Thyroid article that suggests to NOT treat cancer

DebE13 · Post by **DebE13** » Thu Aug 29, 2013 5:36 pm

This makes me question everything. I almost wish I hadn't read it. Although, with all the issues I'm having, I'm not sure if there's a choice.

http://www.bmj.com/content/347/bmj.f4706

Post by **tex** » Thu Aug 29, 2013 7:40 pm

I thought that you had a confirmation that malignancy was present. That article is about non-malignant nodules. It doesn't recommend not treating cancer. It recommends not treating non-malignant nodules.

Tex

JFR · Post by **JFR** » Thu Aug 29, 2013 9:38 pm

tex wrote:I thought that you had a confirmation that malignancy was present. That article is about non-malignant nodules. It doesn't recommend not treating cancer. It recommends not treating non-malignant nodules.

Tex

In my reading of the article it does suggest not treating small "indolent" cancerous nodules, indolent seeming to mean so slow growing (sometimes even shrinking over time) that they are unlikely to cause any problems. I would think that another important factor would be whether or not you were symptomatic. It sure would be nice to know if the symptoms you were having, Deb, were related to the cancer, but that question seems not to be answered. Maybe it can't be. The other important factor seems to be size. Do you know what size these cancerous nodules are? I understand how all this must be making you crazy.

Jean

DebE13 · Post by **DebE13** » Fri Aug 30, 2013 2:23 am

Tex, I had three nodules biopsied, one was benign with a notation of a focal increase in lymphocytes present suggesting chronic thyroiditis. The other two both were malignant noted as malignant cells present derived from papillary carcinoma of the thyroid. Maybe I interpreted the article incorrectly but I thought it was suggesting that this type of slow growing cancer might be better left untreated. All of mine were less than 1mm. Before I saw my endo, it was explained to me that often nodules under 1mm are not biopsied and may just may be monitored. When my endo viewed my ultrasound with me at the office visit he disagreed with the measurement and encourage the FNA so we would know for sure. Maybe being so close, .99mm, he was being cautious.

The pathology report still leaves me confused because it mentions chronic thyroiditis yet they continue to tell me I have no thyroid problems (aside from the cancer) because my labs are normal.

Jean- I was assured all of the symptoms I've been having are not related to the cancer but he wouldn't say for sure that the removal of the thyroid wouldn't help .

However, after the biopsy, I had all the symptoms that go along with it. It was an uncomfortable and painful procedure and I have a high pain threshold. It seems to have aggravated the thyroid and it has been unforgiving ever since. It's all manageable but all very annoying. At first I thought maybe it was in my head because of all the reading I've been doing and is on my mind but then again, I know how I feel. I don't need to make up problems.

Post by **tex** » Fri Aug 30, 2013 9:45 am

We're interpreting that article differently because of semantics. In my vocabulary, a cancer-like growth is not malignant, if it does not pose a significant threat during the expected normal lifetime of a patient. If it is malignant, then it should be treated. If it's not malignant, then treatment is unnecessary, and generally undesirable. At least that's how I see it.

Here's the definition of "malignant" (according to Webster):

1. inclined to cause harm, suffering, or distress. 2. very dangerous or harmful in influence or effect. 3. a. tending to produce death, as bubonic plague.b. (of a tumor) characterized by uncontrolled growth; cancerous, invasive, or metastatic. malignantly, adv.

Incidentally, "chronic thyroiditis" means chronic inflammation of the thyroid, which is definitely an issue that needs attention (regardless of what their worthless lab results show). No organ can perform normally when it is subjected to chronic inflammation, at least not in the long run. Your thyroid appears to be an "accident" waiting to happen.

Tex

DebE13 · Post by **DebE13** » Fri Aug 30, 2013 5:34 pm

I'll have to re read the article because I didnt see that phrase, there was a section specific to cancer. My thoughts have been so muddled that I wouldnt be surprised if I read it wrong. I so much like everything to be black and white and this article placed doubts in my head as to if i am doing the right thing. Although, life is rarely that clear cut.

I have a long list of questions to go over with the surgeon next Wednesday. Most likely, i will always be unsettled. My biggest question is going to be about the pathology report and how it can be possible to have a chronic condition but not have one.