Which do you want first?
Just kidding, you don’t get a vote. You get the bad news first.
As if the universe hasn’t kicked me in the balls enough these past few years, I’ve just found out that I have thyroid cancer.
Fuck.
I had an MRI back in March for my MS (as I do every 6 months or so), and upon examining the images of my neck, an attentive radiologist spotted a nodule on my thyroid gland. It was totally by chance that it was discovered. I was sent for an ultrasound, which is pretty routine when strange lumps appear in/on body parts, and based on that look-see, was sent back for a fine needle aspiration (FNA) biopsy, a procedure that involved a trained medical professional stabbing me in the throat four times with a needle that she insisted was “tiny” but, I submit, WAS STILL A NEEDLE STABBING ME IN THE THROAT. It was…unpleasant. Basically the opposite of this:
The FNA was on May 13, and after that, I honestly kind of stopped paying attention to whatever was going on in my gullet. But then, on May 29, I got a phone call from my doctor, which is never a good thing. As one friend rightly observed, when there’s nothing wrong, they send your results in the mail; when it’s bad news, they call you. The doctor told me that the results of the biopsy showed that the nodule was malignant.
So, that’s the bad news.
Fortunately though, we can quickly take a U-turn and start heading back toward Goodnewsville right away. It turns out that, if you had to get cancer, thyroid cancer is a pretty good one to get. Which is such a weird thing to say, but here we are.
The type of cancer that has taken up residence in my neck hole is called papillary thyroid carcinoma, and of the four main types of thyroid cancer, PTC is the most common (about 80% incidence), is almost always asymptomatic (true here…I wouldn’t have known anything was wrong if it hadn’t shown up on the MRI), is highly treatable, and has a 98% cure rate when caught early (as mine was) and treated appropriately (as mine will soon be). Put simply, it’s the basic bitch of thyroid cancers.
Let’s briefly hit pause for a little anatomy lesson about your thyroid, because I’ve learned a bunch about it and you should too. The thyroid is a butterfly-shaped gland located in the front of your neck, just under the skin’s surface, warmly embracing your windpipe. You have one thyroid gland, though you’ll sometimes hear the terms “right thyroid” and “left thyroid,” which, understandably, may lead some to think that there are two of them. There aren’t, just two distinct sides (lobes); those are the butterfly’s wings. The thyroid gland has one job: to produce thyroid hormone. Thyroid hormone traipses all over your body, regulating your metabolism (i.e., the body process that converts oxygen and food into energy, or, if you’re over the age of 30, that thing that you wish still burned as hot as it did in your 20s). So, it’s kind of a key player. If you want to learn more about the thyroid—and who the hell wouldn’t?—this site breaks things down very well.
Okay, back to me. Because that’s why you’re here, really. What’s next for ol’ EDB?
The treatment for papillary thyroid carcinoma is old school: we’re just gonna cut that fucker out. No chemo needed, just surgery of the -ectomy variety.
Enter: Dr. Rafii, the ENT surgeon to whom I was referred. Michael and I were able to meet him just a couple of days after the diagnosis, and he seems great (though I suppose I don’t know how I’d tell if he wasn’t…). He went to medical schools I’ve heard of, he has done this type of surgery many, many times, he patiently answered our myriad questions, and he laughed at my dumb jokes about not wanting to put my thriving karaoke life in jeopardy with risky procedures taking place near my vocal cords. So in summary: I feel a-okay about letting him slice open my throat sometime within the next month or two.
According to Dr. Rafii, if a tumor is 1.5 cm or smaller, they’ll usually only remove the part of the thyroid gland with the nodule on it. This is called a lobectomy, or a hemi-thyroidectomy. Tumors that are 4+ cm almost always necessitate a full thyroidectomy. Anything in between is approached case by case.
My tumor is 3.4 cm (~1.5 inches), perched on the right side of my thyroid gland. Michael and I have named it Papillary “Pappy” Van Stinkle. And before you say, “Erin, what are you doing naming your tumor? Once you name it, you start getting attached to it!”, rest assured that this is just my silly coping mechanism and I will have no problem Harry and the Hendersons-ing the little asshole when the time comes.
So yeah, for me, Dr. Rafii is leaning toward removing the whole thyroid, since Pappy is approaching the 4 cm size, and on the ultrasound, its shape/borders appeared to be a little unruly. In other words, it’s not a nice, neat, well encapsulated lil’ tumor, and its sloppy composition means it’s possibly more likely to have allowed some nasty cancerous cells to escape into the nearby tissue.
So that’s probably what we’ll do. A full thyroidectomy will mean an overnight hospital stay, but life should return to normal pretty quickly after that. Plus, I’ll have a badass neck scar, which should earn me some serious cred on the mean streets of Redondo Beach. So I got that going for me, which is nice.
If, after the surgery, there is evidence of, or concern that, any cancerous cells might have been left behind, or might have escaped and gone all Richard Kimble elsewhere in my body, I’ll also need to do a round of radioactive iodine (RAI) treatment, which is bananas crazy and fascinating. Here’s the scoop and I’m gonna tell you: evidently, thyroid cells are the only cells in the body that will absorb the element iodine. We all take in harmless amounts of harmless iodine from various foods and environmental exposure without even noticing. But, if your thyroid disrespects you, its unique relationship with iodine can be used against it.
You wanna kill some thyroid cells, here’s what you do: consume a radioactive form of iodine which, when absorbed by the offending thyroid cells (well, any thyroid cells, really), will basically nuke them out of existence. Treating cancer with radiation isn’t that unusual, but in the case of RAI, when you ingest it, YOU become radioactive for a few days. Like, mediocre Imagine Dragons song radioactive. Like, doctor has to check you with a Geiger counter radioactive. Like, don’t go within 6 feet of small children or pregnant women radioactive. Like, Chernobyl but on a much smaller scale radioactive. THAT radioactive. But it’s, like, healthy for you. If you need to kill off thyroid cells. Which I might have to do.
Oh yeah. I also still have MS, and she’s been a little bitch this year too. But I won’t get into that now.
Soooooo….that’s what’s going on with me. How are you?
(I started this blog after my MS diagnosis 3 years ago as an easy and efficient way to update people about the update-worthy goings-on in my life. This qualifies, I think. For whoever is interested, I’ll keep you posted here. Much love ~EDB)
