Today I had my one week follow up appointment with the surgical team. Other than being a little hoarse and a bit tired in general I'm feeling pretty good today. The head surgeon said to give it another three week for my voice to recover and to let them know if it's not healed by then. He also said that the "lump in my throat" feeling would go away as the swelling continued to reduce. Sometimes it feels like something pressing down on my throat so I can't swallow right, breathe well, or talk at all.
Gross details (skip to next paragraph if you're squeamish): He said the incision looked great but he wanted me to work on getting the scab to come loose by cleaning it with hydrogen peroxide and applying some lotion to soften it up. Normally it would have come off already but since I started getting a rash from the topical antibiotic gel I stopped using it.
They also gave me a copy of the pathology report. They presented my case at a conference yesterday (my cancer is famous!) so they had the results sooner than usual. The report confirmed the diagnoses of papillary thyroid carcinoma along with a multinodular thyroid and mild chronic lymphocytic thyroiditis. The biopsy showed the original tumor as being 1.8 x 1.5 x 1 cm in the upper pole of the left lobe of the thyroid gland. The pathalogic stage was listed as pT1b pN0 which means a large stage 1 tumor with no lymph node involvement.
That being said, under "lymphatic/vascular invasion" it says "Present". The surgeon mentioned that due to presenting my case at the conference they have also already determined a treatment plan that will include radiation. Since none of the lymphnodes they biopsied showed cancer I can only guess that the invasion is vascular rather than lymphatic but I'll have to get clarification.
The other reason they may be considering the radiation is how close the tumor was to the surface. When they remove a tumor they try achieve a certain "negative margin" size but that's not possible in the throat because other than the thyroid the only other stuff in there is muscle and cartilage which can't be cut (unless it was a life-saving measure which it wouldn't be in this case). There was only 1 mm between the nodule and the outside of the thyroid which is too close for comfort.
The only other interesting finding was "vague nodularity" of the right lobe which could either have been due to the thyroiditis or have been the beginning of another tumor. There were also a couple of benign cysts but no one cares about those as it's natural for most people to gather cysts as they age.
The next step from here is to meet with the endocrinologist next Tuesday. He'll be taking charge of my care from here out. We'll probably talk about the radiation and all that is involved with that, as well as setting up a plan for lifelong treatment for my lack of thyroid hormones. As for me, I'm doing what I can to rest and recover even if it is a bit frustrating. I sat home on the couch all day yesterday after a very exhausting 30 minute trip to the grocery store the day before that. The spontaneous napping is becoming less frequent, though, and I'm hopeful that by next week I'll be pretty close to back to normal-for-me.
Thank you all for coming along on this ride with me! There is still a ways to go before the end, but the biggest, scariest part is behind me now.
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