Just diagnosed with “ suspicious “ for Follicular Neoplasm

Hello

Could I first ask you what country you are in. TRADS is not a system we typically use in the UK so I'm going to take a guess that you may be in the USA. 

You've clearly done your homework because you're absolutely right that follicular TC can't normally be diagnosed with FNA so your oncologist seems a bit over-confident in telling you it's definitely cancer. 

Are you able to get a second opinion? 

Unless we're missing something in what you've been told, the usual (well normal for the UK) outcome of the FNA result you describe would be a diagnostic hemithyroidectomy. At 5 cm, you're going to want to get shot of that lump before it gets any bigger, whether it's cancer or not. 

RAI for a lump of that size IF IT IS CANCER would be typical. 

If you are in the USA, this could be an insurance 'thing' - one operation instead of potentially two?? - but I think you are right to question your oncologist's confidence that it's cancer.

Thank you so much …Yes I am in the Southern part of the US , am I correct that the term “ neoplasm “ means ( new growth )? And if so we wonder how long it’s been growing to reach 5cm etc. We read of metastasis from follicular neoplasm cancer also in the lungs and bones possibly . My question would be , what physical symptoms would I have that it has spread IF it’s malignant ? I feel fine other than occasional nausea, I am borderline anemic also . Thank you for any advice - guidance 

Neoplasm is indeed another word for new growth of cells but it doesn't always mean that it's cancer. 
How long it has been growing also doesn't have to be a big deal. Mine was 7.5 cm and somehow everybody around me totally failed to spot or mention I had a lump the size of a tangerine sticking out of my neck. Size isn't always an indicator of how likely something is to have spread.

I would urge you not to  go looking for symptoms of spread - you honestly (despite what your onc says) don't really know if that lump in your neck is even cancer yet. It's true that IF follicular TC spreads, it does tend to go to lungs or bones but you're a long way from needing to worry about that yet. 

If it's cancer, and if it has spread (both IFs with good chances of not being the case), the radioactive iodine will zap any spread wherever it's gone to. That's the 'great' thing about thyroid cancers of this type - when they spread, they retain the characteristics of thyroid cells and still pick up iodine. It's the reason why success rates for clearing up thyroid cancers are some of the best of all the cancers.

So please, handle each hurdle as you reach it. Get through challenging this onc about his scalpel happy approach, then get through a hemi, and then if it's cancer, do the completion and then the RAI. 

One step at a time. 

Nausea - you're probably getting that from fear and anxiety as much as any real physical issues. 

Hello. I can see that you have loads of experience in the thyroid cancer matter so would like to ask you some questions on private chat. I only joined this forum few days ago. I've send you friends request. Hope that's OK. 

I would always recommend posting in the forums rather than private messages because a lot more people will see an you benefit from the experience of lots of people that way.

But, yes, I'll accept your friend request.

Hi,hope you doing well,did you ended up having thyroid surgery? Was it cancer? I also have a 3 6 follicular neoplasm,my ent recomended to remove,half of my thyroid. But I want to do radio frequency ablation instead,is a  new treatment that shrinks nodules,with out surgery.

Hi Letty, 
I would strongly suggest you start a new post to ask your questions. Lots of people don't get alerted to new posts on old threads.
Then you can start one about Radio Frequency Ablation and all the comments about that will be easier for later users to find and see.