Wednesday, March 21, 2018

Where we're at, one year later....

My radioiodine treatment was March 3, 2017.  One year later, it is evident that treatment didn't work ALL THE WAY.  My visit with my doctor this week was a mixed bag.  The good news is that my TG levels, the tumor marker number went DOWN after having been up the last two tests.  This is undoubtedly a GOOD THING.  It's now 4.3.  So yay.  But, a full year after treatment, it should be gone gone gone, and it's not.  This fact alone would put me, according to my doctor, in the "biochemically incomplete" category that happens to about 9% of people.  The ultrasound came back with two new small spots in my neck, though.  These are "vague" just yet, and about 1 cm each, but apparently too small to be biopsied.  From what we can tell, they were not there on my ultrasound in September, or on my CT scan in January.  Still.  They could be something, they could be nothing... just like the spot in my lung.  So, since we can't tell, this puts me in the "Indeterminate" category... which means we know the cancer is SOMEWHERE, we're just not sure where it is, and can't tell if the things that show up are the culprits or not.  This happens to about 1-2% of the people who undergo therapy.  It's possible that all residual cancer is microscopic, in which case, if we continue to suppress my thyroid stimulating hormone, it may eventually starve itself out and die without further treatment (this happens about 30% of the time, according to the doctor).  Or, this residual tissue might come back to the point where it's undeniable, and grows to a size that we can see it on imaging distinctly - which happens about 20% of the time.  Then it would be classified as "structurally incomplete response to treatment".  This is the category where things get ugly, and nearly all of the deaths from thyroid cancer occur.  SO... one in 3 chance it goes away, one in 5 chance it gets worse, and, if you're doing the math, that leaves a 50% of chance that it just STAYS THE SAME.  Hangs out there indefinitely, hiding for years on end, which would necessitate continued monitoring every few months forever.  So that's where we're at.

At first, this vague, undefinable place that we're at really bummed me out.  If something is attacking me, I would much rather A) that it NOT attack me, and go away.  But if it's not going completely away, then I prefer B) that it would show itself so that we can FIGHT it.   We can fight what we know.  It gives me a target to go to war against.   This option C), wherein there is something ominous obviously there, but it's not showing itself, so we just have to wait and watch and wait and watch and maybe it'll come attack again, or maybe it won't... being on this heightened state of alert FOREVER?  That's an emotionally hard place for a person to live.  And that's what I told my doctor.  And he understood.  He told me he would send me to Mayo clinic if I wanted, to where the best thyroid cancer doctors in the nation were, but... they would tell me the same thing.  We're in watch and wait mode until we know what exactly we're dealing with.   So be it.  I'm getting good about ignoring all of this stuff until I have to deal with it again every few months anyway.  And obviously, my lesson is to trust God and not myself or the doctors, or radioiodine, or anything else.  Pray that I internalize this truth.

I've come to terms with it all.  Another CT scan in two weeks, more ultrasounds and blood work in July.  For now,  I am taking the decrease in TG as good news, which it is.  I may not be celebrating from the roof-tops just yet, but I will celebrate minor victories, too, because that's all I'm allowed at this point in time.

Time for a margarita.




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