Thursday, March 15, 2007

Thyroid Cancer - Here We Go Again Preparing for RAI

Then it happened again. On April 15th, 2005 I went to my endocrinologist’s office for a check up and to get the results of my labs. My Free T4 was 1.0, TSH was .92 and Thyroglobulin was 34. I wanted to try to suppress my TSH to see what my Tg would be then because it is lower when suppressed but my Endo would not agree. My normal TSH was .1 or below and this was significantly higher. But like sheep I was herded onward to my third RAI treatment. I was told to go off my Synthroid the next day in preparation for the scan. I couldn’t believe it! Here I was doing all the right things and this happens. I asked my endo if it could just be a remnant of tissue that was not producing Tg and was resistant to iodine that now got healthy? Tg is produced by both healthy thyroid tissue and also cancer. He said not possible. I told him that I had done a liver cleanse, was exercising and had started a nutritional supplement program. He discounted my efforts and sent me on my way. Later I acquired the chart notes from this day. His comments were so far out of line. Obviously he has no clue what nutritional treatments are all about. If it doesn’t come from the Merck manual then he doesn’t think it works. Next are the notes from the doctor. I am sure he never thought I would see them.

Stephanie presents for re-evaluation of papillary thyroid cancer treated with near total thyroidectomy in two separate procedures on 3/01/00 and 4/12/00. She was given 103.3 millicuries of radioactive iodine on 5/26/00, and 150 millicuries of radioactive iodine on 01/19/01. The thyroglobulin decreased but never completely suppressed. Back on 11/30/04 the serum thyroglobulin was 11 with negative antibody on Synthroid .137 mg daily. Now on 04/15/05, the thyroglobulin was up to 34. The Free T4 was 1.0 and TSH was .92. The thyroglobulin antibody less than 1.0. Stephanie is feeling well. She states that she has started a new vitamin and “body cleansing regimen” and she states that she knew that through such “healthy measures” she would make any remaining tumor cells “more healthy” and she was very convinced that the thyroglobulin would increase.

Now let me interject here. How in the world do tumor cells become “more healthy”. Is he an idiot or what? The very nature of tumor cells is unhealthy. If they are healthy cells they are not tumor. I did not say this! I asked if there was tissue that became health and started to produce Tg when it had not been doing so previously. This is just like a thyroid gland that doesn’t produce enough hormone but when healthier it will produce more. I did not do a body cleanse but a liver cleanse. Was he even listening to me??? Back to the Chart Notes……

Examination of the neck shows no palpable thyroid tissue. There is no palpable cervical or supraclavicular adenopathy.

PLANS: I told Stephanie that we need to discontinue the Synthroid now. In one month we will check a TSH level. When it is greater than 50, I will refer her to “local hospital” Nuclear Medicine for an iodine 123 body scan. The results will be called to me and I will then treat with 200 to 250 millicures of radioactive iodine depending upon the results of the iodine 123 scan. We will re-start the Synthroid three days after this treatment and do a total body iodine 131 scan seven to 10 days later. The patient is to call me before the next appointment in four months if other concerns arise. We will recheck a Free T4, TSH and thyroglobulin tumor marker at that time.


He was going to administer a high dose of radioactive iodine but I would not see him for a follow up until 4 months after the treatment. Talk about throwing someone to the curb. I truly felt like this doctor and his staff felt like this treatment was a trip to a day spa with a vacation of 10 days to follow. It was completely inhumane.