Today I met with a Radiation Oncologist by the name of Dr. Mudge in the Battle Creek Cancer Center. I was blown away by the attentiveness and care of everyone. Both the nurse and Dr. Mudge took their time explaining all of the details of my treatment. I spent almost an hour with Dr. Mudge alone. He patiently answered every question I had.
The next couple weeks:We’re in a waiting game right now. We’re waiting for my body to deplete all of the thyroid hormone left over from pre surgery and the few days of replacement after surgery. I have been off the hormone since 2 weeks ago today. When the thyroid hormone is depleted, my pituitary gland will start making more of a hormone called TSH (Thyroid Stimulating Hormone). The reason this needs to happen is to over-stimulate any remaining thyroid cells and any possible metastasis of the cancer. The over stimulated cells will soak up the radioactive iodine and be destroyed.
I had my blood tested to get a baseline for TSH today. We need the level to be over 50 to have radiation treatment. This takes on average 4 weeks. Based on how I was talking and asking questions, they thought my TSH levels were still pretty low. Even though I’m feeling some fatigue and mental dullness, apparently the best is yet to come.
So although the magic number is 50, we will do another scan when my TSH levels reach 30.
This scan will require me to take a small dose of the radioactive iodine. This will determine how many remaining cells are still active and if they are cancerous. This will also help Dr. Mudge determine the dosage of radiation so not to over radiate.
The radiation treatment:Taking the radioactive iodine will be a non-issue. It comes in the form of a pill that they administer with lead gloves and on a lead plate. I take it, wait an hour, then I can go home. The issue is managing being radioactive. The first two days are more strict, but I’ll need to stay away from the kids for 5 days. Other than staying away from people, during this time I’ll need to do things like eat with disposable plates and silverware, use a sequestered restroom, not prepare food for myself or others, and eat lots of ice cream (at least I thought that’s what he said).
Two days into the radiation treatment, I can begin taking my thyroid hormone replacement so to get back to myself ASAP. They said it takes at least a couple weeks until it establishes itself and I start feeling normal again.
7-10 days after the radiation treatment, I’ll need to have another scan. Since I will have a much larger dose of radiation, this scan will show anything that the prior scan potentially missed. It will also determine if the radiation treatment was successful.
6 months down the road, we’ll do a third scan to make sure there are no active thyroid cells. If so, I’ll need a second dose of radioactive iodine. If not, we will start a regimen of a yearly scan to make sure it doesn’t come back.
What about the lung nodule?
Since the PET scan was inconclusive, it is still a concern. The first scan (next couple weeks) should determine if those are cancerous cells, if not, the second scan (post radiation) will. Unfortunately, if we see it on the second scan, a second dose of radiation is mandatory. All of these tests are in an attempt to limit the amount of radiation I must take. This is a good thing since many centers just treat with a sledgehammer dose of radiation.
What about the pathology report?
The pathology report came back mentioning two types of cancers being found in my thyroid, papillary and follicular, but neither in the large 3cm nodule that inspired this whole escapade. Dr Mudge said that it’s not uncommon for these two types of cancer to be found together. Treatment is still the same.
Special diet?I loved how well read this team was. He actually encouraged me to stay on my normal diet and didn’t recommend a low iodine diet like many endocrinologists because of studies that had been done that actually showed that absorption of radiation was much higher in other (non-thyroid) cells throughout the body because the body was iodine depleted. I guess that makes sense.
All in all, I can’t be happier with my new treatment team and their care. I am feeling as good as can be expected and feel encouraged by the treatment plan.
I can’t express how grateful I am to have friends and family that have been so attentive and supportive through this entire period. My work family has absolutely stepped up to support me in an extended recovery period making this entire experience bearable and comfortable. I don’t know how I would have been able to keep pace during this time. I have been able to focus on important things. I’ve spent time with the kids, read books, and began working on my genealogy. In just a short time, I was able to take research that my parents have done and trace my family roots back to the 1500’s in Europe on several lines.
I am blessed.
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