thyroid cancer and lymph nodes

I have just had surgery to remove my thyroid on 5-16-11 and was cancer. I am now in the process of under going iodine radiation and get ready to get a body scan to see if it has spread to my lymph nodes or any where else in my body. I am very concerned with it being in my lymph nodes due to them being swollen for about a year now and even larger since the radiation process. Is this normal for them to hurt and be very swollen ( My neck is extremely swollen, huge double chin). Has anyone experience this or has anyone had the cancer spread to the lymph nodes and know anything about this subject?

Report post

7 replies. Join the discussion

Usually you get that information in your ppost surgery pathology report.
The doctor will take a few lymph nodes at that time and a couple days
after surgey you can ask to read it.
It will tell you the size of your nodule and what type of thyroid cancer you have.
If not in your lymph nodes ri is not usually given now.
Really press your surgeon or your endo for this report, so you can
monitor your own care.
You need to tell who ever is directing your care about this swelling.
Glad you found us.

Report post

Unfortunately the cancer can spread into the adjacent lymph nodes, and then onto the rest of the body through them. Press the Endo doc and the oncologist about the lymph nodes. Have them take more than less. Do biopsies on all of them and which ones were located where so they can tell you if it has already spread or if it is isolated to the thyroid bed and just those adjacent nodes. This will have long-term implications. My initial diagnosis was back in 1991, 20 years ago, but because it was already in the adjacent nodes next to the thyroid, over most recent years it has started to spread into other parts of the body. I had many good years without any problems, but it is now spreading. So don't let this slide. Pursue what it means for you. Best wishes.

Report post

Read Up-to-date on the internet about RAI. Dr. Tuttle explains the latest research. I had a double chin and swelling. The initial swelling will go down soon, but then I still had what I thought was significant residual swelling for a very long time. Other people do not have this. If I had it to do again, which I pray I never will, I would have learned about lympathic massage and whether or not it was appropriate for me. Also I would have learned about facial compression garments and found out whether or not that was appropriate. You can ask about these things, but don't do anything without doc's ok. Good luck. Get the pathology report. Read everything you can.

Report post

Redbird - "If not in your lymph nodes ri is not usually given now." This isn't actually a true statement...RAI is recommended even without lymph node spread for any nodule over 4cm and possibly for those 1-4cm nodules, particularly if they are not well encapsulated, and even more so if there is extrathyroidal extension. I didn't have lymph node spread but did have cancer growing outside of my thyroid - hence RAI.

Daisy - Usually only a few lymph nodes in the same neck compartment as the thyroid are removed during surgery, and tested for pathology - but they will only remove those that look suspicious. If they didn't remove any, probably non appeared suspicious while they were in there (my doc only removed 1 and it was negative). The post-RAI WBS should show uptake outside of the thyroid bed in lymph nodes if any of them are affected, although sometimes lymph nodes can be less RAI avid than the originally thyroid tissue - in which case your Tg numbers will be informative.

Report post

Yes. that makes sense.
I didn't think of tumor size, or other invasion.

Report post

My nodules was 1cm in size on the left and one cyst on the right the cells surrounding the nodules was positive for cancer as well. He removed the entire thyroid and I was not happy with the surgeon that I was referred to I could tell he was all about making money on the surgery he might have been a good surgeon but as far as explaining anything to me he kept brushing me off and beating around the bush. My neck swelling and my symptoms of hypotyroism is what made me push my doctors to look further. If it wasn't for me being persistant and knowing there was something wrong the doctors would have done nothing. After the surgery I guess the surgeon talked to my mother and said he thought my lymph nodes looked fine but I did not get to speak to him until my post op apt. I asked him about my lymph nodes and all I could get from his is it is highly unlikely only about 3 percent will be in the lymph nodes. He made no remarks in his report about looking at them during surgery. He told me my endo would take care of my care here on out. He did not want to discuss anything with me but then again he told me it was highly unlikely I had cancer and I did. So he did not make me very confident in him at all.

Report post

I am new to this site as of today.

My situation started with thyroid nodules that were monitored for 8 years. Every other year I would have an ultrasound and every other year an in office biopsy. No issues until my 9th year where the ultrasound picked up a solid nodule. A guided needle biopsy was done in the hospital. Guided needle means they use ultrasound at the same time to assure they are exactly where they need to be. A few days later, I was diagnosed with 2.1 cm papillary carcinoma on my left thyroid with Hurthle cell changes. A opted for a total thyroidectomy which was performed by a vascular surgeon and I received a measurement of RAI of 33, a small dose, two weeks later after surgery.

Nine months later, I was experiencing a sore throat, had another ultrasound done and a new growth was seen in my left thyroid bed that measured 2.0 cm. Doctor said it was an inflamed lymph node that required another guided needle biopsy. Results indicated 1.0 cm cancer cells and the rest of the swelling was lymph node. This time, I switched surgeons, using a highly recommended ENT surgeon for the second surgery in 5/2011. The second surgery was exploratory and a medial radical neck dissection was done as well. Luckily, the ENT surgeon was very thorough as he found a mass on my jugular vein that no one caught on the PET Scan or MRI and the lymph node in question had shrunk itself. The surgeon removed what he could, but explained that microscopic cancer cells were still present and would have to be killed off with RAI due to the location being in my lymph nodes.

I talked to my radiologist, about my scare for more RAI, and we decided to wait on the RAI and take some other precautions as to giving me either more than I needed or less than I needed. He took me off my thyroid medication and put me on a low iodine diet on 5/18/2011. Our goal was to raise my TSH levels to 30 so that I could even get the RAI. It took several weeks to get there. In the interim, I have experienced many symptoms (i.e., headaches, joint and muscular aches, fatigue, swollen salivary glands, blurry vision, confused thought patterns and weight gain). My TSH levels are now 94.9, and I only needed to be at a 30 to have the RAI, so I am waaay hypothyroid, which explains the symptoms.

Today I had a full body scan to see the % of thyroid tissue/cancer remaining and its location to determine the amount of RAI I am going to need. I have had blood work done which indicates my Thyroglobin serum measures 4.0 which is a strong tumor marker as after surgery it was 0.1, which was kind of expected, as its always lower post op. My radiologist says that to get an accurate reading of Thyroglobin serum, your TSH has to be high, in other words, you have to be extreme hypothyroid. He would have been happier had my Thyroglobin serum come back as a 2.0 or less, but it did not, and the reading of 4.0 indicates my body still has thyroid tissue/cancer. Since it was in the lymph node the second time around, it could have spread to other parts of my body or remain in the thyroid bed, either way, the RAI is necessary, so I am scheduled for a dosage of 150, but that will also depend on the results of my full body scan. My Thyroglobin antibodies (Tg AB) count measures 34, which I have done research that indicates Tg AB can disrupt the Thyroglobin serum (Tg) reading and still may not be accurate. But, with it being higher, even at the risk of not being accurate, it still an indicator that I have thyroid tissue/cancer left and it needs to be addressed through RAI.

Lastly, Friday I will get my scan results and I am set up to have a dosage of 150 RAI on Tuesday and I will be in the hospital for 4 days. I will post here again, the outcome of my scan and my experience with RAI at that dosage.

I hope this has helped someone that is going through the same thing. Also, if anyone has experienced what I have, and has had a third re-occurrence, I would be interested in knowing their story. I have read that the more RAI you have the less thyroid tissue you have to work with and things get a little more complicated as to absorption. This is premature information for me, but I am proactive and would like to know what I would be up against should it reoccur a third time.

I find this whole thing scary, so it is one day at a time for me. My prayers go out to all of us.

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Support ThyCa

Help ThyCa: Thyroid Cancer Survivors' Association reach its goals and support people like yourself by making a donation today.

Donate to  ThyCa: Thyroid Cancer Survivors' Association

Discussion topics

Help and information from ThyCa

Community leaders