Follicular thyroid cancer
Prepared with OnCo (onco.cc/prep/follicular-thyroid-cancer/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
14 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example RAS mutations, PAX8-PPARG fusion, TERT promoter mutation, Molecular tests on indeterminate aspirates, Thyroglobulin), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (indeterminate follicular nodule), which of the standard options do you recommend and why?
- 6.For my situation (minimally invasive), which of the standard options do you recommend and why?
- 7.For my situation (widely invasive or metastatic), which of the standard options do you recommend and why?
- 8.For my situation (iodine-refractory), which of the standard options do you recommend and why?
- 9.Am I a candidate for Lenvatinib, Sorafenib, and what side effects should I expect?
- 10.Are there clinical trials I could join, for example of Dabrafenib, Lenvatinib?
- 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 13.I read that “Telling adenoma from carcinoma without surgery”. How does that affect my plan?
- 14.I read that “Bone metastases respond poorly to iodine”. How does that affect my plan?
The words I may hear
- Radioiodine-refractory (RAI-R) thyroid cancer: Thyroid cancer that no longer takes up radioactive iodine, or keeps growing despite it.
Tests and results to bring
Biomarker results to ask for: RAS mutations, PAX8-PPARG fusion, TERT promoter mutation, Molecular tests on indeterminate aspirates (Afirma, ThyroSeq), Thyroglobulin.
Scans and tests linked to this cancer: Thyroglobulin, calcitonin and CEA in thyroid cancer follow-up.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Indeterminate follicular nodule: Molecular testing of the aspirate; diagnostic lobectomy when suspicious. (Thyroid cancer)
- Minimally invasive: Lobectomy alone in most cases; completion surgery and iodine only for high-risk features. (Thyroid cancer)
- Widely invasive or metastatic: Total thyroidectomy, radioactive iodine, TSH suppression; bone metastases may need surgery or radiotherapy. (Radioiodine therapy and whole-body iodine scanning, Palliative radiotherapy)
- Iodine-refractory: Lenvatinib or sorafenib; clinical trials of redifferentiation. (Lenvatinib, Sorafenib, Radioiodine-refractory (RAI-R) thyroid cancer)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.