Who is all closer to the truth?

[Eagle]

Such needinstva opinions of doctors for a long time did not meet. Therefore it is ready to listen to opinions of experts and at this forum.

Mothers cut out shchitovidku in connection with a medullary cancer in April in Kiev. To spend an irradiation it was planned at once after homing in native city. But during operation vocal chords have been damaged or injured.

1. Therefore some doctors in institute have insisted to transfer or carry a course of irradiations till September, yet spadut swell ligaments or cords (the present diagnosis: a paralysis of the right ligament or cord;sheaf, perez left). The voice at mother recently was restored (hoarse).

2. Today the local oncologist has chided it or her that she at once has not passed or has not taken place an irradiation. Speaks, that now it already late to do or make. No effect will exist. It was necessary during a maximum of three weeks after operation to do or make.

3. Some Kiev endocrinologists approved or confirmed, that at a medullary cancer the irradiation is ineffective and is spent basically for reinsurance. It is possible to not spend it or him at all.

4. The checked ENT has told or said, that a medullary cancer - the extremely aggressive disease, therefore an irradiation to begin tomorrow. Except for that has written a direction on feohrapaditomiju since adrenals are first candidates on a cancer after shchitovidki.

So to whom all to listen?

[Light]

Specify the diagnosis completely as he is formulated in an extract from surgical unit.

Result of last analysis on TTG and a thyreoglobulin?

Dose of a L-thyroxine?

Age of your mum? Accompanying diseases?

[VanushkoVE]

Radial therapy (LT) at a medullary cancer is shown at the expressed invasive or aggressive body height of a tumour (germination of a trachea, an esophagus, muscles, etc.) and absence of an opportunity considerably this tumour to remove. Or LT it is shown at nonresectable metastasises (for example, in a bone) mestno.

If, in opinion of the operated surgeon, the primary tumour is removed completely special indications to carrying out LT are not present.



Basis in treatment MRSHCHZH - operation. But, it is far not always it or her it is possible to execute considerably. All depends on prevalence of process.

The control over radicalism of operative treatment as actually and its or his forecasting, is carried out by studying stimulirovannogo a level of a calcitonin of a blood (http: // www.clinthyroid.ru/n_02_03/f_02_06_01.htm).



With MRSHCHZH it is necessary for all patients to carry out genetic research on revealing of the possible or probable mutations RET- defining or determining forms MRSHCHZH which can be passed by right of succession.

[Eagle]

Specify the diagnosis completely as he is formulated in an extract from surgical unit.

Result of last analysis on TTG and a thyreoglobulin?

Dose of a L-thyroxine?

Age of your mum? Accompanying diseases?

Extract from a case history:

*quot; Age: 53

The final diagnosis: the Medullary carcinoma of a thyroid gland pT2N0M0

Bilateral paresis of a larynx (postoperative), a stenosis in a stage of subindemnification. An arachnoidal cyst of the right temporal share of a brain. A hernia of disk -5 with -vascular displays. The is psychogenic-caused -vascular dystonia on hypertonic type with paroksizmalnym current of disease, an astheno-neurotic syndrome. And quot;

Analyses on TTG and a thyreoglobulin still were not spent. Control inspection is appointed or nominated to the extremity or end of July. At present a L-thyroxine on 100 mkg/?OO of 1 times in the morning up to meal.

[VanushkoVE]

1. It is necessary to study or investigate stimulirovannyj a level of a calcitonin of a blood (assay is described in clause or article under the link in my previous post).

2. At a normal level stimulirovannogo a calcitonin assay should 1 time in half a year is spent.

3. At a high level stimulirovannogo a calcitonin, even, despite of possible or probable normal digits of a basal calcitonin, it is necessary to spend search of the possible or probable remote metastasises and to solve the problem on an intervention on lymphonoduses of a neck (I so have understood, that no groups of lymphonoduses deleted).

[Eagle]

Radial therapy (LT) at a medullary cancer is shown at the expressed invasive or aggressive body height of a tumour (germination of a trachea, an esophagus, muscles, etc.) and absence of an opportunity considerably this tumour to remove. Or LT it is shown at nonresectable metastasises (for example, in a bone) mestno.

If, in opinion of the operated surgeon, the primary tumour is removed completely special indications to carrying out LT are not present.



Basis in treatment MRSHCHZH - operation. But, it is far not always it or her it is possible to execute considerably. All depends on prevalence of process.

The control over radicalism of operative treatment as actually and its or his forecasting, is carried out by studying stimulirovannogo a level of a calcitonin of a blood (http: // www.clinthyroid.ru/n_02_03/f_02_06_01.htm).



With MRSHCHZH it is necessary for all patients to carry out genetic research on revealing of the possible or probable mutations RET- defining or determining forms MRSHCHZH which can be passed by right of succession.

Thanks for the answer! On a calcitonin in our city do not check. The analysis in Kiev we shall spend. Only there about stimulirovannyj spoke nothing. If in Kiev will not offer such research, the usual analysis on a level of a calcitonin will be insufficiently?

And in occasion of genetic research. Whether necessarily to carry to Moscow for this purpose mum. It can is possible to hand over these analyses to me or my brother. Or this protoonkogen is not always passed?

[VanushkoVE]

If there is mutation RET-, the probability of its or her inheritance makes 50 %.

[Eagle]

1. It is necessary to study or investigate stimulirovannyj a level of a calcitonin of a blood (assay is described in clause or article under the link in my previous post).

2. At a normal level stimulirovannogo a calcitonin assay should 1 time in half a year is spent.

3. At a high level stimulirovannogo a calcitonin, even, despite of possible or probable normal digits of a basal calcitonin, it is necessary to spend search of the possible or probable remote metastasises and to solve the problem on an intervention on lymphonoduses of a neck (I so have understood, that no groups of lymphonoduses deleted).

While asked to you questions, you have already partially responded to them.:) Thanks!

Extract from the report of operation: *quot; From srednejaremnoj groups the lymphonodus in the size of 0,5 sm, a is soft-elastic consistence is removed. At audit the thyroid gland is increased in sizes due to both shares, koltseobrazno covers a trachea, in the right share education in the size 1,51,5 sm, a dense consistence, the spherical form (TAPB) is defined or determined. Mobilization both add a board. Glands, are visualized and saved recurrent nerves from both parties or sides during 2,5 see the thyroidectomy Is made. In regionarnyh collectors of a lymph drainage of a pathology it is not revealed. And quot; my knowledge in the field of medicine How much or As far as suffice, any sites are removed, and any are saved?

[VanushkoVE]

At MRSHCHZH separate lymphonoduses to delete it is not meaningful. It is necessary to delete a fat with lymphonoduses within the limits of the certain zone of a neck completely.

[Eagle]

At MRSHCHZH separate lymphonoduses to delete it is not meaningful. It is necessary to delete a fat with lymphonoduses within the limits of the certain zone of a neck completely.

You mean, what the nearest year to us again will have to be operated?: (

[R. A. A.]

As the oncologist, I join a voice uvazhaemago Vladimir Eduardovicha. Closely or attentively re-read its or his answers. About a modern status of a problem of diagnostics and the treatment of a medullary cancer of a thyroid gland stated by experts of the Russian oncologic centre of science of Russian Academy of Medical Science by it or him. N.N.Blohina can be looked or seen here (http: // www.consilium-medicum.com/media/onkology //02_03/109_1.shtml), and necessarily and the importance of monitoring of a level tireokaltsitonina at medullary RSHCHZH look or see here (http: // thyronet./th_spec/thyr--3-01-5.htm). If know English it is possible to glance to burzhujam (http: // www.thyroidmanager.org/Chapter18/18-cancerframe.htm). These are the standards standard in the world, unfortunately, that Russia, that Ukraine - problems has precisely outlined Nikolay Vasilevich Gogol:)

[VanushkoVE]

You mean, what the nearest year to us again will have to be operated?: (



All depends on level STIMULIROVANNOGO of the CALCITONIN of the BLOOD.

Once again, I emphasize, STIMULIROVANNOGO the CALCITONIN of the BLOOD, irrespective of a level of a basal calcitonin.

[Eagle]

All depends on level STIMULIROVANNOGO of the CALCITONIN of the BLOOD.

Once again, I emphasize, STIMULIROVANNOGO the CALCITONIN of the BLOOD, irrespective of a level of a basal calcitonin.

Thanks! I unpack or I print out clause or article and I shall show our oncologists because at us such analysis for some reason do not offer, and in fact complex or difficult there anything is not present.