Caroline's story: 'Never too young for cancer'
Monday, May 4th, 2009
I was diagnosed with papillary thyroid cancer in 1996 just after my 16th birthday. Although the median age of people similarly diagnosed is 48 years old, thyroid cancer is the second-most common cancer among females in their late teens. And it is the No. 1 cancer among women ages 20 to 29 years old.
Uncertainty is the best way to describe the month leading up to my December diagnosis. The summer before I had a routine physical – the type you have before you can play high school sports. Nothing seemed out of the ordinary.
It's something how things sneak up on you. I really had not paid much attention to the lump that was growing smack-dab in the center of my lower neck. But my younger brother, who spent more time looking up at me than anyone, was totally grossed out by the lump. Thank goodness his teasing was relentless.
An ominous diagnosis
In a span of a couple weeks, my parents would take me to see a nurse practitioner, ear nose and throat surgeon and an endocrinologist. The nurse practitioner said my thyroid was working overtime and was enlarged. The ear, nose and throat doctor promised me the lump was not cancerous. The endocrinologist said I had to have surgery immediately to remove the cold nodule, which probably was cancer.
I had my doubts about the endocrinologist's diagnosis. My mom had a benign nodule removed from her thyroid when she was 16 years old. In my mind, she was always perfectly healthy and I would be too.
The only memory I have of the first surgery is when the anesthetic began to wear off. I asked the nurse standing over the gurney, "Was it cancer?" She was silent as she replaced the oxygen mask, motioning for me to keep breathing.
A day later, when I was back at home, my question was answered. It was time for round two. This time the surgeons completely removed my thyroid.
One week after surgery, I was back at school. Two weeks after, I was back out on the golf course playing the sport I love. I was determined.
Just before New Year's my parents and I made the six-hour drive to Mayo Clinic Jacksonville. They wanted to take me to a hospital where the endocrinologists have more experience treating people with thyroid cancer. My doctor recommended one radioiodine treatment to kill off any remaining thyroid cells.
He prescribed a 29.9 millicurie dose of radioiodine – anything under 30 means patients don't have to stay in the hospital. Once I swallowed the radioiodine capsule at my hometown hospital, they could not wait to get me out of there. While the radiation worked to kill off any of my remaining thyroid cells, it can be harmful to others, especially children who have their thyroids intact.
The radioiodine exits the body in about five days, and, unlike chemotherapy, it really does not have serious side effects. The hardest part: being sequestered in my room away from my family for three days, and disappointing my then six-year-old sister when I did not glow in the dark.
A good outcome
I was fortunate. Like the majority of patients with papillary cancer, the radioiodine destroyed virtually all of the remaining thyroid cells.
Since my surgery, I've taken a supplement each day to replace the hormones that my thyroid would have produced. It's amazing such a tiny pill supplies a synthetic version of the thyroid hormones we need. I have annual follow-up exams, and have blood work done about every six months to make sure my thyroid-hormone levels are "normal." I've been blessed to be cancer-free ever since.
A couple summers ago during a family reunion, my mom and I had our picture taken with two of her sisters. You could see the resemblance: We had matching smiles and scars. Though all of us have had some form of thyroid disease, I was the only one with a cancerous nodule.
Today, 12 years after my diagnosis, patients of all ages continue to wonder what causes the disease. They're not alone: new data and studies have prompted researchers to investigate why thyroid cancer is increasing at a faster rate than any other cancer.
