follow up blood work how soon how often?

TT performed locally in Miami was done 2/6 it was discovered at that time it was meduallry not follicular and it was positive for 7 out of 10 lymoh nodes in the neck. I have a few questions. Since 2 patholgy labs read the FNA as follicular but it turned out MTC if we had the benefit of knowing presurgically that it was MTC there probably would have been more extensive lymph node removal. planned for the surgery. He took out lymph side nodes and central compartment. Any evidence that radical neck dissection and clean out everything approach works better in the long term outcome of figting this disease? Was this surgery and lymh node removal undertreatment for his MTC because they planned on follicular when they went in and taken by surprise by the outcome of what they found? Working with a local endo as well he wants f/u blood work of Tg (quantative) TSH T4 Sma7 calcitonim Tg ab. However surgeon asks follow up blood work for t4 Tsh and calcium and calcitonin levels. I just now obtained an appt with MD anderson for 2nd opinion on 3/15. Should I do these labs now bring results with me to anderson and asssume they will repeat what they need at Anderson? Do I wait for anderson to do it all on 3/15? How often do you have calcitonium repeated after TT? Will Insurance say unnecessary to repeat these again on 3/15?
Any insights?
Thanks for your input and teaching me on this journey.

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I would go ahead and have the bloodwork done now, and possibly the TSH and T4 bloodwork repeated on 3/15. The Tg number should not change again until after you have RAI treatment (if that is standard treatment for medullary; I am not sure). The calcium and calcitonin levels only need to be measured once if they come back normal, and will need followup if they show that damage was done to your parathyroid glands - but that's important information to have now, not a month from now.

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MD Anderson will want copies of everything, in advance. They will also schedule tests, usually bloodwork & U/S, before you meet with the Dr.

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You should inquire to MD anderson if they would like these blood tests performed before their consult with you.

There are a few members with Medullary here. Hopefully they'll see your post and lend some advice.

The only thing I know is that medullary is very different than papillary/follicular.

good thoughts to you :))

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here is this from endocrineweb, if you have not already seen it:

http://www.endocrineweb.com/conditions/thyroid-cancer/thyroid-cancer-medull ary-cancer

The Use of Radioactive Iodine Post-Operatively

Although thyroid cells have the cellular mechanism to absorb iodine (see papillary cancer page), medullary thyroid cancer does not arise from this type of thyroid cell. Therefore, radioactive iodine therapy is not useful for the treatment of medullary thyroid cancer. Similarly, if medullary cancer spreads to distant sites, it cannot be found by iodine scanning the way that distant spread from papillary or follicular cancer can.

What Kind of Long-Term Follow Up is Necessary?

In addition to the usual cancer follow up, patients should receive a yearly chest x-ray as well as calcitonin levels Serum calcitonin is very useful in follow up of medullary thyroid cancer because no other cells of the body make this hormone. A high serum calcitonin level that had previously been low following total thyroidectomy is indicative of recurrence. Under the best circumstances, surgery will remove all of the thyroid and all lymph nodes in the neck which harbor metastatic spread. In this case, post operative calcitonin levels will go to zero. This is often not the case, and calcitonin levels remain elevated, but less than pre-operatively. These levels should still be checked every 6 months, and when they begin to rise, a more diligent examination is in order to find the source.

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