Thyroid Cancer: A Guide for Patients


When you hear that you have cancer, your world starts spinning, not for a moment or two, but for what feels like an eternity. Then in a short time, it often comes crashing down around you, as well as upon those who love you and care for you, leaving you depressed, frightened, and in deep anguish. The questions are almost always the same. How do I deal with this? Will I see my kids grow up? Will I live long enough to see my daughter get married? Will my grandchildren ever know me? Or if it is your child who has cancer, the first response is "NOT MY CHILD!" Then, after a bit, more questions come. Children don't get thyroid cancer, do they? What did I do wrong?

I have told hundreds of patients the same thing at this moment: "live one day at a time. If it's a good day, don't ruin it with anxiety about the future or regrets about the past. To the extent that you can, let the sun shine in today." After you think about this for more than a heart beat the question is always, "How do I deal with this bad news right now?" The answer is astonishingly simple for most people. You need reliable information about your problem. This is not to mean a pat on the head and the trite words, "Don't worry, this is a good cancer." It always breaks my heart to hear this. There is no good cancer – at least not according to any patient or family that I ever met. If it's your cancer, how on earth can it be "good"?

It became clear to me early in my career that long explanations in the office usually don't penetrate the wall of fear and anxiety and often go unheard by even the most sophisticated patients when the subject is their life and the words "thyroid cancer" come into the conversation. Many times I have had to give a person the bad news that the fine-needle aspiration results show thyroid cancer. Then, after answering a barrage of questions as clearly as I know how to do, the patient often leaves the office shook up and looking stunned. An hour later I get a call from the patient with the following question, "But Doc, do I have cancer? It's OK, you can tell me straight out, I want to know." It usually takes several visits to communicate the information in a way that makes sense to the patient. Even so, this is often less than satisfactory. It takes time to absorb all the information that you need to care for yourself, and unfortunately the particulars of this subject are rife with misinformation.

This book is long overdue. It will provide thyroid cancer patients with a strong set of tools: information from experts, access to Web sites, books, and friendly people who have been there and want to help, and much more. It tells you what your doctor knows about this disease. It should help you to understand and to fight back. Reliable information is a powerful weapon against cancer. It not only puts the problem in perspective, but it gives options and choices that might not be readily apparent to a person. This book might at first glance look intimidating, containing more than you want to know about thyroid cancer and a bit daunting to a person who has no medical background. Reading it like you would a novel is probably not the right approach for most people. I never read textbooks from cover to cover – I can't remember what I am reading when I take this approach. Instead I hunt and peck for information that I want. When one of my questions is answered, a barrage of new ones comes to mind. If you do this, you will find the book a rich source of information, treasures, and nuggets –what doctors have for years called "pearls."

So, this is a book of "pearls" for patients. I have no doubt that my patients will find the answers to many questions that they just don't remember to ask when they are in the office. You will find that this book has answers from experts and truly dedicated people who want to make your life or that of someone dear to you better. My guess is that your doctor will provide further clarification and tailoring of the answers to your personal problem, but you will have a better grasp of the information about your thyroid cancer when the doctor does this.

Physicians must respect the wishes of our patients. To make your own choices and decisions you need information. This book will give you that knowledge. It will give you options and will help you define your own personal choices. This is necessary if you want to help your doctor find the best routes for your recovery. It's your body and your choices that count!

Ernest L. Mazzaferri, M.D., M.A.C.P.
Emeritus Professor and Chair of Internal Medicine,
Ohio State University
Adjunct Professor of Medicine, University of Florida
Fall 2004: President-Elect, American Thyroid Association
Fall 2005: President, American Thyroid Association