It’s American thanksgiving! I’m thankful for my wonderful family and friends (some of whom I will see tonight at a potluck), KITTENS and CARRIE, great colleagues and students, as well as for the kindness of strangers. Since I last posted, I got a little information on Inspire.com but the ThyCa people managed to manually add me to the advanced thyroid cancer listserv, where I got much more good information (including help with a list of questions for the doctor today). I am also grateful for socialized medicine and the fact that I like in a place where there are people who do research on thyroid cancer (and that the cancer wings of the Jewish are better funded and more functional than some others).
So, onto that.
I went to the medical oncologist today. The discussion was serious but inconclusive. There is another CT scan in my future and I’ll be talking with him again in a couple weeks while he gathers more information. Here’s what we know: My thyroglobulin (that’s a tumour marker in the blood) is down from 57.5 to 40.2 after the radioactive iodine. The CT scan report is woefully vague–it says there is no visible update but does not describe the size of the lesions in my lungs. So there will be another CT scan. Also, there is some confusion about prior RAI uptake in my lungs in 2010. So he will talk with my endocrinologist, we meet again in two weeks, and the CT scan happens thereafter at which point we come up with a program for treatment or non-treatment.
The options are:
1. Exploratory lung surgery to get an absolutely firm diagnosis. This isn’t likely to be necessary as everyone is pretty certain it’s thyroid cancer. If it weren’t thyroid cancer, there would be a whole other set of questions.
2. More watchful waiting, which means regular CT scans and followups.
3. Medical oncology treatment with tyrosine-kinase inhibitors, which can slow or stop the growth of metastatic thyroid cancer but do not reverse it.
I’ll know more in two weeks, but even then, it will probably be a bit longer before we’re certain how this particular episode will shake out.