To Look in the Mirror and Not See Further than My Neck

25 Jan 2017

By: Natalie Tully

January is Thyroid Cancer Awareness Month. As you may have read in an earlier blog post, thyroid cancer is the most prevalent cancer in young women under 25. This is the story of one of those young women.

It was June of 2011, and I had just come home to Pennsylvania for summer vacation after completing my sophomore year at the University of Texas (and finally passing organic chemistry). In an effort to get back in shape for our family beach vacation (and after six months of eating like a nineteen-year-old college student does), I went out for a bike ride. Naturally, I was drenched in sweat when I got home and decided to give my mom a sweaty hug-a move she wasn’t exactly keen on. As we play-fought, I turned my head to the side and instantaneously, she went from mom to nurse. She saw a lump protruding from my neck and rapidly went about evaluating it. She decided that the Otolaryngologist I was scheduled to see later that week (nothing says summer vacation like getting your nose cauterized) would need to examine it as well.

Fast forward through that appointment, an ultrasound, and an FNA-all of which lent increasing evidence to suggest the mass might be malignant. A few weeks later, I found myself in pre-op (with a wicked sunburn I got to protest the ordeal) about to go in for either a lobectomy if the mass was benign, or a total thyroidectomy if it was concerning for cancer. I awoke afterwards to a drain coming out of my neck, and spent the next day in my room, trying to digest that the mass was malignant and they’d taken the whole gland. My oncologist (also my neighbor) came in to tell me that the pathology report indicated that the tumor had been papillary thyroid cancer, follicular variant. That meant that when I got released that afternoon to go back to the beach for family vacation, I’d need to start a low iodine diet. Missing out on my favorite foods made the diet seem nothing short of exasperating. Eventually, I got through the diet and took the I-131 dose-followed by five days of isolation (during which I became addicted to How I Met Your Mother, and my mom served me meals on a silver platter at my bedroom door). At the end of the week, my whole body scan was clear indicating the radioactive iodine treatment was complete. Two days later, I found myself on a flight back to Austin to start my junior year of college.

My whole experience of being a cancer patient lasted about 5 weeks from discovery to completion of treatment, which had some pros and cons. On the plus side, I had early-stage disease that was treated quickly and without complications, but the rapid timeline didn’t leave me much time to process what was going on. There were some lingering issues, not having an established endocrinologist being one of them (hypothyroidism + college classes + job=not good). By and large, I was able to return to my life mostly uninterrupted with not much more than a scar on my neck as a reminder. I feel profoundly fortunate for my cancer experience-I was surrounded by people who cared enough about me to let me be angry at them, because they knew far better than I did what was at stake.

So there it is, my mostly tame cancer story. Today, I’m a (mostly) normal 25 year old who takes a pill every morning and has to get bloodwork/scans every so often-really not a bad setup in comparison to a lot of medical conditions. In conclusion, I’d like to share a few thoughts about thyroid cancer that may be helpful to providers:

  1. There is not a simple way to ‘prevent’ Thyroid Cancer- Exposure to ionizing radiation is a known risk factor-but very hard to modify for most patients.There are common-sense steps to improve detection of early disease. Not everyone is lucky enough to have an observant and persistent mother to find their lump for them. Whether it’s breast awareness, thyroid awareness, or anything else-be aware of your body and act when it something doesn’t feel right.
  2. Atkins and Paleo ain’t got nothin on Low Iodine-Thanks to salt being in everything, and most of that salt being iodized, almost anything in a package is off-limits. In time, I’ve come to appreciate what being on the diet did for my awareness of eating whole foods, but at the time, it was the bane of my existence. Take time to read up on the diet to understand (and help counsel) your patients when you prescribe it.
  3. Yes, Thyroid Cancer is a ‘good cancer’ to haveBut you still have cancer. Look at this post-almost six years later and I can remember details down to the scrubs that my nurses were wearing. It’s an emotional event, even if the long-term prognosis is very good. Be mindful of this when diagnosing and treating all of your patients-any diagnosis is a big deal for them.

 

Natalie Tully is an headshotMD/MPH student at Texas Tech University Health Sciences Center in Lubbock, TX. Before starting medical school, she received her bachelors of science degree at the University of Texas at Austin followed by two years working in basic science research at Baylor College of Medicine. Natalie hopes to pursue a career in surgery, and has particular interest in applying her dual degree in Pediatric or Trauma Surgery. In her free time, she enjoys running, cooking, and playing with her dog, Sadie.

 
Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

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