Pam Mendenhall | caregiver of three family members with thyroid cancer | high needle biopsy

One by one, Pam Mendenhall of Dubuque, Iowa, learned that her husband and two daughters were diagnosed with thyroid cancer. All three survived, but she tells the @CancerInterviews podcasts being their caregiver was not easy.

The journey began in 2005 with her then-nine-year-old daughter, Alyssa, who felt a lump in her neck. She went underwent an ultrasound, then a high needle biopsy, followed by painful biopsy passes, in which a needle is repeatedly into the neck, very tough for a nine-year-old. Doctors said the nodule that was examined was benign, but she was diagnosed with Hashimoto’s thyroiditis, in which one’s immune system attacks the thyroid.

Not long after that, Alyssa’s younger sister, five-year-old Jessica, also felt a lump on her neck. Jessica also underwent a high needle biopsy on a nodule and said that nodule was benign, classified as a benign adenoma nodule. Nonetheless, Pam and her husband, Dan, decided to have Alyssa’s and Jessica’s thyroids removed. A nurse pleaded with Pam to perform this procedure on Alyssa because Alyssa would need hormone replacement therapy for the rest of her life.

Once Alyssa’s thyroid was removed, doctors told Pam the thyroid was cancerous, highly unusual for someone of Pam’s age. The diagnosis was follicular thyroid cancer, even more unusual for a child. Pam and Dan next to decide if Alyssa should undergo radioactive iodine therapy. The surgeon could not get all the thyroid cancer cells, so the radiation, administered in liquid or pill form, kills off the rest. With all this radiation in her, once home, the rest of her family had to stay away from her for three days.

In January 2006, Pam and Dan decided to have Jessica’s thyroid removed as well. A post-procedure scan showed Jessica’s thyroid was not cancerous, but she was diagnosed with an atypical follicular adenoma. Doctors said had the thyroid not been removed it probably would have become cancerous.

Dan and Pam Mendenhall did more research, and that he and their two daughters had what is called a ’26 pair deletion’ on their tenth chromosome. They call it a PTEN mutation. Oftentimes people who have that mutation have something called the Cowden Syndrome, which unfortunately for Pam’s family is a cancer syndrome, because it places those with the syndrome at risk for six additional cancers.

This led to tests for Dan, and a doctor told Dan he had several nodules in his thyroid. So, in August 2006, Dan had his thyroid removed.

Going forward, Dan, Alyssa and Jessica need frequent bloodwork, endometrial biopsies and kidney ultrasounds. Pam says it will always have to be this way. With other cancers, when a patient becomes cancer-free five years after treatment, that is a cause for celebration, but thyroid cancer is slow-moving, one can never be sure the worst is over.

In addition to the emotional trauma, Pam needs to play traffic cop, making sure her husband and daughters go to all their appointments.

By way of advice, Pam Mendenhall is a staunch advocate of genetic testing. In the case of her family, it provided them with knowledge that helped them to get in front of thyroid cancer and the possibility of other cancers as much as possible.

Additional Resources:

Thyroid Cancer Survivors’ Association (ThyCa) : https://www.thyca.org