So I had my surgical consult a couple days ago, and the outcome was... mixed...
The good news, is that they say there's about a 60% chance the tumor is not malignant.
Still a 40% chance that it is; but even if it is malignant, it's very slow growing, the lymph nodes are not involved, and this is not the type of cancer that will travel through the bloodstream.
So, that's pretty good too.
The first bit of bad news though, is kind of a big one. They can't operate right now... or rather they can, but the risk is so high, they wont.
Because of the large size, shape, and positioning of the tumor, it's impinging on, and in fact displacing, my airway by several centimeters. That in an of itself is bad, but not so great a risk that they won't operate.
However, combined with my body mass, the fact that my weight is mostly central trunk, the screwed up endocrine regulation, my tolerance to anesthesia and difficulty of calibrating dosages, AND the fact that they are going to be irritating the airway; they say there is about a 10% chance that I will experience a respiratory seizure, airway closure, or a cardiac event on the operating table.
Weighed against the fact that the cancer is not currently life threatening, they have decided not to operate yet.
Of course, the cancer is still growing, and will impinge on my airway more and more (it's made my gag reflex go crazy. Sometimes I want to puke just swallowing normally); plus it's still causing thyroid effects etc... So it has to come out, it can just wait a while.
A while... while I lose 60-100 lbs in 5-6 months.
They want me to go on an emergency starvation level diet, plus get the lap band surgery NOW instead of afterward (that was always the plan if fixing the endocrine issues didn't let the weight work itself out). They've declared the lapband is medically necessary, and are working through the BS with the insurance company now; but it will take a couple months.
The problem is that my current basal metabolic rate is so suppressed by the endocrine problems, that I literally need to go into medically supervised starvation for this to work; reducing my total caloric intake to somewhere around 800 to 1000 calories per day (about 1/3 of the intake necessary to maintain my current weight, even with my screwed up metabolism, and about 1/5 if my metabolsim were "normal").
To make things even MORE complicated, the surgeon believes that while the thyroid is partially responsible; that I almost certainly have paraneoplastic syndrome, which is almost certainly being contributed to by another cancer, or other lesions/growths, causing my pituitary or adrenal (or both) glands to malfucntion
So I have additional endocrine tests to go through, over the next few weeks; probably including a head and chest MRI; but this time with a different endocrine specialist, who has more experience dealing specifically with these issues.
The final good news being, the team of doctors I know have working on my case are total hardasses. Really agressive, really outcome focused, and they get that I didn't do this to myself, that it isn't just overeating or poor lifestyle choices; that something is wrong, that's making my body malfunction in this way, and it needs medical intervention to fix it.