Many of you may not of have even heard of the thyroid, let alone know where it is in the body or what it does. Quick science lesson:
1) the thyroid gland is in your neck (not in your back as a friend thought) just below your Adams apple.
2) It produces 2 hormones which are vital in making every single cell in your body work properly.
3) Thyroid issues are very common. Around 1 in 20 people experience a thyroid problems and women are more commonly affected than men*
In my first blog, I talked about always being a bit of a chubber, being permanently knackered and referenced some serious mental health issues which I took heavy duty psychiatrist prescribed drugs for. I am now 100% certain I have suffered with thyroid issues most of my life. Like many of us in lockdown, I have been sorting out various boxes of "stuff" that have been lurking in our garage for years. Interestingly, I found a letter from my mother to the boarding school matron, dated 1992, outlining my mums concerns that I may have a thyroid issue. Numerous relatives on my mothers side have diagnosed thyroid disorders. I was tested numerous times but all of my tests came back "within range". When my thyroid was eventually removed, Mr Fit (the ENT surgeon) found I had an autoimmune condition of the thyroid called Hashimotos Thyroiditis, as well as a 7cm tumour. I do love to go over and above! So why, despite showing pretty much every hypothyroid symptom under the sun did none of my blood tests show anything abnormal? Part of the answer lies in the type of blood tests which are run as standard by the NHS. Had a fuller, more comprehensive, more expensive blood test been run, my Hashimotos might have been diagnosed and my thyroid cancer prevented. Strangely, I am not pissed off about any of this, I am not looking for someone to blame. I've just been incredibly unlucky. My tumour, although big, was lurking behind my thyroid, rather than on the front, so there wasn't an obvious lump. Mr Fit also charmingly told me my "shortish, chubbyish neck" also meant that it was hard to feel. Since I had my thyroid removed, I am off all the meds prescribed by the psychiatrist and am on a low dose of antidepressants, as many cancer patients are. It is a bit depressing to have cancer, as you can imagine.
So all of this bad luck feels like enough to have fulfilled my bad luck quota right? Oh no, oh no no no my friend. I have managed to get myself an over achieving, Type A class 1 muthafucker of a thyroid cancer. Of course I have. Another quick bit of science for you. Thyroid cancer is still pretty rare, although it is on the increase, possibly because of better diagnostic tool. There are 4 types of thyroid cancer:
1) Papillary - the most common
2) Follicular - second most common
3) Medullary - typically herediatry
4) Anaplastic - rare, more common in older people and very, very hard to treat.
Overall, thyroid cancer has a great cure rate if caught early, leading some unhelpful, flippant knobheads to call it the "good cancer". Thats like saying "a good homocide" or "a good Nazi" in my opinion. However, I accept that as cancers go, there are far worse ones to get in terms of prognosis and outcomes. Even metastatic thyroid cancers (cancer which has spread beyond the thyroid into lymph nodes, lungs, bones or other places in the body) can sometimes be cured and often well managed. So this is all very positive if you have Thyroid cancer option 1 or 2. My little friend is what is termed a poorly differentiated thyroid cancer, probably derived from a follicular variant. This means that when the super clever lab people look at the cancer cells under a microscope, the cells have mutated away from looking like thyroid cells and have gone rogue. This makes my cancer much harder to treat and the prognosis a lot more pants.
Treatment for thyroid cancer is very different to most cancers. The first line of defence is called suppression therapy. Its very sciency but in essence, once you have your thyroid removed, it is necessary to take artificial thyroid hormones (thyroxine) to replace the hormones your body can't now produce. In many thyroid cancer patients, we take more hormone than we really need to put the remaining cancer cells to sleep. This is a life long treatment. Many patients will also have Radioiodine Therapy depending on their tumour type. This involves weaponising iodine with radiation. Thyroid cells are the only cells in the body which absorb iodine so you take your weapons grade horse pill, spend 4 days in isolation in a lead lined room and the little cancer cells suck up all the juicy iodine and get nuked. Its clever shit but not a huge amount of fun. There are side effucks but not like chemo style side effucks. Most of my bone mets like a bit of Radioiodine therapy and have responded well, but I have one big site in my sacrum (its part of your lower back) which hasn't played ball and keeps shrinking but then growing, no matter what we throw at it. Three lots of Radioiodine Therapy, Radiotherapy x 2, 2 embolisation procedures (cutting off the tumour's blood supply), major surgery to scrape as much of it out. As a result, I have ended up on a cutting edge targeted therapy called Lenvatinib (Lenvima in the USA). Radioiodine resistant thyroid cancer is very rare and very special, much like myself! A few years ago, there were virtually no treatment options for this type of thyroid cancer. As a rare cancer and an even rarer subtype, Radioiodine resistant thyroid cancer doesn't benefit from the R&D funding that many other cancers do. The 10 year survival rate for Radioiodine resistant thyroid cancer was less than 10% before these targeting therapies were licensed for use to treat thyroid cancer. It was pretty bleak. I will write more about the various treatments I have had, as they are a laugh a minute (they actually are).
On prognosis, please don't ask me "how long have you got?" Its a shit question. I have never asked my medical team but I have obviously googled the tits off the subject so I know the stats. You are more than welcome to do the same but what I would say is they are just stats and my philosophy is that I don't want to live to a best guess sell by date. If I die before I will feel cheated and if I outlive D Day, I will feel like I am on borrowed time. I trust The Wizard of Onc (my amazing oncologist) to tell me when shit is getting real. Again, I will write more about the Wizard of Onc as she is one badass lady who has prescribed me all kinds of weird medical shit and a dog. For real, she prescribed me a dog. He's called Norman aka Knobdog.
If you are worried about anything you've read here in relation to your own health, have a look at the British Thyroid Foundation website and see your GP.
*Source: British Thyroid Foundation