Monday, January 4, 2021

Living with BRCA - Thyroid Cancer


In early October 2020 my endocrinologist performed a needle biopsy of a bump on my thyroid. The bump (nodule) was found originally by by my PCP, Dr. Anuradha Rangarajan during a semi-annual BRCA physical examination in 2016. Dr. Rangarajan referred me to a thyroid specialist named Dr. Dean Blevin. Dr. Blevin performed the first biopsy and the results were "inconclusive due to insufficient sample tissue." Dr. Blevin and I discussed it and because I had no other symptoms, we agreed to treat it as non-cancerous. We met every six months to check the nodule and he performed an annual biopsy each October. Dr. Blevin moved away in 2019 and Dr. Kerem Ozer took over my case. It was Dr. Ozer that performed the October biopsy for 2020. About a week afterwards, he called me at 8:00 PM to say I needed to see a surgeon.

I made an appointment with Dr. Bridget Brady.

Dr. Brady used a high definition ultrasound machine to view the nodule and surrounding tissues. She pointed out that a lymph node appeared to be cancerous and is laying on my juggler vein. She said I needed surgery as soon as possible and that dissecting the lymph node(s) would not be trivial. In addition, it could take up to 90 days for my voice to return after the surgery.

According to an interesting publication by Comprehensive Cancer Center at UT Southwestern, men and women who have a BRCA1 or BRCA2 mutation may also be at increased risk for colon cancer, thyroid cancer, melanoma, and pancreatic cancer. (2013)

I checked into the hospital on Friday the 13th of November in the year 2020. It's a good thing I'm not superstitious. 

The surgery lasted a little over 3 hours. The entire thyroid and surrounding lymph nodes were removed. The pathology reports indicate the borders were clear of cancer and that's a good thing. However, I still need a radiation treatment to ensure all thyroid cells are killed. The radiation treatment usually happen 3 or 4 months after surgery.

There are a few steps I need to accomplish before the radiation treatment. First is a NO iodine diet for two weeks before the treatment. That includes all dairy, soy, and salt plus many other things I like to eat. I was told to follow the instructions at https://www.thyroid.org/low-iodine-diet/. Then 2 days before the treatment, I get a shot that makes my body more receptive to the isotope. The next day I get another shot. Finally, on treatment day, I take the pill and then go into complete isolation. No one can be in the same room as me for about a week.

I have a former co-worker that went through this several years ago. The fellow he shared the office with, brought in an old Geiger counter, so we could measure the radioactivity. We discovered that after 3 or 4 days, the radiation drops to an acceptable level for mingling with others.

I wonder if there is a way to make a small nuclear power plant for my house while I'm radioactive?

The incision site is healing well but part of my right jowl is numb. I assume there is some nerve damage or the swelling is pushing against the nerve bundle. I just hope it's not permanent. I cannot wear shirts with small collars, like most T-Shirts. One good thing about the pandemic, we don't get a lot of visitors at our house. So I can wear my collarless night shirts all day long.

Please tell me about your experiences with cancer in the comments section. I would love to hear from you.

charlie@livingwithbrcamutation.com


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