A Second Opinion "Leap of Faith" With No Regrets: Helen's Story
By Jim Stallard
Helen Courtney was 47 years old when she felt a lump in her lower neck that was later diagnosed as thyroid cancer. She lived an hour from New York City and came to Memorial Sloan Kettering for a second opinion.
Helen, George, and Allison
One summer afternoon, while waiting in her car at an intersection, Helen Courtney, then 47, was adjusting her necklace when she felt a lump in her lower neck. A few days later, her primary care doctor confirmed that she had six lumps on her thyroid.
Helen got a referral to a surgeon, who said the nodules were most likely benign but sent her for a fine needle aspiration. (This is a type of biopsy during which tissue or fluid is removed using a thin needle for examination under a microscope.) "I was still thinking that it wasn't going to be anything," Helen recalls. But a week later, she got a call from the doctor's office saying that she needed to come in to talk about the test results.
Helen was diagnosed with papillary carcinoma, the most common type of thyroid cancer. "It was almost surreal when he said, 'We found cancer, and we have to take out your thyroid. But you don't have to do it with me. You can get a second opinion.' "
A friend whose father was treated at Memorial Sloan Kettering urged Helen to have a consultation. Taking her friend's advice, Helen called and scheduled an appointment with MSK head and neck surgeon Ashok Shaha.
A Team Approach to Care
When Helen and her husband, George, met with Dr. Shaha a few weeks later, he agreed that surgery to remove her thyroid in a procedure called a thyroidectomy was necessary. He explained that after the operation, he and endocrinologist Michael Tuttle would monitor Helen and that she would need to take replacement thyroid hormone medication. A regimen of radioactive iodine might also be necessary, he told her, to ensure that all the cancer was destroyed. (Radioactive iodine, a form of internal radiation therapy, is administered orally. The radioactive iodine is taken up by the thyroid gland and destroys thyroid cells.)
Even though they liked Dr. Shaha and felt good about his approach, Helen and George were uncertain whether to come to MSK for her treatment or continue with the surgeon closer to their home in the Hudson Valley, about an hour north of Manhattan. As they stood outside Dr. Shaha's office discussing their options, a woman with a noticeable scar on her neck approached them.
"The woman told us that she had overheard our conversation," Helen recalls. "She said that she also hadn't known where to go for her thyroid cancer treatment, but she'd done all her research and had great results with Dr. Shaha." Helen and George took her positive endorsement as a good sign and decided to proceed with Drs. Shaha and Tuttle's team approach.
How to Talk with Their Teenage Daughter
Throughout this process, the couple decided not to give their 15-year-old daughter, Allison, many details about Helen's diagnosis. With Allison so busy with schoolwork and athletics, they didn't want to worry her until they felt confident that everything would be fine. But they quietly alerted her friends' parents about Helen's surgery, just to be sure she would have a few other people looking out for her. Thinking back, Allison says, "I didn't understand why all of my friends kept inviting me over!"
"It was interesting how our friends would give us different advice on whether we should tell her or not," says Helen. "But I wanted to do it in my own time and in my own way." George continues: "Even though it was serious, we had all of the faith in the world in Dr. Shaha and Dr. Tuttle and that the cancer would be gone after her surgery."
Surgery and Follow-Up Care
In late October 2007, a few weeks after meeting Dr. Shaha, Helen underwent surgery at MSK. "I came home on Halloween with my own Frankenstein scar!" Helen jokes. About a week after her operation, she had a follow-up appointment with Dr. Shaha and met with Dr. Tuttle for the first time. Based on the results of the surgery and the pathology report, her doctors did not feel that radioactive iodine was necessary, but Dr. Tuttle started Helen on thyroid hormone therapy to replace the hormones that the thyroid normally makes and to decrease the risk of recurrence.
In the months that followed, Helen's recovery from surgery went well, and she got used to the hormone medication. "I've been able to more or less maintain my daily activities with only slight modifications," she reports. Helen resumed her full-time job as a pharmaceutical representative, and she and her family enjoyed a weeklong vacation to the Grand Canyon in April 2008.
Even though the hospital was an hour away from their home, Helen and George have no regrets about their decision to come to Memorial Sloan Kettering. "Some people don't want to go because of the distance," says George, "but I always tell them that they should go to the best. Don't worry about driving back and forth — your friends will get you down there."
I think because I have a great family and everyone around me is so positive, I feel like nothing's going to happen to me!
One of the biggest surprises for Helen has been the positive attention her scar receives from the people around her. "When Dr. Shaha told me about the incision he was going to make, he said that I should 'wear it with pride' — meaning that I didn't have to be bashful," says Helen, touching her neck lovingly. "I find that I hardly wear necklaces anymore. I'm not afraid to show my scar and I don't try to hide it. I'm not embarrassed by it. This is where I am, this is what I've been through, and if I can help anyone else by them noticing it, then that's good."
Although she realizes that she had a treatable cancer, Helen has come away from her diagnosis with a newfound appreciation for her life as well as for her family and friends. "I had one or two thoughts early on when I wondered if this was it, if I was going to die," she admits. "But you kind of have to go through all of that — what's going to happen to my family, that kind of thing. Cancer is such a scary word, but I think because I have a great family and everyone around me is so positive, I feel like nothing's going to happen to me!"
In 2019, 12 years after her surgery, Helen remains in good health. She continues to see Dr. Tuttle regularly for follow-up appointments, to make sure she stays cancer free. This involves ultrasounds and blood tests, initially done annually but more recently once every two years.
"I always look forward to my visit when I go down [to the city]," Helen says. "I'm not afraid, and I feel very cared for. I can't say enough good things about MSK. I see the science that goes on here and the care that I receive. Looking back, I'm glad I made the leap of faith to seek a second opinion here."
Helen continues taking hormone treatment; she has incorporated the daily pill into her routine with virtually no side effects. She remains active as a pharmaceutical representative and has shared her story with many of the people she sees in and out of doctor's offices during her travels. "I'm always on the lookout for people, especially women. She might be in a similar situation," she says.
Helen is pleased that sharing her experience provides encouragement to others. A distant relative of her husband who had been diagnosed with thyroid cancer reached out to Helen for guidance after seeing this story. The woman ended up coming to MSK herself, where she was successfully treated.
"I'm just thrilled with my treatment at MSK from the beginning, from when I made the first phone call," she says. "That's why I continue to come back, that I don't cut the cord, because I feel that I get cutting-edge care for my disease."
Ashok R. Shaha
R. Michael Tuttle