Daphne Tsai

In 2018, at around Christmas time, I noticed that my voice was hoarse. It was a problem that had occurred often in the past, on and off. I dismissed it as profession-related, in that as a financial advisor I had to talk all day. This time, however, no matter what I did, it stayed that way. By June of the following year the hoarseness had worsened. It took a lot of strength to speak. I finally decided to take time off to rest my voice and see a doctor.

I was referred to an ENT specialist, who looked with an endoscopic camera inside my nose. He told me that I had unilateral vocal cord paralysis. CT scans of my neck and upper chest and blood tests were ordered to find out the cause. Blood tests came back normal. However, the CT scan located a tumor two centimeters in diameter near the base of my neck. The ENT thought it could be in my lymph nodes and recommended a biopsy.

A biopsy was performed and thyroid cancer was confirmed…

At around the same time, I went out with a friend who happened to work with a head and neck surgeon. She encouraged me to see him for a second opinion. When I met with the doctor, I was immediately impressed with how seriously he and his team appraised the situation. They looked at my previous scans and carefully studied my medical history and medications before the consultation.

After his examination, the surgeon told me that I had thyroid cancer. At first, I was displeased. How did he know it was malignant without a biopsy? Couldn’t it be benign? The surgeon explained that the vocal cord, which sits right behind the thyroid glands, was clearly affected, and that kind of thyroid tumor is rarely benign. A biopsy was performed and thyroid cancer was confirmed. Also, cancerous cells were found in a half-centimeter-wide lump in the lymph nodes. That surgeon knew what he was talking about!

I talked more with my family and found out that both of my sisters have thyroid issues—realizing how strong the hereditary influence was, I insisted that my 18-year-old daughter’s thyroid get checked…

I was very grateful that my friend had nudged me to see the surgeon. Due to a cancellation in the surgery schedule, I was able to have a thyroidectomy within two weeks of the biopsy, which relieved a lot of my anxiety. Since the cancer had spread from the thyroid glands to one of the vocal cords and lymph nodes, radioactive iodine treatment followed the surgery. I had to quarantine myself for a week, but did not experience too much discomfort.

In fact, I did not have discomfort other than the voice hoarseness throughout the whole process. That is part of why I first dismissed my symptoms as merely a result of my job. I knew my mother and younger sister had hyperthyroidism, but at the time of my diagnosis, my TSH levels were normal. My blood test was normal. After learning about my diagnosis, I talked more with my family and found out that both of my sisters have thyroid issues. Realizing how strong the hereditary influence was, I insisted that my 18-year-old daughter’s thyroid get checked and found out that she also has a small nodule.

…it’s important not to dismiss the signals your body is sending…

I think awareness is very important, especially because thyroid problems are more common than people realize, and they affect your whole body. People talk about breast cancer and diabetes. People don’t talk about thyroid cancer. My primary doctor was distraught when I saw her before my surgery. She said, “How did I not detect it?” But my thyroid surgeon said that even if you have a lump, it’s hard to detect. And I believe that most medical questionnaires do not inquire about family history of thyroid issues. I think it’s important to increase awareness for patients and the medical field and to recognize the prevalence of thyroid cancer.

In the end, there are so many nuts and bolts, and everyone just has to do their part. I would recommend that you do your research and try to find the best doctors. I had very competent doctors, and the best doctors were also very caring and always gave me their full attention. They explained themselves and studied my other medications to make sure that new ones were safe to take. Finally, it’s important not to dismiss the signals your body is sending. I ignored the hoarseness of my voice for years and I was too ignorant to pay attention to my family history of thyroid issues. If I had, I might have saved my thyroid gland or at least the one vocal cord that was removed. Rather, I have to live with voice hoarseness for the rest of my life. Fortunately, my daughter’s thyroid nodule was detected early and it will be closely monitored.