Surveillance may be suitable for 85% of patients with papillary cancer but what of the 15% with follicular and aggressive follicular variants like Hurthle cell carcinomas?
My FNA and core biopsies were inconclusive, ie they couldn't determine adenoma or carcinoma. Surgery was required to relieve compression on my windpipe and it wasn't until the lobe was biopsied that stage II HCC was confirmed.
Improved ultrasound may detect tiny nodules but until FNA can determine conclusively a) the nodule is a carcinoma; and b) whether it is papillary, follicular or a variant, I wouldn't be inclined to watch and wait.
I think the 15% could end up with the cancer spreading to their lymph nodes, bloodstream & adjoining organs requiring more intensive surgery and a poor outlook.
Improving FNA & core pathology should be prioritised before advocating living with a cancer which may be of a rapid growing and aggressive type IMO.