Rich - Post-Surgery Monitoring

December 28, 2002

>I am interested in your comment- " he had access to more accurate lab

>testing, ultrasound techs/radiologists who specialize in diagnosing

>neck cancers, a nuclear med dept etc " - and would like to know, if you

>would be so kind, the particular monitoring and testing methods you are

>referring to. In particular, PET scans as diagnostic/followup

>methodology. Also, the method(s) of choice(including manufacturer of

>equipment) for monitoring soft tissue recurrence of the neck and

>mediastinum.

In my case the post-surgery confirmation of a potentially more

aggressive papillary thyca variant did make my medical team review

and even debate, what was needed to monitor my condition over the

long-term. The fact that I live in a small town with basic health

care services also contributed to the need for this review.

Our local hospital does not have the approvals, equipment or staff

for RAI. The only local ultrasound clinic missed my primary 3 cm

tumor....(oops) and at the time of my diagnosis did not do a lot of

thyca patient monitoring. Our local services are expanding though....

To date I have not had a CT or PET scan - because my TG has been

less than 1 on and off meds since my initial RAI and other tests

have not shown any evidence of thyca. [neck exams, neck ultrasounds,

RAI scans]. A CT scan has been recommended though and will likely be

scheduled in six months.

As for my post-surgery monitoring I had two RAI scans a year and

a half apart. Both were negative and my TG was less than one. In

the absence of any other indicators of thyca recurrence, I'll likely

scan again in 3-5 years.

I now have my TG/TSH tested every six months as well as a neck

exam and neck ultrasound. I also have an annual chest x-ray. I have

a very basic monitoring program because my condition has been stable

despite my " aggressive " thyca diagnosis. Of course this routine could

change if there is any evidence of recurrence.

, Canada

dx pap hurthle cell variant.

tt 9/99, RAI 100 mCi 12/99

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