Fine Needle Biopsy Results

Yesterday was my scheduled appointment with the endocrinologist to hear the results of the fine needle biopsy that I had on May 20.

The appointment was scheduled for the late hour of 4 p.m. I don't recall ever being scheduled for such a late time-frame even when I was still being evaluated for problems that lead up to my endometrial cancer surgery. I was the only person who got off from the bus when it stopped at the hospital and the waiting room was nearly empty when I got to the section for endocrinology. As the minutes ticked by I eventually found that I was the final person in that massive area and even the staff at the reception desk was picking up and leaving as it neared 5 p.m. But, eventually I did get buzzed back to the inner waiting hall where there were actually a couple of other patients waiting. It was around 5 p.m. then. But, as more time ticked by I was the absolutely final person there and a nurse had even popped out of the exam room and removed her name from the board.

The time spent with the Dr. when I was finally called in was fairly short. She seemed a bit flummoxed on how to speak with me. But, I hadn't wanted my husband to come along as I didn't want to be diagnosed with what I term the "Pet at the Vet Syndrome". That's when a Dr. sees my native speaker of Japanese spouse and then suddenly I get sidelined and must mutely sit there while everything is then directed at my spouse as if I can't speak for myself. That can be really annoying and frustrating as he has a tendency not to pay much attention to any of my medical issues and really doesn't understand what's going on so he isn't a good advocate for me at all!

Anyway, for me, the result was the worst one possible. The results came back "inconclusive". The Dr. said that in 85% of cases a clear diagnosis of benign or malignant can be made with the fine needle biopsy but in 15% of cases the verdict isn't clear. That is basically the same as what I'd read online. She said that thyroid cancer grows slowly so I can probably decide to have surgery soon or wait another 6 months to a year. Anyway, she said that it's the thing I'll need to discuss with the Ear, Nose, and Throat Dr. (ENT) on Monday.

I've needed some time to read up on just what an inconclusive result means and why surgery is warranted. As I understand it, in the case of Follicular neoplasms or Hurthle cell neoplasms they can only be diagnosed after surgery when the entire tumor has been thoroughly examined under the microscope. The major problem is that in about 80% of cases it will prove to have been benign and only 20% of cases will be malignant. So 80% of these patients will have undergone a surgery that removes either their full thyroid or 1/2 of their thyroid and will then need thyroid replacement for the rest of their lives! Goodness gracious how behind the times is that?! I've been reading online about new developments in gene testing to improve the chances of a better diagnosis before such a drastic surgery and that certainly can't come fast enough for me, I'd guess!

I've also been reading online about radioiodine  treatment post-surgery if the tumor proves to be malignant. It sounds really miserable as I won't be able to have contact with children (i.e. my grandkids!) for a certain time period, I could set off radioactive detectors in airports so can't fly for awhile, have to use separate utensils, can't cook, need to double flush the toilet after use...

So, Monday is the day I'll hear what the ENT Dr. thinks about the next steps. This weekend I'll need to think about life planning over the coming year to decide when might be the best time to go ahead with surgery and post-surgical treatement with radioiodine if need be.

I've had an appendectomy and that surgery was a "no brainer". I did have to go into my hysterectomy not knowing for certain if the atypical cells had progressed to cancer yet or not. I remember feeling relieved when I did hear that it was cancer as then it felt like a reasonable justification to lose my uterus, fallopian tubes, and ovaries. But this?! Two months ago I thought I'd be getting a "routine" CT scan as standard follow-up for my endometrial cancer to mark 3 years post-surgery. I certainly never expected this strange outcome.