Testing Tuesday

On Tuesdays I will write about a different kind of biopsy.  It will be a great way to describe each one with detail.  I would love for questions from my readers.  Please ask and I will answer honestly.

Today is dedicated to Thyroid biopsies.  We have all heard of the thyroid and most do not know its' function.  It is common for the thyroid to have nodules.  Most of the time these nodules are found by coincidence during another test, like an ultrasound or CT scan.  Many physicians want to have the nodule biopsied.

Not all facilities or physicians perform biopsies exactly the same.  Protocols vary from place to place.  So I will give a general description.  Typically a nurse will have you sign a consent and stay with you for the whole procedure.  An X-ray tech will assist the doctor.

There is generally no medication given, so the patient can drive oneself to the appointment.  The patient will lye on their back with their head tipped back to help the thyroid pop out.  An ultrasound will be used to guide the Interventional Radiologist to the correct nodule.  The sample will then be given to the lab for analysis.

This procedure is called Fine Needle Aspiration or FNA.  It means that  very small needles are used to collect samples of the tissue.  First the doctor will use lidocaine, a numbing medicine, to numb the track that the needle will follow.  The doctor will put the needle in the nodule and gently push in and out to get the cells for the lab.  About four samples are collected.

                                                              Video Credit: You Tube

After the procedure, many patients describe a feeling of something being stuck in their throat.  This is not unusual and will pass within an hour.  It occurs because the lidocaine injected fills up tissue with the numbing medicine and those tissue are not normally swollen.  So that tissue feels like it is pushing on the throat.

The results from the biopsy are usually available in 3 to 5 days after the biopsy.  The doctor cannot determine the diagnosis during the biopsy.  A pathologist has to examine the samples and it takes a few days.

In total the biopsy takes about a half an hour.  The paperwork and talking take more time than the actual procedure.  Most patients are pleasantly surprised at the ease of this test.



When the doctor is finished  a small amount of pressure is applied to the neck and a bandaid is placed.  It is normal for some bruising to occur.

Picture of the Day

Image Credit: Flickr
What's on the other side?

Life leaves us with so many questions.  Each step taken leads to new paths.  But when it comes to cancer there are numerous unknowns.  Prior to a cancer diagnosis, there are many scary steps to finding a diagnosis.  Fortunately many biopsies turn out to be benign, but before you have the procedure to test the lesion it can be very nerve racking. 

Interventional Radiologists perform many biopsies.  These are not as invasive as surgery and can be done on an outpatient schedule.  The doctors use imaging technology to guide their needle to the correct place.  Many of these can be done without sedation medication.

Although you do not find out the results of your test the day of the procedure, you have to worry about what they could be.  You wonder how life may change.  What will happen on the other side of these tracks if this is cancer?

I cannot tell you how your life will change, but I can tell you that every patient I have worked with is surprised when the biopsy is finished.  They always ask, "Are you really done? or Was that it?".  The actual biopsy is not the hard part.  It is the worrying, waiting, and wondering about the results.

Biopsies that are performed by Interventional Radiologists vary.  They include thyroid, lymph node, lung, bone marrow, liver, renal, soft tissue, and any other lesion that is safe to access without surgery.  It is good to know that the doctor looks at all images prior to approving the biopsy to be done in Interventional Radiology.

Each biopsy is unique and requires the use CT, fluoroscopy, or ultrasound.  The type of structure to be biopsied determines this.

I see on a daily basis how much thought and hard work goes into planning every biopsy.  The staff has already looked into the patients history before even meeting the patient.  This is a very delicate and detailed process.

My one suggestion is that you become a part of your own healthcare.  Ask questions.  Ask questions. Ask questions.  Listen or have somebody with you that can listen.  Write things down or ask the staff to write it for you.  It is essential to be involved.

So when you wonder what lies for you on the other side, remember to be involved and be a part of how you get to the other side.