Follow-Up Scans and a New Glow

Hello everyone. My apologies for being gone for quite some time again. I know I say that a lot these days, but honestly things are getting back to "normal" and life was happening which was taking me away from the blog. That added to the fact that I had actually come to the end of the major part of my main journey with the esophageal cancer and was running out of things that I felt the need to write down. The rest was just continuing physical therapy and doctor's follow-ups. As of this entry I am coming up on 4 years clean of the esophageal cancer. A very good thing!

Earlier this year I went in for my yearly follow-up PET scan. Everything looked good in the esophageal area, the stomach and liver looked good, colon was good, but there was a glow seen in the area of the thyroid. A slight glow. Not too bright which usually means not a lot of activity, but it was new and it was glowing. My gastro doctor said that the radiation could cause nodules and the glow on the scan, but it needed to be looked into due to my history with cancer as well as my family's history. He said to get an ultrasound of the thyroid and also see an endocrinologist. The ultrasound was done first. Three nodules were found on the right lobe of the thyroid. One was 4mm, one was about 8mm, the third was a little over 10mm. For reference, one inch is a little more than 25mm, so these were all under half an inch. We took that information and went to the endocrinologist. Based on the looks and the findings, the doctor decided to have another ultrasound to measure the nodules to see if they had grown at all since the last ultrasound, and also to do an ultrasound guided needle biopsy of each.

A needle biopsy of the thyroid is officially the oddest feeling I have had in my life. They use lidocaine to deaden the skin, then use a thin needle to take the biopsies they need. The odd feeling is when the needle enters the thyroid. It doesn't hurt, but it is a pressure. Then they have to literally bounce the needle to get cells they need into the needle and you can feel that vibration in your throat. It is a very odd feeling. They use a syringe to pull the cells up into the needle and take it out. They then give the sample to a lab person that is in the room with you. They immediately use a microscope to check to see if they have gotten enough cells for the testing. If not, they go in again with another needle. They biopsied all three of my nodules. No issues there. Not sore or anything. I was told that the nodules had not noticeably grown and that the endocrinologist would have the results in a few days.

We met with the doctor six days after the biopsies. I have a new diagnosis - Papillary Thyroid Carcinoma. Cancer was found in two of the three nodules (the third is a small benign goiter).

This is still new to me and I am in the middle of gathering information on it and trying to wrap my head and emotions around it. What I know so far is this: This is the most common form of thyroid cancer. It usually hits a little younger, the average age being 30-50, and it hits more women than men by a ratio of about 3:1. So I am once again not average. Older than the average patient and on the low end of the gender ratio. 10-year survivability of this is 80-90%. It is not overly aggressive and not usually prone to spread. Generally this kind of cancer is not treated by chemo and/or radiation unless it has spread to the surrounding lymph nodes or other tissues. So far that looks like that has not happened. I will be getting a Total Tyroidectomy sometime at the end of September or early October. Afterward I will likely have to take radiated iodine in a capsule form once or perhaps twice to cleanup after the surgery. Also, I will have to take thyroid medication from then on for the rest of my life.

It is still too early for me to have a real feel for this or to put my emotions down in this form. I am doing a few things differently this time around though. I am trying to get all the information I can, I am asking people who have had this and had the operation I am having what I can expect through this whole thing. This has been going on over the last two or three days. Emotionally, it was still a shock, but not the gut punch I had with the esophageal cancer. Not sure why exactly, but I expect it helps to know that this is not really aggressive, not a lot of metastasis, generally no chemo or radiation, and even the surgery happens one day and usually the patient is out the next day and back to "normal" type stuff within a week or two. It is still cancer, and it is still scary. I'm still coming to grips with it. As I do I hope to write more here and perhaps help anyone else who might have this, like I tried to do with the esophageal journey.

If you are so inclined, please keep myself and my family in your thoughts and prayers. If you have gone through this or were a family member or care-giver for someone who did, please let me know. I'd love to talk with you about it.

Also, thank you all again for following along here. Your attention and comments are always welcome and appreciated.  :)