September is Thyroid Cancer Awareness Month. In support of greater awareness ofone of the fastest growing cancers in the US, here is my story:
It was 1120 AM Eastern Time on March 23rd. Many of you were no doubt watching the signing ceremony for Health Care Reform. I was sitting with my wife in a room in the Radiology Unit of my local hospital, when my endocrinologist came in to tell me that the results of my biopsy had come back and I had Papillary Thyroid Carcinoma. My world had just turned.
I had come there because of the vigilance of my doctor. In November, I had started a medically supervised weight loss program (no drugs or surgery, just exercise and calorie control, along with coaching). My doctor had run a very extensive series of tests on me. They actually showed a fairly healthy 53 year old man. My cholesterol was 154. My BP was 120/80. My Glucose level 93. Not bad for someone who needed to lose 100 pounds. The one thing that concerned her was that my Thyroid anti-body levels were sky high (despite the fact that my Thyroid levels were normal). This is indicative of an auto-immune disease called Hashimoto's Thyroiditis, wherein the body starts attacking the thyroid gland, eventually causing hypothyroidism (low thyroid levels). This would be something to watch, as it would eventually cause me to need thyroid supplements.
After three months, new tests confirmed the high antibody levels (everything else was still OK), so she sent me for an ultrasound on my thyroid. The results showed two nodules on my left thyroid. One was 2.5cm wide and the other was .8 cm wide. So, she sent me to an endocrinologist. He decided that I needed to have a biopsy done on the nodules since one of them was larger than 1.5 cm. Only 1 in 19 people with nodules on their thyroid learn that they are cancerous. The odds were strongly in my favor.
The radiologist had very skillfully removed cells from both nodules (the smaller one being quite difficult to do I have been given to understand, but he managed it nonetheless). The larger nodule (the one whose size required that I have the biopsy) showed cells which are consistent with Hashimoto's. However, the smaller nodule had active Papillary cells in it.
Learning you have cancer can be crushing, even when it is a fairly easily treatable form such as I had. I was supposed to go into work that day, but could simply not face the case I was working on at the time -- litigation review of a patent prosecution of a chemotherapy drug. So, I spent the rest of the day reading up on thyroid cancer on the internet. What I learned was heartening.
About 80% of thyroid cancers are papillary carcinomas. This is usually a fairly slow growing form of cancer, and one which is less likely to metastasize to other parts of the body. If it does metastasize, it generally does so to the near lymph nodes in the neck. The standard treatment is a Total Thyroidectomy, in which the entire thyroid is removed, and, during which, any metastasis to the lymph nodes can be observed, and, if necessary, removed. The prognosis for most patients is very good.
So, I was referred to a surgeon who specializes in this type of surgery. After seeing him (and having the pathology confirmed by a second opinion), I was scheduled for the surgery, which I had in late May. It was done on an outpatient basis and I spent that night at home. I was a bit sore immediately afterward, but even that faded quickly. I had none of the other possible post-surgical complications such as calcium depletion, although my voice is slightly raspier than before the surgery.
The surgery was a complete success. Not only was there no evidence of metastasis to the lymph nodes, but, when the pathology on my thyroid came back, it showed that I had only the microcarcinoma (a nodule less than 1 cm). This was due to the very early diagnosis of my cancer. Furthermore, since there was only the microcarcinoma, and no metastasis, and it was diagnosed so early, I did not have to subject myself to the standard followup treatment --- radioactive iodine ablation. This involves starving the body of iodine for up to six weeks , and then taking a radioactive iodine pill at a hospital. The iodine is absorbed by any remaining thyroid cells and kills them off. It is helpful, but it is a radioactive treatment. However, I was thankfully saved from having to endure that.
I am on synthetic thyroid medication, and my levels are monitored regularly, but, unless something goes amiss, I will probably never have to have any further treatment. The 20 year survival rate for someone with my staging of this cancer is 98%. In short, my prognosis is excellent.
As with all cancers, early detection is the best way to ensure a good result. Thyroid Cancer principally effects women (about 3 women for every man), but my case shows that we should all be checked. It effects people of all ages. During your annual physical, your physician should palpitate your neck to try and determine if you have any nodules. And, if you have any history of thyroid problems in your family, you should make sure that your thyroid levels are checked regularly.
For more information on Thyroid Cancer, you can check the websites of
Thyca - The Thyroid Cancer Survivor's Association
or the
American Thyroid Association