Rising Tg again, seems up by over half, should I be concerned?

I had my thyroid out due to papillary cancer in 3/2004, after I had two Radioactive Iodine treatments.

I have some quetions about my blood work:
10/2004 (non stimulated): Tg .2. That's the only one I looked up for that date
05/22/2012 (non stimulated): Tg .5
08/08/2012 (on Thyrogen shots): Tg .5
08/21/2013 (non-stimulated): Tg 1.3

From my previous posts it seems lilke the Tg rise in 8 years wasn't a big deal.

However it seemed odd to me when I got my numbers yesterday and the number had tripled.

I know Tg Antibodies is more the one you need to look out for as far as cancer goes, but I also know we are watching for ANY thyroid tissue...

I have my Tg Antibodies numbers if that helps as well.

Edited August 22, 2013 at 1:39 pm

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What is your TgAB level? I'm very surprised you have any after 9 years. I would be guarded and watchful and have an ultrasound for a possible new baseline for you. On one hand, there might be the possibility that the recent advances (since 2011) in Tg detection could account for some of the slight rise. On the other hand, from what I have seen on this board, tiny rises like that can be a signal that something is up, but it is likely that it is too small to be detected on any scans at this point. I hope it is just an anomaly from antibodies, which my endo said "do whatever they want" and can be an indication of inflammation elsewhere in the body. It stinks to worry and wait.

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Tg anitibodies:
05/22/2012 (non-stimulated): <20
08/08/2012 <20
08/21/2013 (non-stimulated): <.09

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Hi Ren, although your TgAb is good, I would definitely want a thorough U/S of the neck. If anything is even slightly enlarged I would request a FNAB with Tg wash-out (important to get that).

I had surgery and RAI 131 in March and May of 2012. Everything was fine until 6 months later. My U/S revealed a miniscule increase of size of a lymph node. We watched and waited as my Tg was still undetectable. Then, 5 months later, the lymph node stayed the same size bu my Tg went up a mere 5/10 of a point (from 0.2 to 0.7). That was enough to warrant a FNAB with a Tg wash-out. Tg in the LN was 7339. I had a 2nd surgery to remove that chain of 11 LNs in May, 2013. Thyca was found in one other LN. This week I did the thyrogen for stimulated Tg testing, swallowed 4 pills of RAI 123 tracer and today I go for my follow-up scan and possible RAI 131 ablation.

You have gotten this far, look into this further!
Prayers!

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Thank you Celestial,

When I went to see my doctor (the day he ordered bloodwork) he asked me "what I knew about my cancer". And I answered "it's gone".
He then let me know that I wasn't exactly right. He said we could call it in remission but that the last results (not sure if he meant bloodwork or scan) indicated there was probably some thyroid activity that could be cancer or just thyroid tissue.
But he said he would also not put me through a scan this year.
But all that was before the bloodwork.
What I hope he will do is order and U/S of my neck again and then decide what should or should not be done.

I called the office yesterday to see what the doc thought of my bloodwork. Hopefully his nurse will call me back today.

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remember, it's friday...they close medical offices early. i would call again and leave a detailed message and ask for the dr to call you back, not the nurse. we (thycas) should not ever have detectable Tg. all of our Tg cells (cancerous and non-cancerous) should have been ablatied with RAI 131. if it shows up then that means they need to find out why and where.

i find out in a few hours if my stimulated Tg is detectable and if there is any new uptake on the RAI 123 scan :( getting very nervous, sick feeling :p

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Yeah, I doubt calling back will do me any good...but I guess it's worth a shot. I'll try in 10-15 minutes when they open back up after lunch.

I'm sure your nerves are absolutely SHOT!

Sending Prayers your way.

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thanks! i just had the scan. they took extra pics. he said it was standard...for who? people that have something suspicious? waiting for rad dr and endo to confer and then meet with rad dr. i would think they would have let me go if everything was alright.

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Well the nurse called and said the doctor had ordered her to set up following (which she will be calling me for soon):
Ultrasound
Stimulated TMS Scan
PET Scan


OH JOY...I never had a PET scan until last year and when they did they found a breast mass...turned out to be a fibroadenoma (benign) so "no big deal" but lots of fun stress. Now I also get to have regular mamms (even through I am "only" 38) and with my mamm a couple months ago they were watching two other lumps which look to be cysts...but hey I guess another PET scan will give us a better look at those too...



Now begins the waiting game for the tests to be scheduled.... Last time it took MONTHS to get the tests all in....UGH

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Beingcelestial, I am praying for good results, keep us posted. You are such a courageous person. What is FNAB with TG wash-out? A friend of mine had a Mapping Ultrasound which is supposed to be more sensible and accurate than a regular Neck Ultrasound? Have you heard Mapping Ultrasound?
Big Hug,
Rosie

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hi, rosie! well, i posted the results separately but in a nut shell the rad. dr. said NED-no evidence of disease...but that is b/c nothing lit up on the RAI 123 WBS. i guess i should be happy but my stimulated Tg was 0.9. they said that is normal following thyrogen or going hypo. if it was a concern it would have to be above 5. hhmmm, says me in my ever thinking and questioning head...i am BRAF+ so it might not show up on the WBS. my endo told me before that in order to get a FDG/PET scan the Tg would have to be at 10 (unstimulated, i think).

i can't believe the endo never called me after the scan on friday...esp. after i left a message for her. i don't know when the next Tg panel is to take place after stimulated test...anybody know? is it normal to have slightly elevated Tg after stimulation? how long does it take to go back down?

FNAB is fine needle aspiration biopsy. Tg wash-out is when they process, save and test the residual cells from the biopsy that are left in the syringe, instead of just discarding it.

i will ask about the mapping as i'm not sure i had that. my 2nd surgeon did an internal U/S probing during the LND (2nd surgery).

all my tiny freckles/moles keep coming back atypical (could stay that way or turn into melanoma). one came back melanoma in situ stage 0. every time they come back atypical i have to get surgery to remove the layers .5cm wide and to the muscle. my arm is all stitched and bandaged:( i am grateful they are catching these (from one yearly skin examine, i go every few weeks for surgeries and biopsies of every dark freckle-like flaw. melanoma can be BRAF too. they supposedly can't do the BRAF test b/c the stage is too early. i think there is another genetic mutation going on. i wish someone would look at the whole picture.

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Beingcelestial, I was told that the stimulated TG is always much higher than the unstimulated. After your WBS what are your unstimulated TG and TGab results?.

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Stimulated is not always much higher. I'm guessing that means if you already have a positive Tg, even if it's very low like yours.

Why a stimulated TMS scan? I thought that was used to stimulate/manipulate a part of the brain cortex. It's not related to thyroid cancer at all. ??? Did he mean a stimulated TSH test? Hopefully, that would involve Thyrogen.

I hope the PET will be clear. I've read in the past that PETs can't detect thyca smaller than a centimeter. Not sure about that, though. Technology does change.

Wishing you clear information that will help. I was in that awful "don't know" phase for about 8 months and all turned out OK. I hope the same for you!

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@Ren, plead your case to whomever will listen (the schedulers/nurse) or try going somewhere different. that is ridiculous to have to wait long while dealing with cancer make sure you request/obtain copies of test results, cds, reports and store them in a binder. let us know how you make out. prayers!

@rosie, i just had the 1 + year RAI 123 WBS Friday (Aug.23). i don't know when the endo will want to do the next BW. prior to the stimulated BW the Tg was < 0.2 and the TSH was 1.6.

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I will have thyrogen for the scan and more bloodwork.

I kind of wonder if a PET scan is even necessay...but I guess they are just being cautious so I guess that's good?

At this point I almost hope they just find something so we know why the tg nunber keeps rising ,..I jist pray its something small and easily taken care of. Is that wrong?

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not at all! that is how i look at things now. E.g. i keep having to get biopsies of skin issues (see above). i am thankful they are finding all these atypical freckles b/4 they turn into more melanoma. of course i am a nervous wreck but it is what it is and i have to roll and fight. i do wonder though, why this is happening and how to stop it. i wish i could meet with a researcher or someone that looks further into the issue instead of just treating it. there has to be a reason. gosh, they can't keep cutting all my freckles out...but if that is what needs to be done, then so be it. i just want someone to dig deeper (no pun intended...well, maybe).

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I can only imagine. It does seem like NO ONE ever looks at the whole picture.

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i mentioned this-they usually don't do a PET scan unless the Tg reaches 10. (not sure if that is stim or unstim)

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Renfaerie: I'm so glad your TgAB is negative. I hope it stays that way. I have been through a six-month wait. Waiting is not easy. I hope you are able to continue with regular testing until you get answers. Sending good thoughts your way.

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A few thoughts on some comments on this post.

If you do have a positive TG reading unstimulated then the stimulated one could be on average 5 to 6 times higher. Of course if you unstim Tg is not detectable then I would assume that the stim one would also be undectable.

Being Celestial: you mentioned that you are Braf positive. Is it possible that may indicate that you are non-avid for RAI? Doing the Braf test on thyca seems to be a recent thing and perhaps the docs do not know everything about it? If they offer to do a Pet I would do it.

As for getting test results....the law says we can have them when we ask for them. When you have a test like Pet, scans, etc ask the tech doing it "when will the written report be ready for me to pick up"? Tey will make a note of your request and the report can come quickly...sometimes the same day. You do have to go in and pick it up.

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My ultrasound is today :-) glad to have the firat test in sight :-)

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