Oncology Questions? Ask an Oncologist for Answers ASAP
This is Dr. David
the biopsy shows a follicular thyroid cancer.
the best treatment is thyroid surgery.
you can also take super high doses of radioactive I-131 iodine to destroy the whole thyroid gland with radioactive iodine.
but this method guarnatees that you will need to take oral thyroid hormones for the rest of your life.
if you have just 1/2 of your thyroid gland removed, you could still have a normal 1/2 thyroid which will produce thyroid hormone for you.
why don't you want to have thyroid surgery?
it was follicular neoplasm result on fna ...not follicular carcinoma?
(FNA) diagnosis of "follicular neoplasm" does not differentiate between a benign and malignant tumor.
neoplasm is another way of saying cancer.
neoplasm is a malignant cancer.
yes but .....(FNA) diagnosis of "follicular neoplasm" does not differentiate between a benign and malignant tumor.
The diagnosis "follicular neoplasm" is indeterminate, and the majority of cases (70% in the current study) are benign. However, clinical features, including gender, nodule size, and age, can be a part of the decision analysis in selecting patients for surgery.
i guess its a decision only i can make
i thought you couldhave cleared this up ...never mind!
I am trying to help you clear it up
you can talk to the pathologist who read your biopsy report.
I am a cancer doctor
I read these biopsy reports all the time.
there is no benign follicular neoplasm in the thyroid gland.
the pathologist is using it as a term for malignant cancer.
if you have doubts, call up the pathologist who read your biopsy report.
I'm sure the pathologist will clarify it for you.
I will be that they mean it is a malignant thyroid cancer.
these follicular thyroid cancers are slow growing and have very high cure rates with surgery like a hemithyroidectomy.
no its not as i spoke with the surgeon today...perhaps in the uk it is different terminology?
this is important
pls read it
he clearly tol me the only way to determine if it is cancer or benign is to remove it and send to path/
well, then I would follow his recommendations
however the percentage is 75% bengn 25% cancer
and have the surgery to know for sure
or else you will continue to worry.
why did they do the biopsy if the biopsy can't tell anything for sure?
FNA biopsies have a good accuracy rate of knowing what the nodule is if read by a experienced cytopathologist.
from a FNA test there are 3 possible readings
and also 50% of population will have a thyroid nodule
95% will be benign
these are resons to not consider surgery
I worked in a thyroid nodule clinic
we saw 6-10 patients each 2 weeks with thyroid nodules.
every nodule larger than 1cm was biopsied.
nodules larger than 1cm in size have a 20% chance of being malignant thyroid cancer.
the most common thyroid cancers are well behaved like a papillary or follicular cancer which have high cure rates with surgery.
thats what he said
90-99% cure rates.
in the USA, the word neoplasm means malignant cancer.
yesi thought it was a terminology
my dilema is do i opt for surgery or not given i feel amazing and have absolute no health issues at all
thyroid cancer will not cause health issues or symptoms.
the idea is to catch these cancers early and cut them out.
I have also treated patients with metastatic papillary or follicular thyroid cancers
are you also a surgeon?
when they have spread.
that is not any fun.
I am a radiation oncology doctor.
I am a cancer specialist.
I am not a surgeon.
but I work with surgeons and radiologist and pathologist to diagnose these cancers.
do you not feel it necesarry to have another fna test? i have had one test onlt and that it!
so i guess there is no other option then?
I bet the second FNA test wills how the same thing as this one.
I would call up the pathologist.
an FNA when read correctly has a 80-90% chance of knowing if it is malignant or benign.
if malignant, you need the surgery
to be cured of this thyroid cancer.
you don't want to live worrying about this nodule.
and the possibility of it spreading.
yes when i had the fan trst done the operator complained that it was in a very awkward place and that the result may prove inconclusive?
well the results Follicular Neoplasm does not sound inconclusive to me.
pls read this
The thyroid fine-needle aspiration (FNA) diagnosis of "follicular neoplasm" does not differentiate between a benign and malignant tumor. Often cases diagnosed as "follicular or Hürthle-cell neoplasm" undergo surgical excision for further characterization. The aim of this study was to identify clinical features that may help in predicting malignancy in patients with an FNA diagnosis of follicular neoplasm. One hundred eighty-four cases in 167 patients were diagnosed as "follicular neoplasm" among 1,024 thyroid FNA evaluated with on-site interpretation from 1998-2000. The cases were evaluated for the following variables: histologic diagnosis, age, sex, and size of the nodule. One hundred thirty-nine patients were female, and 28 were male (age range, 23-80 yr). Among 122 patients (67%) undergoing surgical excision (lobectomy, 96; total thyroidectomy, 26), malignancy was identified in 37 cases (31%). Nonpapillary (follicular/Hürthle) carcinoma was diagnosed in 11 (9%), follicular variant of papillary carcinoma in 25, and medullary carcinoma in 1 case. The risk of malignancy was greater in males (47% vs. 29%, P < 0.0004) than females, in nodules measuring 3 cm or more (55% vs. 23%, P < 0.0001), than in nodules measuring less than 3 cm, and in patients 40 or more yr old (20% vs. 10%, P = 0.0001) than in patients younger than 40 years. The diagnosis "follicular neoplasm" is indeterminate, and the majority of cases (70% in the current study) are benign. However, clinical features, including gender, nodule size, and age, can be a part of the decision analysis in selecting patients for surgery.
Copyright 2002 Wiley-Liss, Inc.
FNA can miss 1/3 of all thyroid cancers.
i guess having follicular neoplasm is like living with a time bomb
Analysis of the data reveals that the sensitivity of FNA ranges from 65% to 98% (mean, 83%), and specificity ranges from 72% to 100% (mean, 92%) (11,20,26). The predictive value of a positive or suspicious cytologic result is approximately 50%. The overall accuracy for cytologic diagnosis approaches 95% (Table 1).
Table 1. Summary Data From Literature Survey on Thyroid FNA*
FNA have a high chance of predicting what is there.
I would have the surgery because I would not want to live with an known neoplasm in my thyroid gland.
yes i understand you
the irony is dr my wife is in right now, this is her second operation
crazy isnt it
so my turn next!!
she has exact same except heres was multinodular aand 5cm
its not cancer thank god
the surgeon wants me in next week but ill have to postpone as i need to take care of my wife first
best of luck to you and your wife.
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thankyou and i hope you didnt mind me being a bit direct :)