Hello,

I have Stage 4 poorly differentiated thyroid cancer and have been told radioiodine therapy is not working and don't have a great prognosis.  My current oncologist (I am asking to be moved to another onco's list) anticipates I will need Lenvatinib (molecular therapy) within a year.  I have one active tiny lung and one rib met but am non-symptomatic mostly, with the exception of a new very mildly productive cough (one tousse a day with <1/4 teaspoon secs).  I went through a period of feeling exhausted but have come out of that with healthy diet and recommended 1/2 hour exercise 5 days a week.  However, I think I have been having night fevers (but no night sweats) and definitely had one last night but I am feeling well in myself and my cough has not changed.  I am on lifelong TSH suppression.

For various reasons I feel I am not getting the treatment/management I need and have requested a second opinion at the Royal Marsden.  I feel there should be something that can be done to remove one tiny lung met (6mm) that is very slow growing (2mm a year) and a rib met (2.5cm) that is also very slow growing.  Whilst there are further nodules in my lungs, they are inactive currently. 

I am reluctant to go to the GP as I don't want to give the oncologists any reason not to treat me or to bring forward the molecular therapy unnecessarily, as that would really cut my life expectancy and I really feel that I am not that unwell yet!  I have got some rescue antibiotics but don't want to take them unless absolutely necessary as they might interfere with the TSH suppression, which is a really important, and I think, effective treatment in delaying progress.

My question: should I go ahead and take the antibiotics or contact the GP or CNS? (I have never met my CNS and barely know her - she was not there when I was given the news about my prognosis so I don't really feel a connection with her.) or can I get away with self-management.