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Have follicular thyroid cancer with undifferentiated Hurthe cell features, done surgery. Should I get radiotherapy done?

Hi, I once first diagnosed with follicular thyroid cancer with undifferiented Hurthe cell features in 2002. I have the left lobe removed (where lump was discovered). Surgeon was confident it was not cancerous, however, upon pathology of tissue discovered follicular cancer. I then underwent removal of right thyroid lobe by Cancercare surgeon and was discovered to have papillary cancer on that side. I have been monitored with yearly thyroglobulin blood test and ultrasound and this past spring, a lymph node appeared positive for cancer along with eleveated thyroglobulin. I had surgery this past February and they removed a the lymph node from left side of neck along with 12 other lymph nodes that were negative. In September, I am to have follow up with radioactive iodine treatment under the care of a Nuclear Medicine physician. He has consulted with two of his colleagues as to best approach and these colleagues had varying opinions. One said I should have a therapeutic dose of radiation to ensure there were no microscopic cells in my body, the other said to take the thyrogin injections and then test Thyroglobulin level and if within normal range, would not go ahead with diagnostic body scan as the blood test has been proven to be more accurated than a scan. If the thyroglobulin is normal range, then, no additional radiation would be necessary. I am wondering what research has been done as to best approach to ensure microscopic thyroid cells are destroyed and the prevalance of disease returning every few years. I note from my research that thyroid cancer is recurrent around the 8 - 10 year mark and I would like to avoid having further surgery as I was told by my surgeon that he wants to avoid recurrent surgeries due to complications of developing scar tissue.
Wed, 13 Nov 2013
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ENT Specialist 's  Response
Hi, As far as my opinion is, you need to undergo follow up with thyroglobulin levels and neck ultrasound to check for any recurrence. Radio iodine scans are used for knowing the amount of thyroid tissue post total thyroidectomy so that the residual disease if any can be ablated with an ablative dose of radio iodine. Other methods to look for neck masses in such patients are CT, MRI or PET.

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