Case of a fictitious patient: Don Felipe, 70, always left appointments remembering the one thing he had meant to ask. His granddaughter printed a list from this guide, and he brought it folded in his shirt pocket. “For the first time,” he said, “I walked out with answers instead of more questions.”

Why bring a list

Research in people with many kinds of cancer (not thyroid cancer specifically) shows that bringing a written question list helps patients ask more questions and take a bigger part in decisions about their care; lists that come with simple tips on how to use them work even better ^[1]. A list will not by itself make you less anxious ^[2], but it helps you prepare and get the information you need. The studies measured communication, not thyroid treatment results.

Tips: pick your top three questions and ask them first; bring someone to take notes; ask “What does that mean for me?” when a term is unclear; and ask what the next step is before you leave.

1. A nodule was found (Chapters 8–9)

• What did the ultrasound show, and what is my TI-RADS category?
• Do I need a biopsy, or can we watch it?
• If we watch it, when is the next ultrasound?
• Are my thyroid blood tests normal?

2. My biopsy result is back (Chapters 10–11)

• What is my Bethesda category, and what does it mean?
• If it is “indeterminate,” are molecular tests an option for me?
• What are my choices: monitoring, a non-surgical treatment, or surgery?

3. Before surgery (Chapters 14–18)

• Why do you recommend a lobectomy or a total thyroidectomy for me?
• How many thyroid operations do you do each year?
• Will my vocal cords be checked before and after surgery?
• Will you use nerve monitoring?
• How will you protect my parathyroids, and will my calcium be checked?
• Will I need thyroid hormone pills afterward?

4. After surgery (Chapters 19–21, 36)

• Who do I contact after hours, and which symptoms mean I should call 911?
• If my calcium runs low, what is my written plan, and when do I call?
• Who checks my voice and swallowing if they change, and when?
• When can I go back to work, drive and exercise?
• When will my thyroid levels be checked, and who will adjust my dose?
• What did the final pathology show?

5. Thyroid cancer follow-up (Chapters 23–27)

• What is my risk of recurrence, and what is my response to treatment?
• Do I need radioactive iodine? Why or why not?
• What will my follow-up include (ultrasound, thyroglobulin), and for how long?
• What TSH level are we aiming for?

6. My voice or swallowing changed (Chapters 30–35)

• Has anyone looked at my vocal cords since surgery?
• Is one vocal cord moving less, or is the change from something else?
• Would voice therapy help me?
• If it does not improve, what treatments exist, and when should they be considered?

Don Felipe’s tip

“Write the answers next to the questions,” Don Felipe advises. “Next visit, you start where you left off.”

Sources

1. Han R, et al. Effectiveness of question prompt list interventions for patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Asia Pac J Oncol Nurs. 2025;12:100765. doi:10.1016/j.apjon.2025.100765 PubMed PMID 40896753
2. Wang SJ, et al. Question prompt list intervention for patients with advanced cancer: a systematic review and meta-analysis. Support Care Cancer. 2024;32(4):231. doi:10.1007/s00520-024-08432-3 PubMed PMID 38492095

This guide is for general education only. It does not diagnose conditions or replace a medical evaluation. Talk with your own doctor about your situation. In an emergency, call 911 now (in Puerto Rico or the United States; elsewhere, your local emergency number).