muscles were damaged in my second surgery. Maybe that outcome would have been avoided if I had chosen the total the first time around.
 
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If you're really unsure, you can always push your surgery back to weigh your options, do some research and get a second opinion. Even if it is cancer, thyroid cancer is usually so slow growing that waiting a few weeks or months is not a big deal.
 
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