the difference between thyroid cancer reccurence and having a second "primary" cancer after having thyroid cancer

i am writing this blog in response to a topic that came up today in a thyroid cancer survivor website.it is confusing differentiating between thyroid cancer recurrence and having a second primary cancer after thyroid cancer. my sources for my statistics come from these websites/publications: Thyca, NIH( national cancer institute), and an article in PMC- " the risk of second cancers after diagnosis of primary thyroid cancer, by Christopher Kim, et.al. May 23, 2013. i ask that all english majors/ teachers out there, including my daughter, to please excuse the format of my bibliography/ sources. my blog is not a formal research paper, but i would like everyone reading this to be aware that i did fact check, and of course you are welcome to check my sources as well. enough about disclosure.

first, i will talk a little about thyroid cancer recurrence.  thyroid cancer is sort of unique, i guess, in the fact that thyroid cancer patients need monitoring for the rest of their lives. while the prognosis is generally good, the rate of recurrence can be up to 30% . also,  the recurrence can occur many years after diagnosis. my endocrinologist told me that she had a patient, who was doing well for many years, have a recurrence after seven years. recurrent thyroid disease usually occurs in the neck area lymph nodes. it may however, spread to other parts of the body- especially the lungs and bones. here are some more statistics for you, courtesy of the cancer treatment centers of america: of the 30% of patients that do have a recurrence, 80% of those have thyroid cancer in the neck area. the other 20% occur in distant areas of the body ( lungs and bones for example.) here are some signs of recurrent thyroid cancer which may  include:

neck swelling- or a lump that grows rapidly
neck pain that starts in the front area of the neck, but may extend to the ears
trouble breathing or swallowing
voice changes or hoarseness
persistent cough

now these symptoms can describe primary thyroid cancer, not only recurrence. and i for one have had some of these symptoms after treatment. this is just a short list. everyone is different, and you may have other symptoms, some of these, or none at all.

now for the, evidently, confusing part. having a second " primary" cancer after having thyroid cancer. a new primary cancer, not composed of thyroid cancer cells, may occur months or years after the original cancer has been diagnosed and treated. patients have anywhere from a 10%  to 150% chance of having a second, primary cancer. i prefer the good old 30% statistic, which i think is a good average overall. the question most asked, perhaps, is why? what could cause this second, primary cancer? some suggestions are: the cancer treatment itself- chemotherapy or radiation therapy may cause another cancer. also, having certain gene mutations and being exposed to some cancer causing substances- perhaps tobacco smoke, may flip the cancer causing switch. i think ( hope) that more research will be done in this area so that we may all be able to sleep at night.

i had a second primary cancer ( breast cancer) five years after having my thyroid cancer. i found this statistic when i was doing research for this blog, and it is sobering. " nearly one in five cancers diagnosed today occurs in an individual with a previous diagnosis of cancer, and these second cancers are a leading cause of death among cancer survivors". this statistic is from the NIH, (nation cancer institute) , division of cancer epidemiology and genetics.

after my total thyroidectomy, and the removal of two of my parathyroids which were also cancerous, and eleven lymph nodes, my physician sent me to a radiologist to determine if i needed the RAI treatment. my lymph nodes were clear, but one of my tumors was fairly large- 2cm, multifocal, and unencapsulated . the official report was: focal lymphatic/vascular invasion present, unencapsulated tumors, diffusely infiltrated.  translated, my tumors had burst open and were spilling out into my vascular system. i had read about the possibility of breast cancer due to a large dose of the I-131. but, i did not feel, and the radiologist certainly agreed, that i should skip the I-131 dose. the best advice that i read was in a book by m. sara rosenthal. she is a thyroid cancer survivor herself, and she advised that if the radiologist recommended the RAI treatment it was better to get it, then carefully monitor for breast cancer. have all recommended mammograms- take care of yourself, in other words. i do not ask myself why i had breast cancer. i was one of the 30% who have a second primary cancer. was it the I-131 dose? did exposure to some cancer causing substance cause a gene mutation that turned on and caused another cancer? i will never know the answer to this question. i will have to say that for me personally, i would do the I-131 dose again. i had an aggressive type of thyroid cancer- papillary with follicular variant, and i certainly want to do all that i can not to  have a recurrence.

this has been a heavy blog, on a difficult subject. i hope that i have answered a few questions. i choose not to live my life in fear, but i want the facts so that i can make informed decisions. next time in my blog, we will talk about rainbows, puppy dogs, and butterflies. and then, maybe not.