Thyroid Nodules

Hi

I am 43f and at the age of 18 was diagnosed with a colloid nodule on the front/right side of my thyroid, this was FNA and scanned a few more times over around a 10 year period and all fine no change. Last FNA was 2011.

Around 2017 (I think) I felt it was getting larger and more noticeable so my GP referred me back for another scan which was determined to have no changes to previous scans therefore a FNA was not requested. 

The last 12 months or so I've had heightened anxiety, fatigue, stomach issues, amongst other things with all investigations thankfully returned as normal. A ANP at my GP surgery agreed a thyroid review was a good idea and blood tests were in normal range. US scan however, discovered I now have several U2 nodules on the left side and the larger right side one is graded U3. The report stated that although a U3 it still appeared no different than 2017 so no further radiology input was required. The ANP has had thyroid cancer so being very thorough wrote to endocrinology for advice. They advised no action required from them refer to ENT. I attended my appointment a week ago and had a FNA. Results will be by phone call in around 2-3 weeks. 

The sonographer advised me that the U grading system only came in 2014. So my questions are;

Is the large nodule likely to have always been a U3 as it was FNA'd previously? 

What are the chances of a 25 year old nodule now being cancerous?

Should I have had more regular FNA's? 

Are normal TFT's a good indicator? 

I'm trying to remain calm as it's not a new nodule, I've lived with it for my entire adult life. These investigations have happened because I asked for them. Just a bit concerned that I now know a bit more about grading systems that weren't around when I was first diagnosed in 1999 and wondering if I should have been a bit more pro-active. 

  • Don't know the answers to all your questions but it doesn't sound like there was any particular reason for you to have more FNAs.

    I think U3s in general have around a 5% chance of cancer, so the odds are very much in your favour. Your odds are probably lower than that really, as you had a FNA before that showed it to be benign. And 5% is around the percentage of all thyroid nodules that are cancerous, so...U3 doesn't mean cancer is any more likely than it would be had they not got a categorisation. Your odds are pretty much what they are for nodules in general.

    And even in the worst case scenario, which is unlikely to be the case, well, when I was diagnosed with thyroid cancer, the endocrinologist described it as "not the worst situation in the world." The odds are very high that removing your thyroid and maybe some lymph nodes would remove the cancer.

    I know nobody wants any chance of any form of cancer and I remember when I was awaiting the FNA and thinking that even though "thyroid nodules are common, thyroid cancer is rare" and the odds were only 5% that it was cancer, that was still kinda scary.

  • Thank you very much for your reply, it is appreciated. When were you diagnosed and can you share your experience of it all please? The anxiety is really picking up now, it's been over 2 weeks so I know  the results are due soon. I recently read about a lady who had a nodule for 12 years, scanned and biopsied twice a year at her own insistance, told each time benign, I think due to the size they eventually removed it and it was actually papillary cancer. I guess stories like that are rare but it happens. 

  • I was diagnosed in October or November 2019. It was a complete accident. I was at the GP for something completely unrelated and he said "there's a nodule there. Has it ever been investigated?" So it was scanned and biopsied and they found cancer. The nodule was 10.5cm and the cancerous part was 6.7cm, so pretty extreme side, size-wise.

    I got the results of the biopsy a week after it was done.

    I had surgery on the 6th of January, 2020. They removed the thyroid and all the lymph nodes on one side of my neck. I was in hospital for about a week, which was pretty boring. I took nearly 5 weeks off work because I am a teacher and really needed both to be able to speak for long periods of time, at a volume that could be heard across a classroom and to be able to turn my head quickly.

    I had no problems at all with the medication. Was a bit worried about the possibility that it would take time to get the dosage right or whatever or that I would have side effects, but none of that happened. Apart from feeling sick from the anaesthetic for two or three days after the operation and my neck being a bit tender for a while, I felt no different than beforehand.

    I was supposed to have radio-iodine treatment over the Easter holidays, but you know, covid set in, so it wasn't done until the end of May. That is basically just swallowing a capsule, but it is annoying as you have to be in isolation for a few days afterwards as you are radioactive.

    And yeah, you hear about situations like that woman's because they are unusual and because they are interesting. You don't hear about the 95% of cases where people get a nodule biopsied and it turns out to be benign because those aren't very interesting.

  • Yes haha that is so true, I never thought of it that way. My husband does always say I'll find these stories if I go looking for them and I know you are both right ! I need to put Google down and just be patient and positive.

    Thank you for sharing your experience it can't have been easy at the time but you do give a very positive account of it all which is great. My nodule is quite big but the report doesn't give any measurements. When I look in the mirror and use my finger and thumb I'd say it's around 5-6cm in length. I've looked back at old photos and it doesn't really look any different from 20 years ago. I've read that anything over 4cm should be taken out but even at my appointment two weeks ago the consultant said if fna comes back clear she won't be looking to remove it. 

    Are you monitored after treatment or is that is now, surgery + radio-iodine and cured? Hope you don't mind me asking.

  • I don't mind in the least and yeah, it was scary at the time and definitely not something you want to have to deal with, but not as bad as you imagine cancer to be.

    Yeah, I have a scan once a year and blood tests about twice a year. Thankfully, so far all has been good.

  • Thank you again for replying. I'm still waiting for my results. A letter appeared last week on my NHS app from the consultant to GP saying I would get a phone call in 4 weeks time. That means I'm due the call this week coming. The anxiety has really ramped up now. I've had other symptoms start that are unlikely linked, sore lymph glands, aching neck, post nasal drip, but due to them being in the same area I'm just convinced now theres something more going on. 

  • So in closure to my thread, I've chased up my results today and they are THY2 benign. Big relief. Results have been back 3 weeks, letter issued only not arrived ! Lots of unnecessary worry but thankful to the secretary who gave me the results over the phone today.