Total thyroidectomy or not?

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Hi 

I’m in a quandary and need a bit of advise. My surgeon has advised I’ve a 2.4 cm tumour on the right side and he suggests a hemi. I have the option to remove all as there is a family history of thryoid cancer. He thinks my tumour is benign and that’s why suggesting a hemi with monitoring .  If it turns out it’s cancer he will take me back for completion. I’m frazzled and swinging from TT to hemi. Op will be in two weeks in Glasgow 

  • Once you have a TT there is no going back and from what I have read with a partial thyroidectomy you can function and will need less medication.  Take a look at this site which explains it better than I can @Roma75.  www.endocrineweb.com/.../surgery-papillary-thyroid-cancer

  • Hi Roma75,

    I completely understand your thought process!

    I had my hemi on 30th June for “suspected malignant”and the results came back as papillary cancer last week. I’m now due to have my completion in the next couple of weeks. In hindsight it’s easy to say “just take it all out”, and I can definitely appreciate that even more as you have a history of thyroid cancer in the family. I personally am glad that I didn’t go with that approach initially though. I still had a hope that it wasn’t going to be cancer, or if it was that it would be isolated in the one lobe in which case i would still be left with 1 unaffected thyroid lobe. As Petal66 has said, once you go for the full thyroidectomy it can’t be undone. Whereas with the hemi you are likely to still have normal thyroid function after. The recovery is relatively quick after the hemi too, hence why I’m not too worried about having to go through it again.It is whatever you feel comfortable and most at ease doing. Good luck either way and all the best Sparkling heart x 

  • I agree @Rosie_x and especially for younger people unless absolutely necessary that you need a TT, then I think I would prefer a hemi.  I have to have a full TT (on Tuesday) plus dissection as I have at least one lymph node which the biopsy showed as being cancerous, and two small nodules in my lung.  So I don't have the option and want to give myself as good a chance as possible, I am 66 years old though and I feel I have to just go with the advice I have been given.  No history of thyroid problems that I know of in my family but no-one left to ask now anyway.

  • Hello Petal66

    I’m 60 and  had a TT and neck dissection in February  followed by RIA in May.  Feeing fine now on the levothyroxine. 
    Having  a radioactive iodine scan in November  to see what has happened post treatment . Apparently the initial post RiA scan showed a likely nodal mediastinal metastasis. I’ve the tall cell version.which is rare and an additional complication.  
    I hope all goes well on Tuesday x 

  • Good to hear you are fine now @Gold Finch, I haven't a clue what I have apart from being told it is possibly Papillary Cancer of a 2.5 cm nodule and one lymph node also possible cancer (after a fine needle biopsy) hence the dissection plus they said I would need RAI afterwards as there are 2 small nodules in my lung.  I suppose after the operation and pathology reports I will know more.  Fingers crossed very tightly for Tuesday as I have a palsy on my vocal cord r h side, and if they damage the other side I may need a tracheostomy, which scares me to death.  I will be so glad when this is over, and I know it won't be entirely over until I am cleared of cancer and realise that we need to be checked out regularly.  Best wishes to you Gold Finch and for your scan in November and fingers tightly crossed for you too.  Let me know how you go on. xx

  • I understand your fear in relation to your vocal chords.  I was terrified.  We just have to trust the doctors and hope and pray.  I think they have to emphasise the risk but as patients it is hard to deal with.  
    I really hope it goes well for you x

  • Thank you @Gold Finch I do worry quite a lot about everything.

  • Hi

    I had a hemi then found out I had cancer so then needed a total thyroidectomy. I dreaded the second surgery knowing what the first had been like - although it wasn’t as bad - and got very stressed about the situation I found myself in. My thyroxine levels were dipping by the time of my second surgery so what was left of my thyroid was failing so I’d have needed medication anyway. With hindsight I wish I’d had a total thyroidectomy first time - I didn’t have a choice though - though others would possibly choose differently. Hope this helps. 

  • All over with now and back home on Sunday, after Tuesday's operation.  No tracheostomy needed thank goodness, raspy voice but no damage they can see to the other side of my vocal cord.  Now just need to heal.

  • Great news Petal66. Yes I think they always have to tell you the worst scenario such as damaged voice and a tracheotomy. Hope you have a speedy recovery after Great care in Nottingham