Getting Ready For Surgery
You and your care team will work together to get ready for your surgery. Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if youre not sure.
- I take a blood thinner, such as:
About Drinking Alcohol
The amount of alcohol you drink can affect you during and after your surgery. Its important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
- If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know youre at risk for these problems, we can prescribe medications to help keep them from happening.
- If you drink alcohol regularly, you may be at risk for other problems during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.
Here are things you can do before your surgery to keep from having problems:
- Be honest with your healthcare providers about how much alcohol you drink.
- Try to stop drinking alcohol once your surgery is planned. Tell your healthcare provider right away if you:
- Get a headache.
For help, watch How to Enroll in MyMSK: Memorial Sloan Kettering’s Patient Portal. You can also contact the MyMSK Help Desk by emailing or calling .
Checking Your Vocal Cords
Before and after surgery, a doctor may check your vocal cords. This is because the nerves that control your vocal cords are close to the thyroid gland. The doctor may use a local anaesthetic spray to numb your nose and throat.
Then they will pass a thin, flexible tube with a small camera at the end through your nose to look at how your vocal cords move. This can be a little uncomfortable, but it should not be painful.
You may be asked to avoid eating or drinking for a few hours after the test, until the local anaesthetic wears off.
Risks And Side Effects Of Thyroid Surgery
Complications are less likely to happen when your operation is done by an experienced thyroid surgeon. Patients who have thyroid surgery are often ready to leave the hospital within a day after the operation. Potential complications of thyroid surgery include:
- Temporary or permanent hoarseness or loss of voice. This can happen if the larynx or windpipe is irritated by the breathing tube that was used during surgery. It may also occur if the nerves to the larynx are damaged during surgery. The doctor should examine your vocal cords before surgery to see if they move normally.
- Damage to the parathyroid glands . This can lead to low blood calcium levels, causing muscle spasms and feelings of numbness and tingling.
- Excessive bleeding or formation of a major blood clot in the neck
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About Your Thyroid Gland
Your thyroid gland is a small, butterfly-shaped gland in the lower part of the front of your neck . It makes hormones that control the way your body turns oxygen and calories into energy. Your thyroid is made up of a left lobe and a right lobe. The area where the lobes join is called the isthmus.
Your parathyroid glands are 4 small glands located behind your thyroid. They make a hormone that helps control the level of calcium in your blood.
Lymph nodes are small oval or round structures found throughout your body. Theyre part of your immune system and make and store cells that fight infection. They also filter bacteria, viruses, cancer cells, and other waste products out of your lymphatic fluid.
Figure 1. Your thyroid gland
Second Cancers After Thyroid Cancer
Survivors of thyroid cancer can be affected by a number of health problems, but often their greatest concern is facing another cancer. Cancer that comes back after treatment it is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer.
Unfortunately, being treated for cancer doesnt mean you cant get another. People who have had thyroid cancer can still get the same types of cancers that other people get. In fact, they might be as risk for certain types of cancer.
People who have or had thyroid cancer can get any type of second cancer, but they have an increased risk of developing:
Adrenal cancer risk is especially high in people who had the medullary type of thyroid cancer.
Patients treated with radioactive iodine also have an increased risk of acute lymphocytic leukemia , stomach cancer, and salivary gland cancer.
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How Is Thyroid Cancer Detected
Oftentimes, primary care providers initiate thyroid tests if they feel an enlarged thyroid or nodules during an annual wellness visit. They will usually recommend the patient have an ultrasound of their neck and also see an endocrinologist.
It is also common for thyroid nodules to be incidental findings when someone has an ultrasound of their neck for another reason, such as an injury.
If the ultrasound reveals one or more suspicious nodules, the endocrinologist may recommend a biopsy, depending on the size and shape of the nodules and your symptoms.
Ultrasound-guided fine-needle aspiration biopsy of the thyroid gland
A biopsy is required to confirm thyroid cancer. An endocrinologist or interventional radiologist will perform an ultrasound-guided fine-needle aspiration biopsy. They will insert a thin needle into the nodule to take a sample of it. A pathologist will then study the tissue sample to determine if it is cancerous.
Can You Live A Normal Life After Thyroid Removal
Most people return to their normal lives and usual activities within a few weeks after thyroidectomy. If you have cancer, surgery may be the only treatment you need. If surgery isnt expected to cure the cancer, you may need to have other therapy, such as radiation.
Youll likely have regular blood tests, depending on how much thyroid tissue you have left. You may also need to take thyroid hormone replacement to prevent complications. But most people are able to continue their usual routines with the adjustment of periodic lab tests and daily medication.
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Life After Thyroid Cancer Surgery #4 Additional Treatments
Most patients with thyroid cancer do not need any further treatment after they have had the appropriate surgery done by an expert thyroid surgeon. The most commonly used treatment after thyroid cancer surgery, however, is radioactive iodine . This treatment works better the younger the patient is. Iodine is used by normal thyroid cells to make thyroid hormone. Thyroid cancers can possess the same type of key hole on the surface of their cell called a symporter that allows iodine to be taken into the cell. Although thyroid cancer rarely produces any significant amounts of thyroid hormone itself, it frequently maintains this iodine pump and ability to take up iodine. In the treatment of thyroid cancer, this can be taken advantage of by having the patient swallow an iodine pill that has been radioactively charged.
The thyroid cancer patient swallows a radioactive iodine form of iodine called iodine- 131 in a liquid or pill form. The radioactive iodine is absorbed through digestion and circulated throughout the body in bloodstream. Thyroid cancer cells can pick up the radioactive iodine wherever they are located in the body. Once taken into the thyroid cancer cells, the radioactive iodine delivers a local radiation treatment in the area where the iodine is concentrated. Most importantly however, a thyroid cancer diagnosis alone is not an indication for RAI treatment.
What Are The Side Effects Of Having Your Thyroid Removed
The main side effect of having your thyroid removed is a lack of thyroid hormone.
After a near-total or total thyroidectomy, youll need to take daily thyroid hormone pills for the rest of your life to replace the lost thyroid hormone your thyroid naturally made.
If youve had a hemi-thyroidectomy or thyroid lobectomy, theres a 60% chance you wont need to take thyroid medication unless youre already on thyroid medication for low thyroid hormone levels or blood tests reveal that your thyroid isnt making enough hormones.
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Life After Thyroid Cancer Surgery #1 Quality Of Life Expectations
Life after thyroid cancer surgery can be tough and worrisome, especially early on. You should not fret about the recovery or thyroid hormone medication. If your thyroid cancer surgery is done at an expert center such as ours, the complication rates are extremely low, and almost everyone recovers quickly and without issue or permanent problems . Your quality of life is very unlikely to be negatively affected by thyroid cancer surgery done correctly in the hands of experts.
Learn more about finding the best thyroid cancer surgeon here.
Finally, there is a lot of misinformation causing worry about being on thyroid medication, particularly about weight gain and fatigue. Thyroid hormone medication and diligent follow-up regarding the dosage and your thyroid hormone levels is critical after your thyroid cancer surgery. As long as the patient is compliant with the necessary medication and follow-up, then their thyroid levels should be appropriate. If your thyroid levels are where they should be, then thyroid medication or thyroid cancer surgery will NOT be the cause of weight gain, fatigue, hair loss, etc. that everyone is concerned about. The reality is, almost everyone on thyroid hormone medication will do great as long as they take the medication as directed, get their thyroid levels checked 1-2 times yearly at a minimum, and maintain a healthy lifestyle. Thyroid hormone medication is very unlikely to cause symptoms, side effects, or a change in your quality of life.
What To Expect At Home
You may have a drain with a bulb coming from your incision. This drain removes any blood or other fluids that might build up in this area.
You may have some pain and soreness in your neck at first, especially when you swallow. Your voice may be a little hoarse for the first week. You will probably be able to start your everyday activities in just a few weeks.
If you had thyroid cancer, you may need to have radioactive iodine treatment soon.
Get plenty of rest when you get home. Keep your head raised while you are sleeping for the first week.
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How Is Thyroid Cancer Treated
Thyroid cancer surgery
If you have thyroid cancer, your endocrinologist will connect you with an endocrine surgeonor head and neck surgeon who specializes in thyroid surgery. The type of thyroid surgery will depend on the kind of cancer you have, such as papillary or follicular, and size and stage of the cancer.
Thyroid cancer treatments
Early-stage thyroid cancer that has not spread can usually be cured with surgery alone. However, make sure your surgeon is part of and consulting with a multispecialty cancer care team, including endocrinology, medical oncology and radiation oncology.
People with papillary or follicular thyroid cancer that has spread to the neck or other parts of the body usually will have radioactive iodine after surgery. RAI eliminates any remaining thyroid tissue and cancer cells. Depending on the facility, an endocrinologist, nuclear medicine physician or radiation oncologist can administer the oral treatment.
You will need hormone therapy if your surgeon removed your entire thyroid to treat the cancer. Oral thyroid hormone therapy will help your body produce the hormones it needs to regulate your metabolism.
Radiation therapy may be recommended for thyroid cancer that has spread and cannot be treated with radioactive iodine. These types of cancers includeanaplastic thyroid cancer and medullary thyroid cancer.
Thyroid cancer nurse navigators, nutritionists and support services
Speech therapy after thyroid cancer surgery
Stockings To Prevent Blood Clots
The nurses will give you elastic stockings to wear during and after the operation. These help to prevent blood clots forming in your legs.
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Between 6 and 24 hours after your operation, they will take a blood sample to check your calcium levels.
The nurses will encourage you to start moving about as soon as possible. You should have a nurse with you the first time you get out of bed, as you may feel drowsy and dizzy. If you need to stay in bed, they will encourage you to do regular leg movements and deep-breathing exercises. A physiotherapist or nurse will explain these exercises.
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Preparing For Thyroid Surgery
Once your surgery is scheduled, you will go through a pre-operative evaluation with your care team. This may involve blood tests, imaging and/or an electrocardiogram .
This is also when your medical professional will give you instructions for the day of surgery, such as when you need to stop eating and drinking. Its very important to follow all of these instructions to the letter. Otherwise, your surgery may need to be canceled. If you are unsure about any of the instructions, reach out to your provider for clarification.
Neck Pain And Stiffness
The neck is put in an extended position during surgery, and many people avoid moving their necks afterward. This can lead to neck pain and stiffness. Using pain medication after surgery may reduce discomfort, making it easier for you to keep moving your neck so that you have less stiffness later on. Applying a warm compress may also help.
Many surgeons recommend doing gentle stretching and range-of-motion exercises to reduce stiffness. Before doing these, however, make sure to ask your surgeon about their appropriateness for you, any additional exercises they believes might be helpful, how often you should perform them, and whether there are any exercises you should avoid. Recommended exercises may include:
- Gently turn your head to the right, then roll your head so that you are looking at the floor, then gently roll your head to the left.
- Gently tilt your head to the right and then to the left.
- Rotate both shoulders forward in a circular motion.
- Slowly raise your arms overhead, and then slowly lower them back down against your body.
Suggested frequency: 10 repetitions, three times day
Most often, neck stiffness lasts for only a few days to a few weeks after surgery. If yours does not, talk to your surgeon about seeing a specialist in physical medicine and rehabilitation or a physical therapist who can work with you to improve the flexibility of your neck and design an exercise program to restore your neck mobility.
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What To Expect After The Operation
Scar
You will have one scar, 3-4 inches across, along your collar line. This will run horizontally along the natural lines of the skin in your neck. After a few weeks it should be healing well, and after 12 months or so it will hardly be visible.
Stitches/clips
With thyroid surgery, many treatment centres now use skin clips on the outside of the neck instead of stitches. You may have your clips removed 2-3 days after your operation, before you leave hospital, or you may have them removed at around 5-6 days. In this case, they will be removed be your GP or practice nurse. A small drain will be attached to your wound to prevent fluid building up. This will be removed after 2-3 days.
Dressings
You do not need to keep the wound covered with a dressing. Exposure to the air will help the wound to heal more quickly. You can wash as normal after the clips have been removed, but take care to pat the wound dry gently.
Discomfort
Tiredness and feeling emotional
Painkillers
Painkillers may well cause constipation, so its important to get plenty of fibre in your diet while you are recovering. Fresh fruit and vegetables will help to keep your bowels moving regularly.
Life After Thyroid Cancer Surgery #2 Thyroid Hormone Supplements
Depending of the type of thyroid cancer surgery you have, you could need thyroid hormone medication. There are numerous formulations and types, but all these medications do a great job at replacing or supplementing the natural hormone your thyroid makes. Low risk thyroid cancers in patients who only have half of their thyroid removed do not need aggressive thyroid hormone suppression . Many patients who have half of their thyroid removed do not need thyroid hormone supplementation at all. The healthy remaining half of their thyroid makes enough hormone in many instances. If half of your thyroid was removed during your thyroid cancer surgery, you will routinely get your thyroid hormone levels checked to make sure the remaining half of thyroid is making enough thyroid hormone.
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What To Expect Before And After Thyroid Surgery
If you have thyroid cancer or a benign nodule that has grown large enough to cause problems, your doctor may have recommended a thyroidectomy. This is a type of surgery that removes all or part of your thyroid gland.
Its understandable to feel nervous going into any kind of surgical procedure. Lets examine what you can expect before and after surgery, as well as what you can do to aid your recovery.
What Is The Recovery Time For A Thyroidectomy
Many people who have a thyroidectomy, especially a hemithyroidectomy, are able to go home the same day of their surgery after a few hours of observation in the hospital. Some people have to stay in the hospital overnight and can leave the next morning.
Before you go home, your provider will give you instructions on how to care for your incision and stitches and let you know what types of complications and symptoms you need to look out for.
It should take about two to three weeks for you to fully recover.
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