The Good Cancer: Treatment Pathway

The treatment for thyroid cancer usually consists of surgical removal of the thyroid gland (thyroidectomy),  radioiodine remnant ablation and long term monitoring. I will explain these in details.

Thyroidectomy
A delicate procedure because the thyroid gland is surrounded by many blood vessels and nerves.  Thyroidectomies are done in a hospital operating room under a general anesthetic.  the surgeon may remove all or part of the thyroid gland depending on the size of the tumor and whether it is suspected that the cancer has spread to other parts of the thyroid gland.

Following surgery, you surgeon or endocrinologist will usually prescribe thyroid hormone replacement therapy.  This will replace the hormone your thyroid gland was producing prior to its removal.  Without thyroid hormone replacement therapy, you will become hypothyroid.  Many people who become hypothyroid cannot function normally in their day-to-day routine.

Remnant Ablation
In addition to a thyroidectomy, some patients may benefit from an additional treatment called radio-iodine remnant ablation.  Radio-iodine may be used to destroy any remaining thyroid issues that the surgeon was not able to removing during the thyroidectomy.  Thyroid remnant ablations is not recommended fro all patients; whether it is will depend upon risk factors such as tumor size and tumor staging.

Thyroid remnant ablation is performed by giving you a dose of radiation in the form of capsule or liquid.  This radiation, called radiation iodine, targets and destroys any remaining thyroid cells that may be present in the body.  These cells may be normal thyroid cells, cancerous thyroid cells, or both.  This procedure is usually done several weeks after the thyroidectomy.

Thyroid Hormone Replacement Therapy
After your treatment has been completed, you will be placed on thyroid hormone replacement therapy.  Thyroid hormone replacement therapy consists of taking thyroxine which replaces one of the hormones that your thryoid gland would have produced naturally.  This is important because thyroid hormone has a role to play in regulating your metabolism.

My Treatment Pathway
Mr. Pancakes and i  debated whether to remove the complete or partial thyroid.  I wanted the cancerous cells out of my body and didn't care whether that meant i would lose my thyroid and be on medication for the rest  of my life.  Mr. Pancakes believed i did not need to remove my complete thyroid if the cancer cells were only on a small section of my thyroid.  I prayed.  He prayed.  We both prayed.

And when i finally spoke with my new ENT (ear nose throat) specialist, Dr. W, he recommended that i have a total thyroidectomy.  The main reason was that if he removes half of my thyroid, then radio-iodine therapy may not be effective (if needed post-surgery), i would still need to be on hormone replacement and i would merely have an appendage hanging in my throat without a purpose.  Psychologically it might make me feel better however medically and physically, there would not be useful.

For some reason, after these conversations with God, Mr. Pancakes and Dr. W, i felt a sense of peace i haven't never felt before.  I knew that the right decision was for me to have a total thyroidectomy and be on hormone replacement therapy for the rest of my life.  And amazingly enough, i was completely comfortable with this decision.

To be continued...fear vs. faith!