How can I manage my suspicious cancerous thyroid nodule?

Question

Hi doctor,

A year ago, I got a biopsy for two nodules in my thyroid. The result for one was benign, and the other inconclusive. This year, I went back to a different doctor to redo my indeterminate biopsy. She advised me to do both again, because through ultrasound, they look angry or vicious. On my right side, which was benign, is the largest at 2.6 mixed solid and cystic with vascularity, and the other, which was indeterminate, is more of a solid or heterogeneous. This time, my report came back as indeterminate for the benign one and the other as 40 % suspicious for cancer.

This was done through the afirma gene expression. I also have one more nodule on the lower portion that is too small to test. The doctor is pushing me for a thyroidectomy. I am still young and active. I hate the thought of removing such a vital thing in my body and taking pills every day just on chance. If I come to know it as cancer, then I have no problem taking it out. Is there any more in-depth test I can do before I change my whole life? What would you do? I am scared, and I just feel stuck. Unfortunately, I do not have my reports. Any advice would be deeply appreciated.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

In this situation, the most important fact would be to know whether there is a family history of thyroid cancer and which type. Not all thyroid cancers are the same; some are more aggressive than others. Sorry, I was still trying to understand if the nodules are in one lobe of the thyroid or one in each lobe. If you have both on one side and not bilateral, then you may very well benefit from partial thyroidectomy, and you will still have thyroid hormone in your system and may not require thyroid supplementation.

The alternative would be to follow up every six months and biopsy any suspicious lesions or changes in size or shape of the lesions. If I were in a given situation and had the medical knowledge that you have, then I would prefer thyroidectomy. Since one of the nodules has a 40 % chance of turning malignant, I would not take that risk.

I hope this information helps you.

Feel free to ask further queries.

Thank you.