surgery vs radoactive Iodine treatment

[Guest guest]

I have a small nodule which 2 biopsies were unable to get enough

cells to give any info. I was scheduled for surgery for lobectomy

when my preop blood work came back with a slightly low TSH. Now

doctor thinks nodule is hot and I'm slightly hyperactive. So I am

having I123 uptake and scan this week. They have given me the option

to have surgery or radioactive I131 treatment to treat this nodule.

I would really like to understand what the long term course is for

someone who has either of these treatment options. Anyone willing to

share what happens down the road, I'd be grateful to hear about your

experience. Thanks.

Ann

>

> I'm glad your friend will be pursuing a good doc stateside because

I'm

> really concerned over her current condition/treatment. The American

Thyroid

> Association (_www.thyroid.org_ (http://www.thyroid.org) ) will

have referrals in

> the Florida area; she should call ahead to make an appointment and

be sure to

> bring her lab results.

>

> As for the " general protocol, " I was hyperthyroid way before

becoming

> hypothyroid. At the time I was diagnosed with Graves' disease

(autoimmune

> hyperthyroidism), I was in a very severe, horribly symptomatic

thyroid " storm. " I

> agree -- it's way worse than being hypothyroid. I had three choices

of treatment:

> radioactive iodine treatment to " kill " part or all of the thyroid

gland,

> surgery to remove all or part of the gland, and a drug called, in

short, PTU,

> which is what I chose to do. It took a year and a half to get my

thyroid levels

> back to normal and, in subsequent years, I did have episodes of

> hyperthyroidism.

>

> If what your friend has is autoimmune hyperthyroidism (they'll

probably want

> to do a thyroid uptake and scan to see if all or part of her

thyroid gland

> is overactive), it's likely that she will become hypothyroid either

from RAI or

> surgery, or just because the thyroid gland has a tendancy to burn

itself out

> over time. This is what's happened to me. But the thought of,

somewhere down

> the line, becoming hypothyroid is not something to worry over.

What's

> important is that she get good, solid treatment and monitoring

from now on.

>

> Please keep us posted! I'll keep your friend in my prayers.

> Maureen Pratt

> ************************************** AOL now

offers free

> email to everyone. Find out more about what's free from AOL at

> http://www.aol.com.

>

[Guest guest]

>

> I have a small nodule which 2 biopsies were unable to get enough

> cells to give any info. I was scheduled for surgery for lobectomy

> when my preop blood work came back with a slightly low TSH. Now

> doctor thinks nodule is hot and I'm slightly hyperactive. So I am

> having I123 uptake and scan this week. They have given me the

option

> to have surgery or radioactive I131 treatment to treat this nodule.

> I would really like to understand what the long term course is for

> someone who has either of these treatment options. Anyone willing

to

> share what happens down the road, I'd be grateful to hear about

your

> experience. Thanks.

> Ann

>

>

There is a third procedure where they inject ethanol alcohol into the

nodule to destroy just the nodule.

Hot nodules tend not to be cancerous so you also have the otpion of

doing nothing and just monitoring them, but this would depend on

symptoms etc.

ATD's can help with symptoms although multinodule hyperthyroidism

tends to not go into remmission like Grave's so a lot of Doctors tend

to not use it other than to bring the thyroid numbers down to normal

range.

RAI is uptaken by the whole thyroid gland, it will destroy the whole

thyroid gland , and they would have to give you a large enough dose

to destroy the gland..

Surgery could remove the nodules and still leave you with most of

your own thyroid, so it would be possible to not need replacement

therapy but would really depend on locale and size of nodules as to

what needs to be removed.

I believe the Mayo clinic does the ethanol injections, I would

investigate that option, and I would also investigate the option of

doing nothing in hopes the nodules burn themselves out or disappear

over time. I know a lot of people have nodules and it just means

having them checked once a year for changes..

Have you had them biopsied? I know less than 5 % of nodules are

considered Cancerous and when it comes to hot nodules it is almost

unheard of.. but being hot nodules they will operate independant of

the TSH and can cause symptoms of Hyperthyroidism.

I think it is more of getting a full idea of the whole picture and

what is involved, locale etc. before deciding to make a decision..and

your doctor can use ATD's to control the hyper symptoms until you are

confident with what ever decision you make.

Kats3boys