Second opinion, thyroid cancer surgery finally put survivor in remission

It’s taken nine years, but Paulette Spivey finally can say with confidence that she’s living without any evidence of cancer.

“I know that I wouldn’t have gotten well had I not gone to MD Anderson,” she says. “No one else could locate the source of my problem.”

Initial thyroid cancer surgery and lymph node removal

Paulette’s “problem” was the high level of thyroglobulin she continued to experience. She’d had her thyroid removed in 2008 after she was diagnosed with papillary cell carcinoma, an often slow-growing form of thyroid cancer. She had radioactive iodine twice, and in 2015, a second neck surgery to remove cancerous lymph nodes. But she still had cancer.

Over the years, Paulette saw four endocrinologists in Arkansas, where she lives. None of them could explain why her blood tumor markers were still detectable.

But when a CT scan performed last October showed nodules in her lungs, Paulette became proactive.

“My endocrinologist thought that it was a metastasis. His recommendation was that we wait six months and check it again to see if they were bigger,” she recalls. “I just knew I would be crazy if I had agreed to wait six months to find out if it is indeed metastasis.”  

A second opinion at MD Anderson

Paulette asked her doctor to refer her to MD Anderson for a second opinion. She had friends who’d been treated here and knew of its reputation from them.

At Paulette’s first appointment, Maria Cabanillas, M.D., said that the likely reason for the persistently elevated thyroglobulin level was that not all of the thyroid cancer had been removed in 2008, and she’d probably need another surgery to remove the cancer that remained in her neck after her previous treatments. As Paulette recalls, “Then, my husband speaks up and says, ‘Dr. Cabanillas, how could you know that? She hasn’t even had any tests yet.’ Dr. Cabanillas just kind of laughed and said, ‘I know, but we do this every day, and I’ve seen a lot of cases, and that’s just what I think we’re going to find.”

Paulette then underwent several tests. That evening, she received a phone call from Cabanillas.

Based on Paulette’s test results from earlier that day, Cabanillas repeated exactly what she’d told the Spiveys that morning, and that the surgery was scheduled for January.

“I was just blown away,” Paulette recalls.

Thyroid cancer surgery at MD Anderson

On Jan. 25, 2017, Mark Zafereo, M.D., performed Paulette’s thyroid and neck surgery. To minimize scarring, he went in from an incision made during one of her earlier surgeries.

During the surgery, Zafereo discovered more cancer in Paulette’s neck. He removed a small portion of two neck muscles that contained many tumor nodules, as well as 11 lymph nodes, eight of which tested positive for cancer.

“Dr. Zafereo was so, so careful,” she says. “He just did a wonderful job, which made my recovery easier.”

Paulette had her drain removed four days after the procedure and was able to get back on the treadmill just a few days later. She can do everything she could before, and the indentation in her neck from where Zafereo removed the muscle is barely noticeable.

Life after thyroid cancer

During her last follow-up appointment in May, Paulette learned there were no signs of metastatic disease on the CT scans or the ultrasound.

“There was no disease on the imaging and my thyroglobulin level was undetectable, which is the first time that’s happened since this all started,” she says. “All signs indicate that they removed all the cancer.”

Paulette knows she has a higher chance for recurrence in the future since her cancer had spread to her lymph nodes and muscles, but she’s not letting fear consume her.

“I have MD Anderson on my side and I know they can take care of it, so I’m not worried,” she says. “I’m going to enjoy this as long as possible, and I’m going to be happy and excited. If I have to come back down, I will, but until that time, I’m going to be very thankful.”

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