Diabetes Self-Management Blog

I’m writing this the week of Thanksgiving, and while I’ve a litany of things I’m thankful for, that’s not what I’m writing about this week. Instead, it’s only slightly later than one day after I found out that I have cancer. I’ll share with you an edited version of an e-mail I shared with many of my close friends last night.

I wish to take care of this correspondence in one fell swoop in order to… well, I want to get this unhappy news off of my chest as quickly as possible so that my wife and I can resume our discussion of whatever it is people discuss when they hear this type of news. I hope my thoughts are somewhat coherent tonight. They may not be.

I found out on my way home from work, via a phone call from my endocrinologist, that the thyroid biopsy I had last week (which you can read about in all its glory here) came back positive for cancer. Papillary thyroid carcinoma.

First, let me step in before you say, “He told you over the phone that you had cancer? While you were driving?!” and tell you that, following last week’s thyroid biopsy, I’d developed a persistent sore throat and had put in two calls to the doctor’s office to ensure that this wasn’t a complication of the biopsy. No one called me back today until my endocrinologist phoned me. I just happened to be on my way home from work.

It makes sense now that no one talked to me. They most likely knew the biopsy was positive for thyroid cancer and wanted someone who knew me to handle the breaking of the bad news. And, yes, my doctor didn’t want to tell me over the phone, but his judgment told him I’d want to know sooner rather than later. His judgment was correct.

Second, as far as being slapped with a cancer diagnosis goes, with ten being the worst and one being the best, a papillary thyroid carcinoma is about a two. Two = good. Really. (Relatively speaking, “as far as being slapped with a cancer diagnosis goes.”)

Yes, it’s a big deal. It is cancer. At times I want to downplay its significance, emphasize the success rate, that it’s not such a big deal relative to possible other cancerous diagnoses. That’s well and good. Then again, it’s a big deal, for me, because, well, it’s me. I have cancer.

Please note: There is a 97% cure rate for papillary thyroid cancers.

But of course, this sucks.

My endocrinologist, has already referred me to a top thyroid surgeon within the University of Michigan Health System. That surgeon will contact me next week to discuss the next steps. I think I know pretty much what the next steps will be, although the when and the many specifics that will come from my and my wife’s questions have yet to be answered. The not knowing sucks.

What I’m pretty sure will happen is that they’ll remove the thyroid completely. Then I’ll have a radioactive iodine treatment to make sure that all the cancerous cells are destroyed. (I think my downtime — whenever the surgery is — will be one to two weeks.)

After that, oh joy, I’ll be on some kind of hormone replacement medicine for the remainder of my days. Given the insulin, the statin, and the antidepressants I’m already taking, what’s one more attendee at the party? (If anyone wants to give me a really cool Monday through Sunday pill case as a joke, just make sure it’s something I can actually use!)

The good thing is that thyroid cells are unique in that they absorb iodine, so I won’t have to undergo chemo or radiation (in the conventional sense) to rid my body of the remaining cells (more about that halfway down the page here).

So, yes, I thought I should share this with certain people, because, well, part of who I am is someone who shares things like this.

Happy November holidays. I’ll continue to update you on the thyroid cancer as I learn more.

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Comments
  1. Eric, I am so sorry to hear your news.
    After having a thyroid scare myself last year I am well familiar with the less-than-fun thyroid biopsies, and have been thinking about you. I’ll continue to think positive thoughts for you and am so glad that there is every reason for lots of hope.
    I always love reading your blog as you and I grapple with diabetes in similar ways. You’re well prepared to tackle this medical hurdle, and I’m confident that you will do it with strength, courage, and good humor. (Although, it’s also okay to have plenty of moments where you feel the opposite!) Know that there are many of us out there pulling for you.
    All the best for the holiday,
    Laurel

    Posted by Laurel |
  2. OMG, Eric. It is just totally not fair for a person with one chronic illness to get another. So sorry - no, angry - no, empathic — I don’t know — all of the above, with you!

    Yours,
    AmyT

    Posted by AmyT |
  3. Oh, Eric!
    I’m so sorry the news wasn’t good, but thankful it is a cancer with such a high success rate and a condition after the surgery that can be managed with a pill. Both my mother and her mother were on thyroid medication for much of their lives.
    I must say I was stunned; I always look forward to Thursdays for your blog and was hoping for better news.
    I’m holding you and your family in the light this holiday and as you deal with this crisis.

    Posted by Deb |
  4. Dear Eric.

    Thanks for keeping us posted. Glad to hear that there is a 97% cure rate. And it is great that you have such good care at your health system.

    Posted by CalgaryDiabetic |
  5. I am so sorry for your news, Eric. I actually cried for a little bit after reading this (which was a little awkward and totally confused my husband as I don’t know you) since you have been something of a role model for me over the l=past 18 months. I started reading your blog shortly after I was diagnosed with Type 1 diabetes (as an adult). You always seemed so brave and so together, and — not knowing anyone who has Type 1 diabetes — provided an example for me of someone in a similar situation who was coping and coping well. So thank you for that, you really helped me through some tough times.

    Cancer is a terrible thing to find out about, but I feel confident that you will face this challenge as you have clearly faced other challenges in your life — with courage, dignity, and insight. And I feel certain that this will only prove to be another way in which you will be a role model to others. Best of luck, and I hope things resolve quickly (as they will certainly resolve successfully).

    Posted by Laura |
  6. I had a stage 1 Papillary cancer in 2007. I found that the organization called Thyca.org to be extremely helpful. I wish you the best and hope you have a speedy recovery.

    Posted by Noreen |
  7. To all those who’ve commented,

    Thank you for your good wishes and thoughts. I have yet to hear from the surgeon, and if I do before I write my next blog entry, I’ll let everyone know what’s going on, as well as let you know (if I talk to the surgeon and get to my many many questions) how this overlaps with the diabetes.

    Just when I think, “hmm, lately I haven’t had much to write about…”

    Best,
    Eric

    Posted by Eric L |
  8. Eric, thanks for sharing.

    The fact that you’ve done more than a bit of research on this (”97% cure rate for papillary thyroid cancers”) is a helpful lesson.

    My two-cents: your dog can be a real good part of your treatment. It’ll listen, be empathetic, and give you unconditional support [no offense to your wife :-)]. Talk your pooch for an extra walk in the Arb or Gallup Park

    Dude, IMHO, your glass is more than half full.

    - Ex-A234

    Type 1, diagnosed in A2 in ‘77

    Posted by Ex-A2er |
  9. Eric, I’m very sorry to hear your news and I wanted to share my story with you. I was diagnosed with Thyroid Cancer in October of 2007. I developed late onset of Type 1 diabetes in May of 2007 and my endocrinologist did a routine thyroid sonogram because my TSH levels were a little low. Fortunately (or unfortunately as the case may be) they found a nodule in my Thyroid gland. When I had the FNA done, the test came back as “suspicious”. I was referred to a specialist at John’s Hopkins, where she told me that I needed to have my entire thyroid removed. At first I argued with the recommendation because the test was “suspicious” - it was not conclusive that I had cancer - and I wanted to have another FNA performed. After many long discussions and a lot of research, it was clear that once they find a “suspicious” nodule, no matter how many more test are done (even if they come back negative), you still have one that may be cancerous. I had a full thyroidectomy in February 2008 and after the surgery, they found 3 nodules in my thyroid that all tested positive for papillary cancer. I then underwent Radio Active Iodine treatment and had to follow the low iodine diet for 4 weeks prior – not so fun. However, the RAI is a relatively simple procedure with little side effects. After the treatment, they did a full body scan – because they need to make sure the cancer has not spread – that is when they found an area in my abdomen that collected the Iodine – meaning another organ in my body may be affected. The Doctors diagnose was that I may have some thyroid cells in my ovary and it could be affected by the cancer as well. To be sure, the specialist at Jonh’s Hopkins made me wait a year before I underwent RIA again. This process was to ensure that the first test was accurate and that the thyroid cells were in an organ and not just getting stuck in my bowel. The final diagnosis was that the RIA was getting trapped in my intestine and that my other abdominal organs were not affected.
    To date, I’ve been given a clean bill of health from my Thyroid Cancer. However, I get blood work done by my endocrinologist every 3 months to ensure my thyroglolbuline is undetectable and I’m still clear of any danger of recurrence.
    I just wanted you to know that you are not alone. It is a lot to undertake and the uncertainty is overwhelming but you will make it through this! Good luck to you and your family.

    Posted by Amy S. |
  10. Eric,
    I had a thyrodectomy in April 2009 for Papillary Thyroid Carcinoma. It was done in St. Joes. I wanted to do this in UM hospital but could not get an appointment sooner. I went for a routine follow up check up after 6 months. My endocrinolgist did an ultrasound and found tissues on right thyroid bed and lymph nodes. My thyroglobulin was 31. The biopsy came positive for PTC. I met the top surgeon at the UM hospital yesterday. He had scheduled a second surgery end of this month. He will try his best to remove allmost all of the tisses. My 2cents- Getting the right surgeon is a must. There are only 1 or 2 surgeons in this area who can cure 100%. The cure for PTC depends on the Surgeon you choose. When is your surgery?

    Posted by Mano |
  11. Been there, survived it, and I know you will too. Yeah, you’re going to feel like expletive until they get your meds at the right level — tired as you’ve ever felt, achy, brain-foggy, itchy, and you’re going to gain weight (sigh) — but it will pass. Stay positive but give yourself permission to “wallow” every now and then. It may be the “easy cancer” but it’s still cancer. Thyca.org is a great resource, as are the thyroid boards at about.com. Take care!

    Posted by Andrea |
  12. My mother had her thyroid removed at the University of Michigan Hospital in April, probably by the same doc (top in his fielf) and he did a great job,and all other staff were also suberb.I hope you have the same experiemnce she had and you have a speedy recovery.
    I am also a cancer survivor( 10 years) so I know how hard it is to get the diagnosis, even when you are told you have a ‘good one’
    {{{HUGS}}}
    Joyce

    Posted by Joyce |
  13. I’ve never read your blog before, but I am glad I just did. I’ve had type II for more than 20 years, with many of those years uncared for because of medical misdiagnosis (that is another story). Additionally, I have had surgery for Thyroid Cancer. Two surgeries finally found the malignant nodes and were removed. However, my experience with Cancer is extensive. Twelve years ago, my right kidney (stage 1) was removed. Luckily, margins were clear and no further treatment needed. Went my merry way and then a few years later I developed Non-Hodgkins Lymphoma (stage 1). Had chemo for six months and went into remission. A few years later I developed the Thyroid Cancer (stage 1) and at the same time they found a (stage 4, metasticized) KIDNEY nodule from the cancer surgery many years previously before,on my right lung. My thyroid and the lung nodule lobe were removed in a dual surgery and I again went through another 6 months of chemo. A Quadruple bypass completes this story. Through all of this, I gained and lost weight, was able to pretty much keep up with my life by just keeping as active as I could. Many naps were necessary, but I just feel so much healing is through attitude and prayer, if you believe. With all these problems, I still (maybe foolishly) feel having Diabetes is the worst and most dangerous. I am in remission from all cancers, but diabetes is with me (us) 24/7. I know you will do well! YOU! have to believe in your health. Just love your family, be your own advocate, pay attention to and ask questions of your doctors. I look forward to reading of your successful journey in the future. God bless.

    Posted by Char |
  14. Dear Eric,
    I have been reading your blogs since being diagnosed with type 2 four years ago. Just wanted to let you know what an inspiration you have been to me and how you have helped me cope with my disease. I will keep you in my prayers that God will help you as you have helped so many others. God Bless.
    Cindy

    Posted by cindy schell |
  15. Eric - Am very sorry to hear this about this recent diagnosis and the newest battle you will need to fight. By reading your blogs, I’ve found you to be well educated and positive about whatever has been thrown at you and hope that you can remain being a fighter and stay proactive and fight this latest blow. Think positive! I don’t know how religious you may be, but, really prayer does help. All my best to you -

    Posted by Mary |
  16. Eric - have been reading your blogs from the beginning. You feel like family. THinking good thoughts for you, kiddo. Cathy

    Posted by Cathy A |
  17. Eric,
    I do not have diabetes, however, I am a registered dietitian, and I receive updates from this site. What got my attention was that I too have/had thyroid cancer. I found a golf ball sized lump on my neck in July 2009. After a MRI and FNA I was diagnosed with follicular cancer. I had a total thyroidectomy in August 2009. They also discovered two nodules of papillary cancer. I kept hearing from the doctors that this is the “best” cancer to have. Not very comforting. I had the RAI and three body scans before they gave me a clean bill of health. It took my a little longer to recover because it caused my RA and fibromyalgia to flare up. We are still trying to get the right amount of Synthroid. It is a funny thing that I really didn’t hear about thyroid cancer until my diagnosis. It is comforting to hear from others to know you are not the only one. I pray that you too will soon be a thyroid cancer survivor.

    Posted by Robin |
  18. Eric,
    Read and enjoy your column all the time. Do not have your new problem but have others. This is to wish you the best of luck and good Dr’s and I know that you will come through this as you have all your other trials. Regards Lorraine

    Posted by Lorraine |
  19. Hi, Eric. Nothing to say other than I’m thinking of you and your fam during all of this. I’m happy you’re working with people who know you well — I’m happy you’re a guy who asks the right questions.

    Will look for updates.

    Posted by Jess |
  20. Hi, Eric
    I was diagnosed with thyroid cancer In november 2009,Straight words are I am scared of the cancer but I also fear the operation.

    Posted by Seabass |
  21. Hi Eric and thread,

    I am 24 years old and have ulcerative colitis and just received a phone call that I also have papillary thyroid cancer. I know things will be fine - but I am supposed to start my first semester of law school in 2 months and I am nervous that dealing with the appointments, procedure, and aftermath will be too stressful and time-consuming on top of my preexisting health issues and the stress of beginning law school.

    Since there are so many people here who have been diagnosed similarly, could you let me know how long, difficult, and stressful the experience was for you to help me determine whether it will be possible to move ahead with my academic plans.

    Posted by emily |
  22. I have type 1 diabetes, have an Animas Insulin pump and just diagnosed with papillary thyroid cancer. I was told that my diabetes would not cause complications during the 4 hour surgery to remove the thyroid. I rhink you have to fast before the surgery and then the four hours of surgery thats almost 8 hours without food. How do you keep blood sugar level? Will someone monitor my blood suge?. Should i expect higher or lower blood sugers? I would appreciate to hear someone detailed personal account of what to expect. Also my doctor explained an increased in the thryoid medication should prevent weight gain. Why do some people see an increase in weight?

    Posted by Angela |

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