Ah, thyroid cancer. That beautiful thing that people assume is curable and “no big deal.” The truth is there is no good type of cancer. Anyone who says there is hasn’t had it or watched a loved one go through it. Actually, people who say that are just relieved because when you say thyroid cancer they don’t think they have to feel sorry for you because they assume you’re cured or will be soon. They don’t have to get emotional or know what to say. Be sensitive. Don’t say that shit. (Excuse the language.)
There are four main types of thyroid cancer: follicular, papillary, anaplastic and medullary. The names come from the type of thyroid cells where the cancer cells grow. Papillary is the most common type, accounting for roughly 80% of thyroid cancers. It has a high ten-year survival rate, which is why people assume it’s not that awful. One patient I know responded to a “wow, you’re lucky you got the good cancer” with “Yeah, I know, right? I hope you get it too.” Puts it in perspective a little. No one wants cancer. Papillary is very treatable but if not caught early, like all cancers, it can be deadly.
Follicular cancer is less common—only 15% of the people who get diagnosed with thyroid cancer have this type. It is considered “more malignant” than papillary, possibly partly because it’s found more often in older adults and is very rare in children.
Anaplastic is the rarest—less than 1% of thyroid cancer is anaplastic. It is very deadly and most patients do not live more than one year after diagnosis. Enough said.
And that brings us to medullary thyroid cancer. It’s the third most common, making up 3% of the total thyroid cancer cases. It originates in the parafollicular cells of the thyroid (the C cells), which make calcitonin, a hormone. Thus, measuring the calcitonin in someone’s blood stream can be an indication of abnormal growth of C cells, meaning the cancer is spreading or growing. Not everyone who has medullary thyroid cancer has Multiple Endocrine Neoplasia 2a like me, but 99% of people who have Multiple Endocrine Neoplasia 2a develop medullary thyroid cancer, which is why we had Owen’s thyroid removed.
Ten-year survival rates for medullary thyroid cancer are 90% if the disease has not spread outside of the thyroid (like Owen’s), 70% when it’s spread locally to lymph nodes in the neck, and 20% when it has spread to other parts of the body. My beautiful cancer falls into that middle group—70%. So what’s it like to live knowing you have a 70% chance of being alive ten years from now? It’s weird. It can feel very scary. Especially when you’re only 35 years old and you have a small child. Ten years from now I’ll be 45 and he will be 13 (nearly 14). But I wonder, what are my basic odds of surviving the next ten years anyway? Between car accidents, other illnesses, and general statistics, my odds can’t be 100%. Are they 90%? 85%? Who knows. But today I’ll take 70%. A low C grade. Because that’s the hand I was dealt. And every six months I get to be afraid again for a few days while I wait for my calcitonin results. I’ll allow myself to worry and be scared for those few days. After that it’s back to living. I’m always telling my nieces to only worry about things they can control. I can’t control how this cancer will grow and spread, so the only thing I can control is how I think about it and what I choose to do with the time I’ve been given on Earth. I choose to live with gratitude and appreciation for everyday things. That’s my choice.