Thyroid nodule...inconclusive biopsy and possible surgery

Hi Everyone, 

I went to the doctors with a pulled neck muscle around 3 months ago and whilst she was examining me she found 2 swollen lymph nodes which she wanted checking out so I was referred for an ultra sound scan. Whilst having my scan they found a small nodule on my thyroid but was reassured that it looked fine but he would be mentioning it on my report. I was then referred to ent by my gp and the consultant there had a good look at my throat etc and seemed unconcerned but wanted the thyroid consultant to look at it. When I got to the thyroid consultant he seemed very concerned  and told me the nodule looked “abnormal” and was sent straight for a biopsy! After a a scary 2 weeks my results have come back as inconclusive and I have been given the option of another biopsy or to have it removed. Forgot to mention that my thyroid is also slightly over active and I have an appt with endricology in Nov. 

Has anyone else been in a similar situation? My anxiety is through the roof 

 

Emma

  • No problem. Yes I had my left lobe of thyroid removed in Oct 2018 and doing well since. I had a 2.5cm cancerous nodule (papillary type) with no evidence of spread. My bloodwork was normal prior to diagnosis and I had no symptoms. 

     

    I have bloods taken and neck ultrasounds every 6 months. So far I haven't needed any meds and didn't have rai treatment. The right lobe has been picking up the slack so far. 

  • Hi Hoof1, just wanted to thank you for posting your story and about how your FNA and surgery went as it's been so helpful and reassuring.

    Our stories are quite similar (so far) as I found a painless lump in the left side of my thyroid a few months ago, though when I think back I may have been aware of something there for up to a year so I feel so stupid for not getting it checked sooner. For a long time I wasn't certain if it was just how my neck had always been but then in June I realised the lump was larger and obviously growing. I've not had any symptoms from it other than a slightly hoarse voice at times and needing to clear my throat more than usual which didn't ring any alarm bells before.

    I was seen by a nurse practitioner who took bloods and referred me for an ultrasound. Bloods came back normal (TSH and CRP fine) and it took nearly a month before I got a date for the ultrasound. I had that on 5th August. As soon as the scan started I could tell the sonographer wasn't happy. She told me I had a 6cm nodule in my left lobe ("a whopper") and that at least half my thyroid would need to be removed. I asked if it could be cancer and she said yes in such a way as to make me think she was sure that's what she was looking at. I felt my stomach drop and honestly thought I was going to cry during the rest of the scan but managed to hold it in and keep composed.

    The original nurse practitioner called me a few days later to explain the nodule was suspicious (grade U4). I saw an endocrinologist on 17th August who went through what would happen if it was benign, indeterminate or malignant on the FNA. If malignant, she recommended full removal of the thyroid and RAI treatment. I had the FNA this week on the 25th and am now waiting for the results. I'm convinced it's cancer at this point as am guessing the odds are in favour of that with a U4 grade.

    Weirdly what I'm struggling with most isn't even the (likely) cancer at this point, it's the thought of losing my thyroid and having to swallow a radioactive substance. I've had very poor mental health for 20+ years (OCD, anxiety, low mood) and the thought of all this being exacerbated by levothyroxine is horrendous. Plus I'll never stop thinking I've got cancer with every ache, pain or lump, even if it's unlikely.

    I'm wondering why the doctors are satisfied with only removing half the thyroid in some cancer cases. My ultrasound showed that the right lobe looked healthy and didn't demonstrate any lymph node involvement, the nodule is well contained in the left lobe. If that remains the case after further investigation, I was hoping to just have my left lobe removed to give me a chance at continuing to make my own hormones. I mentioned this to the consultant but she said that would go against NICE guidelines and that they'd recommend full removal. Is that because my nodule is 6cm? Or perhaps it depends on the exact type of cancer or maybe the age of the patient? I'm 38 (and female).

    I know I'm jumping the gun a bit here as don't have my FNA results yet but I'm preparing for the worst as don't think it would be healthy to cling on to the idea of it being benign. If it is benign then that will be an amazing bonus, though I know cancer could still be detected during the full analysis after surgery. Either way I need at least half of my thyroid out and I'm pretty scared.

    Anyway, sending love and support to anyone else out there who is going (or has gone) through this. It's hard, especially when you've had no symptoms and feel physically well. Feels impossible to get my head around.

    P.S. For anyone worried about the FNA, I was ridiculously anxious during mine to the point where my full body was visibly trembling. But it was absolutely fine. I felt a tiny sting when they administered the local anaesthetic (hardly any pain at all) and then genuinely didn't feel anything at all during the sampling to the point where I was shocked when they told me they'd done the first one! I think having a large nodule helped though as they had a lot of surface area to choose a sampling site from. I was panicking for nothing anyway so to anyone about to have it, just try to relax before and during it. Deep breaths and, like Hoof1 mentioned, concentrate on a fixed point on the ceiling. It will be over quickly.

  • Hi Ditzie.

    Did you get your results through, I fojnd the waiting time tremendously difficult. 

    Just wanted to check in.

    E. Xx

  • Hi moonfish.

    I can really relate to where you say it's hard to get your head around the situation when you feel physically well. I remember even after my diagnosis having a conversation with my husband where I said "but do you think there's a chance maybe I don't have cancer". I felt like a fraud because I wasn't "unwell".

    Hoping you receive your results quickly so you know what your full treatment plan is, but if you have any questions in the meantime, fire away.

    Xx

  • Hi

    Yes got my results on 28th July. They came back indeterminate! It was just a relief to finally have them.

    Since then I have had a hemithyroidectomy (right side removed) on 17th August and am doing really well so far. I have my post op check up in 2 weeks and hopefully find out more about my lump!

    How are you?

    Ditzie

  • That's great news that you're recovering well - well done! I'm 4 weeks post total thyroidectomy and right neck dissection, 90 lymph nodes out of which about a quarter were positive. Meeting my oncologist in a week and should learn more on RAI timings etc. Its slow improvements but getting there. 

  • Hi Moonfish,

    Could be size of nodule. My surgeon said I was low risk going by American guidelines. No history, no symptoms, nodule <4cm and was encapsulated with no evidence of spread. 

     

  • Hi,

    I am new here.  It has been very reassuring reading all your posts.  I am currently waiting for my FNA results which I had 2 weeks ago.  I have just been told that they are not conclusive and they have been sent for a second opinion.  I am fortuante that I have been able to go private through work but it has been very stressful with all the waiting and getting an email this morning with no news really has been disheartening.  To give a bit of background I went to see an ENT for an issue with my ears, whilst I was there he had a feel of my neck and said he thought my thyriod was enlarged so referred me for a blood test on thyriod levels and an ultrasound.  This was about 4 weeks ago.  I still haven't had the blood results for the thyriod levels.  The first ultrasound they found a large nodule on the right side (I wasn't given a size), he assured me he didnt think it would be anything to worry about but it would be up to the consultant if he wanted to do a biopsy.  He requested to see the blood results and said there was a sign antibodies were attacking the thyroid.  Two days later I get an email asking to go for a FNA with no explanation so I got myself all worked up over this and basically since then I haven't managed to bring the stress leves back down!  At the ultrasounded guided FNA I burst into tears when they called me into the room, it was more the not knowing what to expect or even being given the reasons for being sent for it.  I couldn't have asked for a nicer Dr he sat down and explained everything in plain english for me.  He again reassured me that he didn't think it would be anything to worry about but of course the biopsy results would tell us for sure - which 2 weeks on they haven't :(  I'm fine with having surgery if that is what they suggest, but it is this not know and checking my emails every 5 minutes that is driving me crazy :( Sorry for the very long post, I haven't really asked anything, I think I just needed to get it all out.

     

    I hope everyone is doing well, and thank you again for posting your experiences it really has helped.

  • Hi FieryStripes,

     

    Seems like a long time to be waiting. Did u check your junk on your emails to make sure results aren't there?

     

    Waiting is the worst but try not to jump to conclusions and steer clear of dr. Google is my advice. You will convince yourself you have some crazy thing wrong with you otherwise.

     

    Hope all goes well.

     

  • Sorry to hear you are going through such a stressful time. I know how awful waiting is.

    I had thyroid cancer two years ago and just to reassure you that even the worst case scenario is manageable. I'm sure the doctor told you that thyroid cancer is usually fairly easily treatable, but as somebody who went through it, I basically had an operation to remove my thyroid and then got back to my life a couple of weeks later as if nothing had happened (well, apart from the stress of the whole thing). Obviously, you never want any kind of cancer, but the worst you are likely to have to deal with is surgery.