Tuesday, April 19, 2005

Medullary Thyroid Cancer with Low levels of Calcitonin years after the Surgery.Where is the cancer located?

Many patients have cancer marker for medullary thyroid cancer, years after the surgery. PET Scanning, MRI, CT, and Iodine scanning are usually negative. Where is the cancer?
A 52 Y/O female, 10 years after total thyroidectomy for medullary thyroid cancer sees me for a second opinion.She has a calcitonin of 35. Her pre-surgery calcitonin was 11,234. She knows she still has some cancer, but she is disturbed, that physicians can't find it. Also, she has a mother with the same disease. However, she is afraid to have her kids screened for the disease, because she is worried, they wont be able to get medical insurance, if they are found to have the same cancer. Her neck examination was negative except for a thyroidectomy scar. However, I was able to find, with the new high frequency Italian Ultrasound, several abnormal tall nodes in Zone 4 lateral to the thyroid bed,that had the findings of suspect cancer nodes. Using modern ultrasound methods, a biopsy of the largest node was performed, and washings from the aspirate from the node was positive for calcitonin. The patient is having a lateral neck lymph node surgery soon. As for the 6 children, who have not been sceened for cancer, they have set up appointments for DNA studies to see if they have the gene for this cancer. If they have the gene, and are treated by total thyroidectomy before the cancer occurs, they will be cured, and will never have the cancer at all.
They will be able to have medical insurance coverage, as the diagnosis was pre-cancer.The ones with the cancer will be picked up early with the best prognosis for long term survival.

Remember,if you have cancer marker for thyroid cancer, thyroglobulin TG, or Medullary cancer marker, calcitonin, and all the studies are negative, you need a complete neck cancer lymph node evaluation by a thyroidologist with high frequency ultrasound equipment, to look for the location of your residual metastatic cancer, which is surely there in the neck.

Check www.thyroidologists.com, for one of our thyroidologists near you.


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