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Aster's avatar

Your thoughts on thyroid removal for inconclusive biopsy results?

Asked by Aster (15315 points ) January 15th, 2014

I’m not saying that endocrinologists enjoy removing thyroids because they’d go broke if they didn’t. I ‘m just wondering how you feel about all these thyroids being yanked out after a biopsy result for cancer of “inconclusive?” My opinion is keep your knife away from my throat unless there is clearly cancer in there or anywhere else in my body. In 1985 a GP said I needed a hysterectomy and she was wrong. Dead wrong. Never had one.

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21 Answers

jca's avatar

I had something similar happen to me. I had inconclusive results from an idiot doctor. She sent me to a surgeon. Why go to a surgeon? They do surgery. What the next move should be was a second opinion. I went to an excellent endocrinologist and had the biopsy results seen by his pathologist. There was no cancer.

He told me “if you do have thyroid cancer, it’s the best cancer to have because it won’t spread.” He also told me ‘You don’t worry until I tell you that you have something to worry about.”

My mom, at the time, told me “your goal is to save your body parts.” In other words, don’t just go having things taken out until you’re positive they should be removed.

gorillapaws's avatar

As the son of a surgeon who has done hundreds (maybe thousands) of these procedures over his 35+ year career, I can share a few things about this procedure. One is that it is tricky. The neck has a lot of critical stuff in a very small area, and the thyroid glands are very close to the vocal chords and are very small. This is not a procedure he would want to do if it could be avoided. If your MD thinks this is the best course of action, then it probably is. If you do have thyroid cancer and you don’t get treatment, you will die.

If I were in your shoes, I would absolutely get a second opinion, but I would do it as quickly as possible since cancer and time don’t go well together. There are some surgeons who specialize in only this procedure, you might want to seek one out. A sincere best wishes to you.

Aster's avatar

@gorillapaws thank you so much but it isn’t my thyroid I asked about.
“Treated or untreated, common thyroid cancer unlikely to cause death

Patients with papillary thyroid cancer experience favorable outcomes regardless of receiving treatment or not, according to a study published in the Archives of Otolaryngology – Head & Neck Surgery (2010;136[5]:440–444).
The study, led by Louise Davies, MD, MS, and Gilbert Welch, MD, MPH, focused on 35,663 patients with papillary thyroid cancer that had not spread to the lymph nodes or any other area at diagnosis.

Researchers found that papillary thyroid cancers of any size that are confined to the thyroid gland are unlikely to result in death due to the cancer.”

gorillapaws's avatar

I’m very happy to hear that! sighs in relief

Juels's avatar

I’m already on thyroid medication. Doesn’t seem like my thyroid is helping me much as it is. So, if I was told to have it removed, I would first get a second opinion. If both doctors advised me to have it removed, I would. I avoid unnecessary risks but I don’t believe in letting a potential threat hang around either.

Skaggfacemutt's avatar

Definitely wait until they have a “positive” result, and even then get a second opinion.

Rarebear's avatar

Endocrinologists don’t remove thyroids.

gailcalled's avatar

Don’t they yank them out?

Rarebear's avatar

@gailcalled Nope. You don’t want to get anywhere near an endocrinologist with a knife.

gailcalled's avatar

Or a crochet hook?

jca's avatar

How about an endocrinologist with a nail clipper?

Rarebear's avatar

Just by way of explanation. Endocrinologists are internists. You go to an ENT, head and neck, or general surgeon to get your thyroid removed.

gorillapaws's avatar

@Rarebear What is the standard of care regarding thyroid removal for inconclusive biopsy results? Has it changed?

jca's avatar

I would say the OP should have a second opinion and have those biopsy results sent to a second pathologist.

Rarebear's avatar

@gorillapaws I don’t know. It’s not my area of expertise. And the word “inconclusive” is vague.

gailcalled's avatar

@Aster: Your quesiont of March,2011: http://www.fluther.com/115238/would-you-have-your-thyroid-removed-if-the-reports-said-this/

“Ultrasound: results inconclusive
Biopsy: results inconclusive.
Doctor (who removes thyroids) feels it: It may not be cancer but I think it is.
There are three “tests.” Have the thing out or not? Age of patient:
55. (I would not)”

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cazzie's avatar

There are forms of thyroid cancer that do go systemic, so saying ‘it is the best cancer to get because it won’t spread’ is misleading, but the most common is isolated to the thyroid.
I find doctors too eager to either burn out or chop out the thyroid. Endos, of course, don’t do the surgery, but they can be pretty quick on the referral. I had some good doctors in New Zealand who were happy to treat my Graves with medication, but when I moved to Norway and had my baby, they were ready to burn it out with RAI when it started acting up again. My infant was just weeks old and they wanted to give me RAI, uuummm… no. I took my meds (which were absolutely safe for breastfeeding, according to the doctors themselves) and my thyroid calmed down again, just as I told them it would. I went on breastfeeding, stayed in remission, going off my meds and having no more spikes. Doctors are not always right. They are just human beings using their best guess.

Aster's avatar

It is extremely common for endocrinologists to say to their patients: “if you have to have cancer this is the best one to have.” Expect to hear it.
Thyroid cancers can and do spread to the salivary glands, the tongue, the esophagus, the trachea and on and on. A person can end up with half their jaw gone, unable to swallow so they need a feeding tube in their stomach, frozen shoulder, inability to speak at all or above a whisper all while the cancer is spreading to their bones. It is not “the best kind of cancer to have.” And the surgery guarantees nothing. However, if the cancer is confined to the thyroid you can be cancer free for decades. That would be Stage One. Stage 4 is when it spreads to distant organs or even to the spine.

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