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Elaine - Jane - thyroid cancer

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snip>If the surgeon proposes to take out only one lobe first, or leaves a

thyroid remnant, that's because they haven't had

enough experience and are concerned of damaging something. You want it all

to come out in one operation.

Jane - I *absolutely* disagree with you there. It depends on the type of

cancer, whether or not it is still encapsulated, its size, how large it is

and about 100 other things.

The first surgeon I saw was adamant that on the off-chance my lump was

cancer, he would remove the whole gland - I was only 32 and could not

believe that was necessary - for instance you don't automatically remove

both ovaries, breasts or kidneys if only one is diseased! Thyroids produce

hormones which we desperately need and if there's a chance half the thyroid

gland can be saved, then that should be a surgeon's aim. As you say thyroid

cancer is *usually* slow growing so *if* the other side is involved, then a

second hemithyroidectomy can be carried out at a later date. In the

meantime 3-6 monthly ultrasound monitoring should be carried out.

I did lots and lots of research before my surgery. There are several

excellent papers published about the pros and cons of hemi -v- total

thyroidectomy. Unfortunately I can't find them now - don't know if I kept

them. They were published in American medical journals as I had to go

through the National Library in Australia to access them.

Fortunately I then saw a less " knife happy " surgeon who was agreeable to a

hemithyroidectomy and as a result I didn't have the big crash that so many

people seem to have post-surgically as I was still producing hormones. In

fact I was pregnant less than 3 months after surgery. I did start hormone

replacement but that was as a result of a bullying endocrinologist - to this

day I wish I'd never started it.

Elaine - there are " radical " surgeons and " conservative " surgeons and by

" conservative " I mean a surgeon who wants to save as much of your healthy

tissue as possible. If you only have cancer on one half of your gland then

" better out than in " is not necessarily so. If you have a hemithyroidectomy

you can also avoid RAI and retain functioning, healthy thyroid tissue. You

need to do a lot of reading, talk to several surgeons, consider your age and

all kinds of things before agreeing to a total thyroidectomy.

Total thyroidectomy and subsequent RAI *can* be simply an easy option on the

part of some doctors as then you're " cured " and you go away - but then you

start on the medication merry-go-round. Just my thoughts and experience.

Donna in Oz.

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