Thyroid troubles

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beach sunrise
Posts: 356
Joined: Thu Mar 05, 2020 7:14 pm

Thyroid troubles

Postby beach sunrise » Sat Dec 19, 2020 1:44 pm

Happy Holidays everyone!
Question: U/S results are in of thyroid. Noted a pretty good size nodule on the left side with 2mm calcification. Per ACS standard suggests biopsy of the nodule. Is there another way to determine if its cancer or not? I have read some about testing procedures and would love your experience/opinion also.
My surgeon said he is not an expert in the area but would guess that biopsy would be the best way to go.
Also, what blood panels would be in order that are important, including those not SOC?
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
8 rds 6-10 CEA 11.4 4 more no oxa
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug. Adding Everolimus soon.
MHL1+
PMS2+
MSH2+
MSH6+
POLD1
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

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Green Tea
Posts: 292
Joined: Mon Oct 24, 2016 10:48 am
Location: Nusa Tenggara

Re: Thyroid troubles

Postby Green Tea » Sat Dec 19, 2020 2:53 pm

beach sunrise wrote:Happy Holidays everyone!
Question: U/S results are in of thyroid. Noted a pretty good size nodule on the left side with 2mm calcification. Per ACS standard suggests biopsy of the nodule. Is there another way to determine if its cancer or not? I have read some about testing procedures and would love your experience/opinion also.
My surgeon said he is not an expert in the area but would guess that biopsy would be the best way to go.
Also, what blood panels would be in order that are important, including those not SOC?

I suppose that you would need to have the full set of thyroid tests so that you have a good baseline for this point in time. All I know is that there are both "Total" and "Free" T4 tests, so your panel should include both of them. Apparently the Thyroglobulin tumor marker test is not so useful for cancer diagnosis, but it might be useful just to have this test done anyway as part of the overall thyroid baseline at this point in time. The Calcitonin test is a sort of tumor marker test for medullary thyroid cancer.

Thyroxine T4 test
https://medlineplus.gov/lab-tests/thyroxine-t4-test/

TSH (Thyroid stimulating hormone test)
https://medlineplus.gov/lab-tests/tsh-thyroid-stimulating-hormone-test/

Thyroglobulin test
https://medlineplus.gov/lab-tests/thyroglobulin/

Calcitonin test
https://medlineplus.gov/lab-tests/calcitonin-test/

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beach sunrise
Posts: 356
Joined: Thu Mar 05, 2020 7:14 pm

Re: Thyroid troubles

Postby beach sunrise » Sat Dec 19, 2020 5:50 pm

Here's testing done in the past. I took on the mindframe of rp1954 and CRguy back in March and again in May. Haven't had the thyrogloblin or the other test yet because I didn't know about them when researching back then. I do now :) The other thing is non-invasive things to investigate this before/instead of biopsy maybe as a way to confirm or not cancer?
Calcium 9.6 mg/dL (12-1-20)
FEB-MARCH
TSH 1.39 mg/dL
Iga 99mg/dL
t-Transglutaminase IgG 2 U/mL
" " IgA 2 U/mL
Deamidated Giladin Abs IgG 5U
" " IgG 2U
Endomysial Ab IgA NEGATIVE
Thyroid Peroxidase Antibody 173 U/mL (May) terribly high
" " " 218 U/mL (Feb) terribly high
Thyroxine T4 8.13 ug/dL
Free T3 2.88 pg/mL
Parathyroid Hormone PTH Intact 11.1 umo/L
Last edited by beach sunrise on Sun Dec 20, 2020 12:46 pm, edited 1 time in total.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
8 rds 6-10 CEA 11.4 4 more no oxa
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug. Adding Everolimus soon.
MHL1+
PMS2+
MSH2+
MSH6+
POLD1
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

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CRguy
Posts: 10264
Joined: Sun Feb 10, 2008 6:00 pm

Re: Thyroid troubles

Postby CRguy » Sat Dec 19, 2020 8:38 pm

Glad you are being proactive and aggressive in the follow up :!: :!:
Yes I know ... the " miss more for NOT looking " concept :shock: 'cos it IS what I live by

There have been a number of functional type scans, alternate imagings etc. for thyroid
and a couple of links here indicate that as far back as 2015
https://pubmed.ncbi.nlm.nih.gov/24299506/

the serologies PLUS a FNA ( fine needle aspiration = cytology = "biopsy" ) are recc'd
and validated as per current ACS protocols
https://www.cancer.org/cancer/thyroid-c ... nosed.html

My take is : the more info you have ... the BETTER armed you are to deal with what you find.
IMO : complete the serology part, and do consider the FNA and possibly an MRI / PET- MRI ... IF the pending results are still not giving you the answer.

Cheers and best wishes homie
AND ... keep ON kickin' colorectal ... and any other kinda' BUTT !!!!
CRguy on the Journey
Caregiver x 4
Stage IV A rectal cancer/lung met
14 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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beach sunrise
Posts: 356
Joined: Thu Mar 05, 2020 7:14 pm

Re: Thyroid troubles

Postby beach sunrise » Sun Dec 20, 2020 12:44 pm

Thanks, CRguy, as always!
Merry Christmas to you and family!
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
8 rds 6-10 CEA 11.4 4 more no oxa
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug. Adding Everolimus soon.
MHL1+
PMS2+
MSH2+
MSH6+
POLD1
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

User avatar
beach sunrise
Posts: 356
Joined: Thu Mar 05, 2020 7:14 pm

Re: Thyroid troubles

Postby beach sunrise » Sun Dec 20, 2020 4:29 pm

A thyroglobulin paper if anyone is interested.
http://www.thyca.org/thyroglobulin.htm
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
8 rds 6-10 CEA 11.4 4 more no oxa
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug. Adding Everolimus soon.
MHL1+
PMS2+
MSH2+
MSH6+
POLD1
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

boxhill
Posts: 662
Joined: Fri Apr 06, 2018 11:40 am

Re: Thyroid troubles

Postby boxhill » Mon Dec 21, 2020 7:53 am

In addition to having thyroid-specific tests, has anyone suggested consulting an endocrinologist or other thyroid specialist?

My sister had thyroid cancer about 40 years ago. In her case, a grapefruit-sized tumor that barely showed on the surface, and had pushed her esophagus to one side. When it was removed, the initial frozen section did not reveal cancer, but when the whole tumor was examined it was there. There are several alternatives to treatment if it is thyroid cancer, probably more now. Long story short, she is still with us and leading a very active and fulfilling life at the age of 72. Oh, and in 2013, she had CRC--probably Stage 2, no chemo or node involvement--with a temporary colostomy! NED ever since.

She's a survivor, I guess. Takes after my mother, who in her lifetime has had both polio and TB, and is still going strong and living totally independently at 97.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
Stop Key
8/20 MRI NED

User avatar
beach sunrise
Posts: 356
Joined: Thu Mar 05, 2020 7:14 pm

Re: Thyroid troubles

Postby beach sunrise » Mon Dec 21, 2020 11:05 am

Good morning Boxhill!
Thank you for the insight.
Just Wow, your sister had a huge one. I am happy she came thru just fine. And your Mom is doing great! All of you are Tough ladies!!! I like that.
I have an endo, suppose to be the best at my hospital. He has no bedside manner. Personality like a wooden door, haha. But if he's top of the game I don't care really.
The thyroid scores on 2 nodules were a 3. But they only want to biopsy the one nodule that has a calcification and the other one sonogram in a year. I haven't had a follow up with him about results, just reading recommendation off the U/S report.
My surgeon and I talked about results and he said the endo will follow the recommendations listed most likely and will keep him in the loop. Goodness, one thing after another!!!
I've been researching like crazy about the findings and don't seem to come up with much, maybe because Thyroid cancer isn't as common. IDK

UPDATE: Call from endo today. He said he would like to wait and do another U/S in 6 mths. I asked if thyroid can drive CEA, he said he doesn't follow it with thyroid and does not believe it has much effect on it. He will get with my surgeon and if surgeon wants to go ahead with biopsy then he will do it. Whew, what to do, what to do!!!
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
8 rds 6-10 CEA 11.4 4 more no oxa
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug. Adding Everolimus soon.
MHL1+
PMS2+
MSH2+
MSH6+
POLD1
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"


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