Yesterday I met with an endocrinologist, and I was very encouraged by all the information I received from him. He told me he is part of a team at Yale that works together on thyroid cancer treatment, which includes thyroid surgeons, ENT specialists and radiologists.
He ultrasounded my neck and on a TV monitor showed me the bad actor, which is a 1.1 cm carcinoma located almost at the middle of my thyroid, between the left and right lobes. He described it as small. Due to its location, he outlined 3 possible procedures, all of which assume no further cancer is found in my lymph nodes after lymph node mapping is conducted by a thyroid radiologist Thursday morning. He also discussed the risks of nonsurgical monitoring (as suggested in the NY Times article posted earlier in the thread), which include the possibility of difficulty swallowing and spread of the cancer to the esophagus as well as metastisization to the lungs.
The first possibility is complete thyroidectomy, which would involve some risk to the vocal cords which is created by removing the left and right lobes. This would be the most aggressive and intrusive approach, and I would have to take synthroid the rest of my life and rely on it for correct thyroid hormone replacement.
A second possibility is an isthmusectomy, involving removal of the middle of the thyroid but retaining of the left and right lobes. With this procedure I would retain thyroid hormone production capability and need, at most, a small booster of synthroid. This procedure would be less intrusive and not carry the same risk to the vocal chords as the complete thyroidectomy.
A third possibility is a newer procedure, now being done primarily at major medical facilities in the USA like Mayo Clinic, and very recently started at Yale, called an alcohol ablation. This involves no surgery but rather a shot of alcohol into the carcinoma/tumor, which is then ablated or killed by the chemicals. The procedure is painful, but would allow retention of the entire thyroid gland. Due to my history of inflammatory bowel disease, my candidacy for this newer procedure is not clear.
The next step hinges on the results of Thursday's ultrasound and biopsies of the lymph nodes.
Anyways it would be nice to have some choices but it is still wait and see for 2 weeks.