Thyroid nodules a year after rads?

AnnAlive

I've been hypothyroid for a few years and my PCP happened to order a thyroid ultrasound a couple of weeks ago. The results show multiple nodules -- called multinodular goiter. PCP wasn't so concerned that there are multiple nodes that are smaller, but one measures 2 cm (and he said greater than 1 cm is a concern for cancer). I've been referred to an ENT and probably will have that bigger nodule biopsied.

I completed 7 weeks of rads a little over a year ago. Browsing around I see thyroid nodules are usually benign. My radiation field went up a couple of inches on the left side of my neck and crossed the midline a bit, so I'm supposing it may have caused the nodules. No mention of nodules on my initial PET scan before treatment, but I'm due for another PET next month.

Experience with thyroid nodules anyone?

crabbiepattie

Hi Ann,

My RO said the radiation field that includes your collarbone and side of the neck causes some thyroid damage and might cause a need for thyroid hormone or more thyroid hormone for hypothyroid people. I didn't think to ask about the specifics of the damage or about nodules, but I'll bet you're right about your nodules.  I didn't have that area radiated after all, so I can't blame my nodules on that. I didn't find out about them until about a year after rads, though.

My PET scan did not mention any thyroid nodules, but my whole thyroid lit up because of auto-immune inflammation. Now you'll have the before and after PETs to compare.

Apparently multiple nodules are the norm, but multinodular goiter sounds like a considerable volume of nodules. Your 2 cm nodule is probably benign, but you need to be sure.  I had my one 1+ cm nodule biopsied - fine needle, not many nerves in the area - not bad at all.  It was benign but now I need an ultrasound every year to see how it is doing.

Hugs,

Pat

AnnAlive

I picked up my thyroid ultrasound report (and a DVD of the images to give the ENT). The report describes both lobes as "diffusely abnormal in texture" and the 2 cm nodule in the right lobe is described as a "dominant mass...predominantly hypoechoic and completely solid" and there are 2 other subcentimeter hypoechoic nodules. The left lobe has numerous hypoechoic nodules, the largest 1 cm with "a central calcification which shadows." Looking up these various terms is not very encouraging, but most thyroid nodules are benign, and I'll just have to wait for biopsy.

I am wondering how often surgery is recommended even if the most suspicious node is benign because they can't be sure with so many nodes.

I guess I could call my RO to ask if the radiation treatments on my neck/collarbone area likely caused the nodules so soon. I suppose the ENT should know too.

SheilaB330

I have Hashimototo's Thyroiditis, a goiter, secondary hyperparathyroidism and some nodule that my endocrinologist monitors - had 28 needle biopsies of it back in 2003. It really does not change size from year to year. Will be interesting to see if any changes.



My endocrinologist having me to panel of tests - Comprehensive Metabolic Panel, HbA1C (hyperglycemic low level diabetes) vitamin D Level, PTh, TsH and a Free T4. Then she'll repeat them and do ultrasound and bone density scan a couple of weeks post radiation completed.



I am not a doctor but year before cancer discovered, biopsy done on same breast although they were more concerned with areas of calcification which they biopsied. There was none in other breast that knock on wood doesn't have cancer. Have heard calcification can be dead cancer cells. Wondering if any similarity when in thyroid?



Call your endocrinologist as sounds like a fine needle biopsy would give your answers. here is a link answering what hypoechoic nodules means. http://www.everydayhealth.com/specialists/cancer/hensley/qa/what-are-hypoechoic-nodules/index.aspx

Good luck. Pathology reports always sound so nauseating and scary. Sheila

AnnAlive

Update - I did have the fine needle biopsy, and the specimen was insufficient, so results were inconclusive, although no cancer was noted. At the clinic where I had the biopsy, I was told my ultrasound from the doctor's office was poor quality; the radiology tech couldn't find the main hypoechoic nodule that had been reported, so chose another small nodule, along with the one with the calcification. The ENT decided I can wait 6 months for another ultrasound. Nothing else was done at this time! The ENT also said that it would take years for radiation therapy to cause thyroid cancer. I don't think my thyroid nodules are a worry at this time.

kingjr66

I too have been diagnosed with several thyroid polyps (6 of them, 3 over 1cm).  My biopsy is scheduled for February 5th.  Even though most of us have had radiation for our breast cancer, this may not be necessarily the cause of these thyroid polyps/nodules.  Thyroid cancer usually does result from exposure from radiation.  How many of you have had dental xrays through the years?  I know with me they are too numerous to count.  Now when you go to the dentist they place the lead bib on you all the way up to your jaw (if they don't, make them).  I also grew up within one mile of a nuclear power plant that has been leaking radiation into the air and river for many years but they still will not shut it down.  I believe my cancer, as well and my mother's and my aunt's breast cancer are related to the plant and my mother and niece have had thyroid cancer.  All of us within reach of the nuke plant.  Don't even get me started on the further statistics I have researched on breast and thyroid cancer within 10 miles of the plant.  Too alarming for me.  I still have not done enough research on the topic of thyroid cancer from breast cancer.  However, I would put my money on my breast cancer coming from thyroid cancer.  I will not know further if in fact it is cancer but I am aware that if you have multiple polyps this is a good sign that they will be benign.  Thyroid cancer is usually just one nodule, not multiple ones.  And thyroid cancer is very curable.