Thyroglobulin Update

What is Thyroglobulin? I'm glad you asked. It is the form that thyroid hormone takes when stored in the cells of the thyroid. If the thyroid has been removed, thyroglobulin should not show up on a blood test. Doctors measure thyroglobulin level in blood to detect thyroid cancer cells that remain in the body after treatment.

The normal range for serum thyroglobulin (Tg) is 0 to 30 ng/m. In early 2005, my Tg was 789 and rose to 1,050 after the thyroid was removed on 04/15/05. In May my Tg rose to 1,119 and then as high as 5,200 before my neck dissection in June. Three weeks after my neck dissection, the Tg fell to 540. A month following my radio-iodine treatment (July 2005), the Tg dropped to 249. In October, the Tg dropped to 200. Just last month, my Tg dropped to 116!

It's encouraging to see the Tg continue to fall. However, any Tg is an indicator that I still have the cancer. Since I now have no thyroid, my Tg should be zero. An average Tg range is 10 to 20 for someone who has a thyroid.

Based on the results, my next treatment will probably be sometime in May. The date is still being coordinated with the nuclear medicine department at Washington Hospital Center. I'll post the schedule once I receive it.

Thank you all for your continued thoughts and prayers.

Inspirational Scriptures

The following Bible verses were really a help to me during this journey. I'm thankful I have the Lord Jesus Christ to carry me through this trial. Without the Holy Spirit as a Comforter, I cannot imagine going through cancer. I have peace knowing where I will spend eternity when I die.

I've included the dates of when I came across these verses, which you can relate to the time of my surgeries/treatment.

7/8/05 - Philippians 4:6-9
Be careful for nothing; but in every thing by prayer and supplication with thanksgiving let your requests be made known unto God. And the peace of God, which passeth all understanding, shall keep your hearts and minds through Christ Jesus. Finally, brethren, whatsoever things are true, whatsoever things are honest, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things. Those things, which ye have both learned, and received, and heard, and seen in me, do: and the God of peace shall be with you.

7/1/05 - Matthew 6:19-21
Lay not up for yourselves treasures upon earth, where moth and rust doth corrupt, and where thieves break through and steal: But lay up for yourselves treasures in heaven, where neither moth nor rust doth corrupt, and where thieves do not break through nor steal: For where your treasure is, there will your heart be also.

7/1/05 - Psalm 61:1-4
Hear my cry, O God; attend unto my prayer. From the end of the earth will I cry unto thee, when my heart is overwhelmed: lead me to the rock that is higher than I. For thou hast been a shelter for me, and a strong tower from the enemy. I will abide in thy tabernacle for ever: I will trust in the covert of thy wings. Selah.

06/22/05 - II Corinthians 1:3-4
Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; Who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God."

06/15/05 - Isaiah 40:29-31
He giveth power to the faint; and to them that have no might he increaseth strength. Even the youths shall faint and be weary, and the young men shall utterly fall: But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint.

05/27/05 - Philippians 4:13
I can do all things through Christ which strengtheneth me.

Radio-Iodine Treatment Effective

The radio-iodine treatment continued to take effect months after the dose was administered. The tumors have shrunk in my lungs, and there are less of them!

It looks like my next treatment will be in May or June 2006. The treatment intervals have to be spaced apart about 10 months, otherwise the bone marrow and white blood cells could be suppressed too much.

Thyroid Cancer Prognosis

There are various prognosis staging methods for thyroid cancer. Following is my prognosis using the three different methods:

MAICS - 20yr Survival Rate 56%
TNM - Recurrence 7%, Mortality 11.6%
AMES - High Risk, 46% Mortality

According to another source, the 5 year survival rate is 48%.

One thing going for me is my age (under 45), but the distant metastases to the lymph nodes and lungs doesn't help.

Radio-Iodine Treatment 07/07/05

On 07/07/05, I received a 100 mCi dose of I-131 radio-iodine via capsule. I was held in a lead-lined room in isolation for 30 hours before being cleared by radiation safety. Basically, they measured my radiation levels with a geiger counter before releasing me.

Once I was released, I was told to keep a safe distance from people for 3-5 days and to especially stay away from young children and nursing mothers. This was difficult, as my children were ages 5 and 7 at the time. I didn't want to expose them to unnecessary gamma rays though, so I stayed in the family room (basement) for the next week.

Bilateral Modified Radical Neck Dissection 06/01/05

On 05/23/05, I received my first Thyrogen injection to increase my TSH levels. The dosimetry process officially started on 05/25/05, when I received my first dose of I-131 radio-iodine via capsule, 2.2 mCi. The dosimetry scanning commenced that afternoon and continued Thursday and Friday. Based on Friday's imaging (05/27/05), there was a new development.

The radio-iodine scanning shows where any thyroid tissue or tumors are present. The tests confirmed that the tumors were present in my lungs AND in the lymph nodes in the neck. Since the cancer was in the lymph nodes, the lungs would not receive the necessary radio-iodine treatment without first having the lymph nodes removed.

I left the hospital on Friday, 05/27/05 at 12:00pm, and received a call from my doctor before arriving home that I would need Bilateral Modified Radical Neck Dissection. In preparation for the surgery, my doctor had already arranged an MRI for the following Sunday and an Ultrasound on Tuesday. The inpatient surgery was scheduled for the following Wednesday, 06/01/05.

The surgery took much longer than expected, as the surgeon was having to slice through scar tissue from the thyroidectomy, which took place two months earlier. I remained in Phase I recovery for several hours as my heart rate was extemely high.

The pathology report on 06/15/05 indicated that 17 lymph nodes from the neck and sternum and 2 tumors removed from trachea were positive for papillary carcinoma.

Referred to World-Renowned Thyroid Cancer Expert!

My Oncologist referred me to Dr. Leonard Wartofsky at Washington Hospital Center in D.C. Following is what THYCA has to say about him:

Dr. Wartofsky is a past president of the American Thyroid Association and was the 2001 recipient of the Distinguished Educator Award of The Endocrine Society. His specialty is endocrinology, and he is a world-renowned authority on thyroid disorders and thyroid cancer. He has published over 300 articles or book chapters in the medical literature, and is editor of the medical textbook titled “Thyroid Cancer: A Comprehensive Guide to Clinical Management,” and the co-editor of the patient and caregiver reference book titled “Thyroid Cancer: A Guide for Patients.”

Total Thyroidectomy 04/15/05

The next step in this journey was to have my diseased thyroid totally removed. But first I needed to recover from the open lung biopsy. The surgeon who performed the open lung biopsy said he had also performed total thyroidectomy surgeries in the past. I opted to use the same surgeon, so on 04/15/05 I was admitted once again to the hospital. The hospital stay for the open lung biopsy was 5 days compared to the thyroidectomy which was only 2 days. Both surgeries were a success, but left me a little sore, tired, and weak.

The pathology report came back ten days following the thyroidectomy. According to the report, I also had stage II Follicular Carcinoma, a second type of thyroid cancer.

Open Lung Biopsy 03/15/05

On 03/15/05 I was admitted to the hospital for my first surgery in this journey. Two days later, while in the hospital with a chest tube, I was informed I had Papillary Carcinoma, a form of Thyroid Cancer. I was puzzled how thyroid cancer would be in my lungs. A short time later, an Oncologist met with me in the hospital room. I asked what stage of thyroid cancer I had, and he indicated stage IV. My next question was how many stages are there? He told me there are four stages. He added that this type of cancer is very treatable, but that didn't ease my concerns too much at the time. He then said that if one was to get cancer, this would be the best kind to get. This is because thyroid cancer is well-differentiated, and many have been cured through surgery and treatment.

The Journey Begins 02/20/05

In February 2005 (one month after my 27th birthday), I developed pneumonia-like symptoms and went to the doctor after a few days of very high fever (103+), night sweats, and chills. The doctor tested me for flu, but the results were negative. He listened to my lungs, and said I did not have pneumonia. However, something didn't sound quite right.

To be on the safe side, the doctor sent me to radiology for a chest x-ray, and told me he'd call the next day with the results. Once the x-ray was taken, it seemed the nurse forgot about me. I waited for a long 10 minutes or so, and finally she returned and said the doctor wanted to see me right away. She told me "good luck."

I went back upstairs to the doctor to find out what he needed. It turned out there were hundreds of small nodules over both lungs. He didn't know what they were, and tested me for TB and Melanoma. Both of these test results returned negative.

I was referred to a pulmonary doctor, who asked if I had an earlier chest x-ray for comparison. Well I hadn't been to a doctor for 10 years, as I rarely got sick growing up. He was unable to determine what the nodules were, even after ordering a CT Scan. The doctor said I would need to undergo an open lung biopsy.