Tuesday, June 29, 2010

Information on Radioactive Iodine

Because the cancer was in the lymph nodes, I have to take the radioactive iodine treatment. As of right now, if I have a job, I'll be doing the treatment after the wedding and honeymoon. Here's some information I found online about it. I have not talked to a medical specialist about what will happen in my case, or what I will be doing.

From the Mayo Clinic:

Radioactive iodine treatment uses large doses of a form of iodine that's radioactive. Radioactive iodine treatment is often used after thyroidectomy to kill any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren't removed during surgery. Radioactive iodine treatment may also be used to treat thyroid cancer that recurs after treatment or that spreads to other areas of the body.
Radioactive iodine treatment comes as a capsule or liquid that you swallow. The radioactive iodine is taken up primarily by thyroid cells and thyroid cancer cells, so there's a low risk of harming other cells in your body.
Side effects may include:
  • Nausea
  • Dry mouth
  • Dry eyes
  • Altered sense of taste or smell
  • Pain where thyroid cancer cells have spread, such as the neck or chest
Most of the radioactive iodine leaves your body in your urine in the first few days after treatment. During that time you'll need to take precautions to protect other people from the radiation. For instance, you may be asked to temporarily avoid close contact with other people, especially children and pregnant women.

From Endocrine Web:
Thyroid cells are unique in that they have the cellular mechanism to absorb iodine. The iodine is used by thyroid cells to make thyroid hormone. No other cell in the body can absorb or concentrate iodine. Physicians can take advantage of this fact and give radioactive iodine to patients with thyroid cancer. There are several types of radioactive iodine, with one type being toxic to cells. Papillary cancer cells absorb iodine and therefore they can be targeted for death by giving the toxic isotope (I-131). Once again, not everybody with papillary thyroid cancer needs this therapy, but those with larger tumors, spread to lymph nodes or other areas, tumors which appear aggressive microscopically, and older patients may benefit from this therapy. This is extremely individualized and no recommendations are being made here or elsewhere on this web site...too many variables are involved. But, this is an extremely effective type of "chemotherapy" will little or no potential down-sides (no hair loss, nausea, weight loss, etc.).

Uptake is enhanced by high TSH levels; thus patients should be off of thyroid replacement and on a low iodine diet for at least one to two weeks prior to therapy. It is usually given 6 weeks post surgery (this is variable) can be repeated every 6 months if necessary (within certain dose limits).

There's also some information WebMD, which tells you what to expect:

Radioactive iodine, given in a liquid form, is absorbed and concentrated by the thyroid gland. The treatment destroys thyroid tissue but does not harm other tissue in the body.
See an illustration of the thyroid gland .
While radiation can cause thyroid cancer, treatment of hyperthyroidism with radioactive iodine does not increase your chances of getting thyroid cancer.

What To Expect After Treatment

Within days, the radioactive iodine passes out of your body in your urine.
To avoid exposing other people to radioactivity, it is important to do the following for the first 5 days after your treatment:
  • Drink plenty of fluids.
  • Avoid spending a lot of time around others, especially children and pregnant women.
  • Do not sit next to someone in a motor vehicle for more than 1 hour.
  • Avoid kissing or sexual intercourse.
  • Sleep in your own room.
  • Use separate towels, washcloths, and sheets. Wash these and your personal clothing separately for 1 week.
To further reduce the chance of exposing other people to radioactivity:
  • Wash your hands with soap and lots of water each time you use the toilet.
  • Keep the toilet very clean. Men should urinate sitting down to avoid splashing. Also, flush the toilet 2 or 3 times after each use.
  • Rinse the bathroom sink and tub thoroughly after using them.
  • Use separate (or disposable) eating utensils for the first few days and wash them separately.

Why It Is Done

Radioactive iodine may be used to treat hyperthyroidism in people who have noncancerous (benign) thyroid nodules that make too much thyroid hormone.
Radioactive iodine is also used if you have your thyroid removed (thyroidectomy) because of thyroid cancer. Radioactive iodine therapy destroys any remaining thyroid tissue or cancer cells that were not removed during surgery.

How Well It Works

In almost all cases, your thyroid hormone levels will return to normal or below normal after radioactive iodine treatment. This may take 8 to 12 weeks or longer. If your thyroid hormone level does not go down after 6 months, you may need another dose of radioactive iodine.
If you have thyroid cancer and you are treated with radioactive iodine, it may take from several weeks to many months for your body to get rid of any remaining cancer cells.
Your thyroid nodule is unlikely to grow after being treated with radioactive iodine.


The risks from radioactive iodine treatment include:
  • Metallic taste in your mouth.
  • Dry mouth.
  • Sore throat.
  • Neck pain. Radioactive iodine treatment can make your neck swell up or hurt.
  • Nausea or vomiting, which is usually mild.
  • Constipation or diarrhea.
  • Fatigue.
  • Unusually low (hypothyroidism) or unusually high (hyperthyroidism) thyroid levels

Monday, June 28, 2010


I have some pictures from the surgery & after that I wanted to share:


The ceiling had stars on random tiles!

Balloons from one of my friends

Balloon and flowers from my family

The dressing and drainage tube

The incision site

Looking good!

Well-Wishes: Pathology Results

After letting everyone know about the pathology results, I got tons of texts and messages from family & friends.

Paula can officially say she's a cancer survivor. It's all out!

Woo Hoo!! Go Paula..Go Paula.. ( :

Love! Praise God from whom all blessings flow! HUGS!

Thats what I said Sue...Run Paula Run...So happy for you!

awww congrats paula.

I cried.

yay! I'm so happy for you!!

I am so happy to hear that. It is another positive answer to prayers.

Paula, awesome news that they got it all. I have a friend that has gone through the treatment...you'll do great!!! Love you girl

~Aunt Sherrie, Josh's family

Words can not express the joy that I am feeling for you today and for Josh and for all who love you! A tear came to my eye and praise to my lips for God's watching over you from the discovery of the concern and now through the treatment to come!
Continued prayers on your behalf will be said and much love and hugs are sent to you!

~Mary, Josh's sister

Thanks for keeping us informed. I am sorry to hear it was cancerous, but happy to hear that that they got all of it out. You are such a kind, precious person...I feel confident that it will work out well for you. You remain in my thoughts and prayers.
~Aunt Mary, Josh's Family

In addition to praying for you, I will pray for Daisy, she will miss you.
~Clint, Church Family

Pathology Results

Last night I got a call from Dr. Caldwell with the results of the surgery: I can officially say I'm a cancer survivor!

The nodule was cancerous, and it spread to 3 of the lymph nodes. I need to do radioactive iodine treatments, and I'm hoping I can get in to my specialist's (Dr. Freedman) office ASAP.

For the most part, it confirms what we've suspected. I thought it was going to come back cancerous, but never dreamed that it had gone to any lymph nodes. I am so thankful to Dr. Chamberlain (my primary doctor) for feeling the thyroid, and even though almost every test came back normal, he continued to pursue it. I am also so glad we decided to do a biopsy, even though it grew only a small amount. If we waited another year to do this, it could be too late, or way more difficult to cure or fight.

This entire experience, even though it's not over, has been so wonderful. No, I would never ask for this to happen, but in the experience, I came out of a mini depression seeing all the friends and family that truly love, support and care for me, I saw that Josh is the right man for me (not that I ever doubted it, it just reassured me that Josh is the one that will take care of me in sickness and in health), and I got my own experience with God. I always believed, but never had a moment where I said, this is what it means to be a Christian, and this is my moment where I know that He IS here, and He is helping me through everything. This has done so much for my faith, and I'm hoping to write a blog or journal, or perhaps just a regular blog centered on it, about my faith. I'm not sure what I want to do yet, or how I will, but I'll let you know (I'll also take suggestions!).

Thank you so much for your prayers and love!

Thursday, June 24, 2010

Well-Wishes: Surgery

I have had so many friends support me through e-mails, facebook messages, visits in the hospital or at my house. One family even sent me an edible arrangement! I was so excited! I have the best friends and family ever, and so glad that so many people sent us messages, let us know they were praying, and willing to visit me.

Here are some more well wishes that I got in response to going in to surgery:

Josh, Paula is and will continue to be in our prayers (as well as YOU!) Ray & I prayed together this morning before he left for work and I am going to call him now to give him the updated info.God Bless,
~Sue & Ray, Church Family

Definitely praying for Paula. Love you both very much! With JOY in Him,
That's good news Josh, praising God that every thing went well! Please give Paula our love!
~Brenda, Church Family

Yes, of course, we will be praying for Paula this morning. Thank you for letting us know. I'm sure she will do well, but sorry she has to do this now. No surgery is easy. We just want her to be well and be able to enjoy both weddings, Quinn's & yours!! Love you both,
~Grandma & Charlie, Josh's Family

My prayers are with you! May everything work out just fine.

~Aunt Mary, Josh's Family

Thanks for the update. It was good to hear that the surgery was over and went well for Paula.

~Laurie, Church Family

Josh:: PAULA'S SURGERY IS AT 11AM TODAY INSTEAD OF 6:30 PM. pray for Paula the doctor and us all waiting that everything goes smoothe please :-)
Deb::Thoughts with you Josh..
Mary:: praying...hugs!
Tammy:: Prayers coming your way :)
Dawn:: lots of prayers!!!!!!!
Ann:: whoa, it's 11:00 right now. Prayiing

6 People like this

Mary:: Sharing in your happiness and relief Josh! Will keep praying... hugs!
Michelle::  :)
Mary:: Woo Hoo! God is good, all the time! Just think she still at this time of day would still not have been able to eat and anticipating going in, if not for the cancellation. Praise God for His perfect timing in getting this surgery scheduled promptly and her surgery time being moved up. God is in the details! Hugs!
Sherrie:: Give her our Love Josh!
Josh:: so so true. will do

Josh Merrill We just got to go see her she's tired but looks really good and isnt in much pain at all. She's doing very well thank-you for all your thoughts and prayers!
4 People like this

Dawn:: thank god!!!! we will keep praying for her.
Chrissy:: yay! Give her all of my love for me! :)
Bob:: glad paula is doing good

Paula Sarma Is enjoying the last full day with a thyroid. Happy father's day!
Dawn:: we will be praying for you tomorrow
Allyson:: :( love ya good luck... everything will be fine
Susan:: OH NO! Sorry to hear/see this! Good luck with all, we'll be thinking of you tomorrow and hope to get an update asap!
Paula::Thanks! I know! I'll just be happier when I wake up after! Not looking forward to the IV, and hopefully I'll be much better after.
Laurie:: I'll be praying for God's comfort for you tomorrow and for the God's guidance in the skill of the surgeon.
Lori:: I will be praying extra hard for you tomorrow morning. My preacher is praying for you as well.
Paula: Thank you everyone! :)

Jennifer:: i'll be thinking and praying about u!! i ♥ ya

Sherrie:: Praying for you! Have Pam calling me as soon as you are out! I am especially covering the IV part.
Paula:: Thanks! Just gotta deal with all of the shits and blood work now.

Paula:: Haha shots. That's the touch screen for you...
Sherrie:: maybe your first word is the correct one :-)
Paula:: haha true!

Paula 's surgery was moved up to around 11am. Going in asap
Judy Lynn:: Good luck! i'll be keeping you in my thoughts and prayers all day :-)
Jennifer:: good luck Paula everything will be fine! Thoughts and prayers are with you! ♥ ya

Deb:: Hey..thoughts and prayers are with you...remember..just a little nap and you will be good to go...your a strong beautiful woman..just a little bump in the road...xo

Josh:: Your doing great god is watching over you my bride

Paula:: Is in her room relaxing and resting. Just a sore throat
6 People like this
Tammy:: So glad to hear this :) We will keep praying for a quick recov
Mary:: ...not just like, love! Hugs!
Jennifer:: thats awesome! Jen && i were gunna stop by later 2 c u 4 a lil bit
Amanda:: Yay, glad everything is going well!
Shannon :: Huzzah!
Peter:: Good to hear youre home keep resting
Kristin:: Considering you're texting you must not feel that bad. :)
Crystal:: PTL! Glad to hear everything went well so far. praying for an easy recovery!
Paula::Well I'm not home but feeling pretty good. Doing pretty well too.. just hoping the drainage tube can come out. Not enjoying the shots and blood draws either.
Dawn:: glad all is well. feel better soon.
Bob::glad to hear your doing ok i prayed for ya. Get better soon
Sue:: So happy to hear everything went smoothly!!

Rick:: not gonna lie, uncool for not seeking my opinion first about this surgery thing. Everything is for the most part fine until rick goes of the grid for a weekend, way to be considerate of others. That being said, GLAD YOUR DOING WELL!
Paula:: Haha sorry. It was all a little short notice. Thanks! :)
Amy:: So happy it went well. Let me know when your settled at home and I can come bother you!
Paula:: Haha ok! Maybe on wed you can come over after I'm settled

Paula:: is finally home!
19 People like this
Jennifer:: I hope your doing good!
Amy:: YAY!
Sue::That's awesome!!
Kelsey:: yay!
Cathryn:: Yeah!
Shannon:: Yay! Drain?
Myke:: Bark! Bark! Bark! (a direct quote from your daughter, Daisy.)
Dawn:: glad to hear it!!!!
Chrissy::I hope you get to feeling 100% soon, ma'am! I love you! ♥
Mary:: Wait Dad, I hear Monet and Bella barking also...oh that was yesterday at the picnic. LOL!
Mary:: I am glad to hear that all went well. God is good.
Susan:: Our prayers have been answered! Our God is an awesome God! We will continue to pray for you for a speedy recovery!
Cristen:: i hope all went well and i hope u have a gppd recovery
Paula:: ahaha! My daughter went crazy yesterday! :) Unfortunately, I do have a drain...not excited about that. Hopefully on Thurs or Fri it can come out!
Kelsey:: yay! get lots of rest dear :) let me know if you need anything

I feel so blessed to have so many people out there praying and thinking about me!


This past Monday, I was scheduled to be at the hospital at 4pm for a 6:30pm surgery. Monday morning, I got a phone call from the hospital at 7:30 am asking to come in ASAP so they can start by 11am! I was completely freaked out, and was so nervous, but it was best to do it ASAP, so I wasn't waiting around all day.

We got all situated and got to the hospital by 9am, where they took me back to get my IV in, and by 10am, the surgery was starting.

Me before the surgery, with my cool hat....that I didn't have when I woke up.

At 11:30am I was being woken up and brought into recovery, and around 12:30pm, Josh and my mom were able to come see me. They had to search around to find me a room, since I came in so early, and by 1pm, they brought me up to my room. (When I can upload my photos easier I'll post them up)

It really wasn't that bad, since the only thing I was awake for was the IV. The recovery is actually the harder part. I haven't been in a huge amount of pain, so the most I've really taken is Ibuprofin. I've been very tired, expression-less, and it's just been hard to move with all of the bandages and the drainage tube being in still (oh yeah, I have that...it's not really that fun). I'm hoping that can come out today or tomorrow. I'd assume tomorrow, but I just want it out so I can feel better. When I go in to get the tube out, they'll take off the bandages, and we'll see what it looks like!

For now, that's all I really have to say about the surgery. Easy on my part. I'll post more after I get the drainage tube out!

Wednesday, June 23, 2010

I'm Home Recovering!

Sorry for not updating in the hospital (I was on Facebook a lot of the time). I'm now home and resting and recovering from the surgery! I'm doing very well now. I'll post in a couple days about how everything went. Actually, on Monday morning I got a call to come in so they can do the surgery around 11am! The whole morning early! It worked out so much better, and I had extra recovery time.

Don't worry, I'll post more details and such in the next few days. I have so much mail to check and things to catch up on!

Saturday, June 19, 2010

Pre-Op Appointment

Yesterday I went in for my Pre-Op appointment at the Pre-Admission Testing Center at Rochester General Hospital. It wasn't too bad, but we were there two and a half hours! I got blood work done, had to give a urine sample, got a chest x-ray, and talked to lots of people!

We got a ton of information on what will be happening on Monday there, and it calmed my nerves a lot. I'm still really only nervous about the IVs & anestesia, but I don't really have any choices, so I have to deal. We talked about what they would be doing with the surgery, the process and a little bit about what will happen when I'm there overnight, and a little about medications and what to eat/drink before.

I can't eat solid foods after midnight on Sunday, and can only drink water, apple juice, and black coffee or tea until 2:30pm Monday. Oh! I got an exact surgery time: 6:30pm. The paperwork said it will take about two to two and a half hours, but I think that's by the time in back in my room (which I'll most likely be sharing, I can't have a private room).

After that Pre-Admission appointment, I went back over to Dr. Caldwell's office to talk to the RPA, Stephanie. She talked about what will happen before, during and after the surgery, filling us in on anything else we didn't know at that point. She gave me prescriptions for my hormone replacement therapy pills, and told me what to get for after (Tums, to prevent any kind of calcium problems).

I still have to read over all of the papers I was given yesterday, so I'm sure I'll get more information there. I've felt better each time I've met with a doctor about this, but I'm still scared of this surgery!

I'll have my iPod with me on Monday and Tuesday, so I'll be able to write a little post about what happened the day after the surgery, if I'm up to it.

Wednesday, June 16, 2010

Surgery News

At 1:00 pm yesterday, I had my consultation with the surgeon. After a lot of waiting, a lot of questions were answered and we walked out with a surgery appointment!

I spoke with the nurse practitioner, and told her what's been going on and why I was there. She was even all excited about the wedding! When we said that and how I wouldn't be on the insurance after that day, she said she'd put me at the top of the list!

I then spoke with the surgeon, Dr. Caldwell (after some more waiting). We talked about what was going on, what he wants done (well, what the specialist wants done), and briefly explaining what he's going to be doing. He'll be taking out the whole thyroid and some lymph nodes in the area. Apparently, the thyroid is almost the whole length of the neck! He'll make a cut at the bottom of my neck, and take the thyroid and lymph nodes out. I'll have a drainage tube after for a couple days (it looks like a straw sticking out! It's weird!), and staying at least overnight. I'm hoping they take out the tube so I don't have to worry about it!
So, Friday I'll be going to RGH for lab work and a chest x-ray, then going back to the Linden Oaks Office to talk about pre-, during, and post- surgery with the RPA (I forgot what it stands for). More questions will be answered. Monday evening I'll be going to RGH for my surgery!

It's a weird feeling. I don't feel nervous at all, but I am nervous. I'm sure I'll feel it on Monday! It's such a great thing to have it done this early! A true answer to a prayer! I hoped we could get it done before the end of June so I could have maximum healing time before the wedding, but didn't think I'd actually be able to do it, and this soon! I could have gone in on Friday to do the surgery if I really wanted!

I'll be the 6th thryoid removal of the day on Monday, so he'll be all warmed up! :)

Tuesday, June 15, 2010

How I Get Through It

My faith has played a huge part in my reactions to the news. I have prayed everyday since I've heard, and my nerves have been calmed like you wouldn't believe! I know everything will be ok, even if I am scared.

I've always loved this song, and now I feel it's the perfect soundtrack to this event, so it has even more meaning. I listen to it every night before I go to bed.

What Faith Can Do Lyrics

Everybody falls sometimes
Gotta find the strength to rise
From the ashes and make a new beginning
Anyone can feel the ache
You think it’s more than you can take
But you're stronger, stronger than you know
Don’t you give up now
The sun will soon be shining
You gotta face the clouds
To find the silver lining

I’ve seen dreams that move the mountains
Hope that doesn’t ever end
Even when the sky is falling
I’ve seen miracles just happen
Silent prayers get answered
Broken hearts become brand new
That’s what faith can do

It doesn’t matter what you’ve heard
Impossible is not a word
It’s just a reason for someone not to try
Everybody’s scared to death
When they decide to take that step
Out on the water
It’ll be alright
Life is so much more
Than what your eyes are seeing
You will find your way
If you keep believing

I’ve seen dreams that move the mountains
Hope that doesn’t ever end
Even when the sky is falling
I’ve seen miracles just happen
Silent prayers get answered
Broken hearts become brand new
That’s what faith can do

Overcome the odds
You don't have a chance
(That’s what faith can do)
When the world says you can’t
It’ll tell you that you can!

I’ve seen dreams that move the mountains
Hope that doesn’t ever end
Even when the sky is falling
And I’ve seen miracles just happen
Silent prayers get answered
Broken hearts become brand new
That’s what faith can do
That's what faith can do!
Even if you fall sometimes
You will have the strength to rise

The official music video is here, but you can't embed it.

Thursday, June 10, 2010

Information on Parathyroid

In addition to being careful of my trachea, voice box, and other things inside my neck, the surgeon is going to have to be careful of my parathyroid.

Most people have four pea-sized glands, called parathyroid glands, on the thyroid gland in the neck. The parathyroid glands make parathyroid hormone (PTH), which helps your body keep the right balance of calcium and phosphorous.

My doctor said that people REALLY only need one, but they need to preserve as many of them as possible during the surgery. If anything happens to them, I'll have calcium problems. My mom works with someone who's mom had calcium issues, and it lead to many other issues inclucing stroke problems.

There's a lot to pay attention to!

Wednesday, June 9, 2010

Information on Thyroid Nodules

A lot of the information on nodules are repetitive. I went to the Mayo Clinic and the NIH for information on this, and the information is very similar.

The main information:

Thyroid nodules are growths of cells in the thyroid gland. These growths can be noncancerous (benign) or cancerous (malignant). Some nodules are fluid-filled (cysts), while others are made of thyroid gland cells. Sometimes, what feels like one nodule will actually be a collection of small nodules.
Thyroid nodules are more common in women than in men. A person's chance of a thyroid nodule increases with age.Only a few thyroid nodules are cancerous. 


Most thyroid nodules don't cause signs or symptoms. Occasionally, however, some nodules become so large that you can:
  • Feel them
  • See the swelling at the base of your neck
They may become apparent when you're shaving or putting on makeup. Men sometimes become aware of a nodule when their shirt collars suddenly feel too tight.
In some cases, thyroid nodules produce too much thyroxine, a hormone normally secreted by your thyroid gland. The extra thyroxine can cause problems such as:
  • Sudden, unexplained weight loss
  • Nervousness
  • Rapid or irregular heartbeat
Although thyroid nodules are seldom cancerous (malignant), a nodule is more likely to be cancerous if it:
  • Grows quickly or feels hard
  • Causes you to become hoarse or to have trouble swallowing or breathing
  • Causes enlarged lymph nodes under your jaw or in your neck

Exams and Tests

Very often, nodules produce no symptoms. Doctors will find thyroid nodules only during a routine physical exam or imaging tests that are done for another reason. However, thyroid nodules that are big enough to feel during a physical exam occur in a few people.
If the doctor finds a nodule or you have symptoms of a nodule, the following tests may be done:

Treatments and drugs

Depending on the type of thyroid nodule you have, your treatment options may include:
  • Watchful waiting. If a biopsy shows that you have a benign thyroid nodule, your doctor may suggest simply watching your condition, which usually means having a physical exam and thyroid function tests at regular intervals. You're also likely to have another biopsy if the nodule grows larger. If a benign thyroid nodule remains unchanged, you may never need treatment beyond careful monitoring. Talk to your doctor if you're not comfortable with this approach or want more information on other options.
  • Thyroid hormone suppression therapy. This involves treating a benign nodule with levothyroxine (Levoxyl, Synthroid), a synthetic form of thyroxine that you take in pill form. The idea is that supplying additional thyroid hormone will signal the pituitary to produce less TSH, the hormone that stimulates the growth of thyroid tissue. Although this sounds good in theory, levothyroxine therapy is a matter of some debate. There's no clear evidence that the treatment consistently shrinks nodules or even that shrinking small, benign nodules is necessary.
  • Radioactive iodine. Doctors often use radioactive iodine to treat hyperfunctioning adenomas or multinodular goiters. Taken as a capsule or in liquid form, radioactive iodine is absorbed by your thyroid gland, causing the nodules to shrink and signs and symptoms of hyperthyroidism to subside, usually within two to three months.
    Because thyroid hormone is released into your bloodstream as the nodules are destroyed, in rare cases your symptoms may worsen for a few days or weeks after therapy. You also might experience neck tenderness or a sore throat. And because this treatment eventually causes thyroid activity to slow considerably, you may develop hypothyroidism.
  • Surgery. The usual treatment for malignant nodules is surgical removal, often along with the majority of thyroid tissue — a procedure called near-total thyroidectomy. Occasionally, a nodule that's clearly benign may require surgery, especially if it's so large that it makes it hard to breathe or swallow. Surgery is also considered the best option for people with large multinodular goiters, particularly when the goiters constrict airways, the esophagus or blood vessels. Nodules diagnosed as indeterminate or suspicious by a biopsy also need surgical removal so they can be examined more thoroughly for signs of cancer.
    Risks of thyroid surgery include damage to the nerve that controls your vocal cords and damage to your parathyroid glands — four tiny glands located on the back of your thyroid gland that help control the level of calcium in your blood. After thyroidectomy, you'll need lifelong treatment with levothyroxine to supply your body with normal amounts of thyroid hormone.
You can get full information from the two links at the top of the page.

Information on Thyroid Cancer

There's a ton of information out there! A med student friend of mine sent me the information below. You can also find a ton of good information here.

Thyroid cancer

Thyroid cancer is a cancerous growth of the thyroid gland.

Alternative Names
Tumor - thyroid; Cancer - thyroid

Thyroid cancer can occur in all age groups.
People who have had radiation therapy to the neck are at higher risk. Radiation therapy was commonly used in the 1950s to treat enlarged thymus glands, adenoids and tonsils, and skin disorders. People who received radiation therapy as children are at increased risk for getting thyroid cancer.
Other risk factors are a family history of thyroid cancer and chronic goiter.
There are several types of thyroid cancer:
  • Anaplastic carcinoma (also called giant and spindle cell cancer) is the most dangerous form of thyroid cancer. It is rare, and does not respond to radioiodine therapy. Anaplastic carcinoma spreads quickly and invades nearby structures such as the windpipe (trachea), causing breathing difficulties.
  • Follicular carcinoma accounts for about 30% of all cases and is more likely to come back and spread.
  • Medullary carcinoma is a cancer of nonthyroid cells that are normally present in the thyroid gland. This form of the thyroid cancer tends to occur in families. It requires different treatment than other types of thyroid cancer.
  • Papillary carcinoma is the most common type, and usually affects women of childbearing age. It spreads slowly and is the least dangerous type of thyroid cancer.
  • Cough
  • Difficulty swallowing
  • Enlargement of the thyroid gland
  • Hoarseness or changing voice
  • Neck swelling
  • Thyroid lump (nodule)
Note: Symptoms may vary depending on the type of thyroid cancer

Exams and Tests
A physical examination can reveal a thyroid mass or nodule (usually in the lower part of the front of the neck), or enlarged lymph nodes in the neck.
Tests for thyroid cancer:
  • Elevated serum calcitonin (for medullary cancer) or serum thyroglobulin (for papillary or follicular cancer)
  • Laryngoscopy showing paralyzed vocal cords
  • Thyroid biopsy showing anaplastic, follicular, medullary, or papillary cancer cells
  • Thyroid scan showing a nodule that does not light up on the scan (cold nodule)
  • Ultrasound of the thyroid showing a nodule
This disease may also affect the results of the following tests:
  • T3
  • T4
  • TSH
Treatment varies depending on the type of tumor.
Surgery is usually the treatment of choice, and the entire thyroid gland is usually removed. If the physician suspects that the cancer has spread to lymph nodes in the neck, these will also be removed during surgery.
Radiation therapy delivered by taking radioactive iodine is often used, with or without surgery. Radiation therapy with an external beam of radiation can also be used.
After treatment, you need to take thyroid hormone to replace what your glands used to make. The dose is usually a little higher than what your body needs, which helps keep the cancer from coming back.
If the cancer does not respond to surgery or radiation and has spread to other parts of the body, chemotherapy may be used, but this is only effective for a third of patients.

Outlook (Prognosis)
Anaplastic carcinoma has the worst outcome of all the types of thyroid cancer. It is usually fatal despite treatment.
Follicular carcinomas are often fast growing and may invade other tissues, but the outlook is still good -- most patients are cured.
The outcome with medullary carcinoma varies. Women under age 40 have a better chance of a good outcome.
Papillary carcinomas are usually slower growing. Most people are cured and have a normal life expectancy.
Many patients who have surgery or radiation for thyroid cancer must take thyroid hormone pills for the rest of their lives.

Possible Complications
  • Injury to the voice box or nerve, and hoarseness after surgery
  • Low calcium levels from accidental removal of the parathyroid glands during surgery
  • Spread of the cancer to the lungs, bones, or other parts of the body
When to Contact a Medical Professional
Call your health care provider if you notice a lump in your neck.
Also call if your symptoms get worse during treatment.

There is no known prevention. Awareness of risk (such as previous radiation therapy to the neck) can allow earlier diagnosis and treatment.

Ladenson P, Kim M. Thyroid. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 244.
National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology 2008: Thyroid Carcinoma. Version 1.2008.