Thy 3a really confused

Hello  

The FNA test produces a result - in your case Thy3a - which determines what happens next.  

We have a thyroid cancer nurse specialist calledGeri - Macmillan but she's on holiday at the moment so I went looking through some of her old posts to find you this explanation: 

"

Thyroid nodules are very common and reported to be present in up to 50% of the population, although most people will never be aware they have them. They generally don’t cause too many problems, and only around 5% of them turn out to be cancer.

In previous years, it would not have been unusual for surgeons to advise removal of the thyroid for someone with a thyroid lump, or at least half of it for diagnostic purposes. Thinking has changed in recent years and there is a growing body of evidence in favour of monitoring nodules. Some studies followed hundreds of patients over many years found monitoring and assessment to be safe. Most people with thyroid nodules never developed thyroid cancer. The small percent that did were treated and were still alive and well many years later.

This knowledge makes doctors extremely confident that if things change and someone develops thyroid cancer, then treatment outcomes are nearly always very good.

However, you also have an inconclusive THY3 biopsy result. THY3a  or THY3f means an indeterminate result, where somewhere between 9 and 43% turn out to be cancer.

THY3a results signify abnormal cells, and the current UK guidelines for a THY3a result is to repeat the ultrasound and /or FNA. There is no time scale put on when this needs done, as each person’s situation is looked at on an individual basis.

THY3f results signify a possible follicular growth (benign or cancer), and the current UK guidelines for a THY3f result is to remove half the thyroid to get a definite diagnosis. It’s impossible to get a definite follicular diagnosis from a biopsy. The doctors need to take half the thyroid to do this.  

The THY3 results that are more likely to be cancer usually have more suspicious features on ultrasound. You might find it helpful to ask your doctor to talk you through the ultrasound results.

You ask if the nodule doesn’t change much over time is this more likely to mean its benign. The answer is sadly no, thyroid cancer is generally very slow growing and in some cases, may takes years to develop into a large tumor.

If your doctors felt that it wasn’t safe to leave it for a few months, then I’m sure they would be more insistent on surgery."

If you are interested in reading the whole of that thread, you can find it here.

Can I ask if your phrase 'nuclear feature' might be an auto-correct from your phone or tablet for 'no clear feature'?

From what Geri has written, it sounds like you're likely to be on a 'come back and see us and we'll keep checking up on you' with the doctors.

I hope that helps. As she says between 9 and 43% of these turn out to be cancer - so you've got pretty good odds in your favour. It's never good to have to lose half your thyroid just to find out, so the watch and wait approach makes good sense.

Thanks a lot Barbara for prompt reply. I have e reallyd this and it's very useful. 

Thanks again.

Great, Geri writes some really great responses to questions so I do tend to recycle them.

I hope you'll pop back and let us know what the doctors decide to do for you.

Hi Capri,

I was also diagnosed Thy3a after FNA and was told by an endocrinology registrar I had follicular thyroid cancer.

The surgeon he then passed me on to said this was not definitely the case, as I had already determined for myself, and ordered a follow-up FNA in 6 months. This came up with the same result and he says from now on they will monitor it by ultrasound, so I have another appointment 6 months from the last. 

From what I have read, untrasound is more appropriate for monitoring for suspected follicular cancer. I too have had lots of thoughts and worrying over this. he did say if I really wanted, he would take out half my thyroid, but that that might mean having to take tablets.

I don't think I would have given the whole thing a second thought if the registrar I initially saw hadn't told me I had follicular thyroid cancer and sent me away with a website address giving me more information about it. I would have been perfectly happy to go with the surgeon's decision without having this doubt in my mind.

Thanks Piglet 171 for your reply ,

I have few questions, If u don't mind to share.

Have they done surgery ?

Initially your report was normal and then it turned to follicular cancer?

Do you have any symptoms  ?

Sorry if I am asking too much, I'm just thinking to decide in advance if ENT specialist suggest for half thyroid surgery as BHS process is already very slow.

I hope you must be feeling ok .

Thanks Barbara,

Just read the bottom part of your reply.

 COrrect a phrase from my previous email, it's "Nuclear features of paplliary carcinoma are not identified ".

Yes I was thinking about the same approach to wait and watch.

Hi Capri786,

Sorry I have taken so long to reply.

No surgery they are monitoring by ultrasound. My nodule is only 5mm.

First FNA not enough cells, repeat FNA Thy3a.

A week after second FNA I saw an endocrinology registrar who told me I had follicular thyroid cancer.

He passed me on to the endocrine consultant/surgeon who told me this was not necessarily the case - the nodule could be follicular cancer or benign and that his advice was monitoring. I had phoned my GP about the result after seeing the  registrar and she confirmed what consultant/surgeon told me about no certain diagnosis. I have no idea why the registrar told me what he did.

The point I was trying to make was that if it hadn't been for the registrar telling me I had cancer, I don't think I would worry about the surgeon's advice and recommended course of action. Now I do wonder and worry.

As to symptoms, my nodule was found incidentally during an ultrasound of my parathyroid glands as I was vitamin D deficient and went to my GP as I was tired all the time. After a good while on Vit D supplements I am still tired all the time. Nobody seems that bothered as all my blood tests come back fine.

I hope you are now getting some sort of satisfactory advice from the doctors.

Hi Everyone,

I had a follow-up appointment today after Thy 3a diagnosed in April 2017. Dr suggested a scan after 4 months and FNA if required which will be further decided by radiologist. Dr Said, if my repeat scan will be similar than it will be up to me to go a head for surgery or keep monitor it until the nodule change the size or any further complications.

I dont know its the coreect decision, need your suggestion please. 

Thanks in advance.

Hi capri

I'm doing the same with my solitary nodule. It's only 12 mm but solid with more blood flow than they'd like and my tsh is normal. I've had two fna biopsies and both non diagnostic. I could go ahead with a core biopsy now but I've decided to do watch and wait. I'm having another ultrasound in 3 months time. It's a risk but half a thyroid out is also a risk as the odds are in my favour. Hope you make the right decision for you. X

Hi everyone,

Unfotunately my Thy 3a turned in to thy 5. My nodule is 11mm and Aftet MDT they have decided to remove left side  of throid only. 

This news makes me so dipressed which I couldn't explain as I have two young daugters and when ever I see them, I couldn't control my tears because they don't know what there dad is going through.

I have few questions to ask, if someone can guide me or share the experience.

Doctor suggested me to remove only left side of thyroid where as I am thinking to request them to remove full ?

Will I get RAI ?

Quality of life after full thyroid removal ?

Survival rate with Thy 5 ?

Any further suggestions, if I have missed.

Many Thanks for your support