How Is Thyroid Cancer Treated
Most cases of thyroid cancer can be cured with treatment.
Usually, people with thyroid cancer need surgery, either to remove their entire thyroid gland or a part of it . Sometimes its also necessary to remove nearby lymph nodes.
Other treatments include thyroid hormone replacement therapy , and radioactive iodine treatment . Some people also need chemotherapy, targeted drug therapies or external radiotherapy.
In some cases, where the cancer hasnt spread beyond the thyroid gland, doctors may recommend active surveillance. This means closely monitoring the cancer, rather than having immediate treatment. Active surveillance usually involves regular ultrasounds and physical examinations.
How Do I Choose A Thyroid Surgeon
A high-volume surgeon is best. Whether you opt for a general, endocrine, or head and neck surgeon, you want to choose a provider who does a lot of these surgeries every year, says Dr. Lieb. Dr. Chen says a good volume to shoot for is 100 per year or more.
You can find directories of qualified surgeons at the American Association of Endocrine Surgeons or the American Academy of Otolaryngology Head and Neck Surgery.
Thyroid Cancer: What Women Should Know
The symptoms start slowly. Fatigue is the most common. There might bechanges in hair, nails or skin, and other vague complaints that could becaused by aging, diet, stress or dozens of other factors.
Women in the prime of their lives, busy with work and families, may noteven notice. When a doctor finally diagnoses an underactivethyroiddue to cancer, it often comes as a shock.
Jonathon Russell, M.D., assistant professor ofOtolaryngology Head and Neck Surgeryat The Johns Hopkins Hospital, says, Typicalthyroid cancerpatients are women between the ages of 30 and 60younger than many peoplewould think. Theyre likely to put off getting seen by a doctor and mayblame their symptoms on other causes.
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Surgery For Thyroid Cancer
Most patients with thyroid cancer have some type of surgery. Surgery is done to take out the tumor and all or part of the thyroid gland. Sometimes lymph nodes are taken out from the neck, too.
Side effects of surgery
Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. Possible side effects of thyroid surgery include:
- Bleeding or a blood clot in the neck
- Damage to the parathyroid glands
- Short or long term problems with your voice
When To Get Medical Advice
See a GP if you have symptoms of thyroid cancer. The symptoms may be caused by less serious conditions, such as an enlarged thyroid , so it’s important to get them checked.
A GP will examine your neck and can organise a blood test to check how well your thyroid is working.
If they think you could have cancer or they’re not sure what’s causing your symptoms, you’ll be referred to a hospital specialist for more tests.
Find out more about how thyroid cancer is diagnosed.
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Watchful Waiting Aka Active Surveillance
Dr. Harari notes that there has been increased interest in watchful waiting, also known as active surveillance, for thyroid cancer. In New York at Memorial Sloan Kettering Cancer Center, it is the standard of care for certain populations, she says.
Watchful waiting can be a good choice for people who have small nodules that are not growing quickly or are not invasive in nature. It can also be a good treatment option for people who are very worried about having surgery, Dr. Harari says.
One reason why watchful waiting is garnering interest is that while diagnoses of thyroid cancer have increased over the last decade, mainly as a result of increased imaging done for other purposes, mortality from it hasnt changed.
People are having chest CTs for other reasons and they pick it up, or they have a carotid artery ultrasound and see it, Dr. Lieb says. But if these nodules hadnt been discovered, many of them wouldnt have caused a problem at all they are small, low-risk cancers.
Dr. Chen agrees. The fact that we are finding more and smaller cancers hasnt impacted the death rate, she says. So when we operate on people with small early-stage cancers, we may be doing unnecessary surgery with the potential for complications because all surgeries have risks. So we have someone who probably wouldnt die of thyroid cancer, but we have given them a lifelong problem with nerves, voice loss, and hypoparathyroidism . Its not good.
How Does Thyroid Cancer Affect Pregnancy
Thyroid cancer is the second most common cancer diagnosed in pregnant women . Approximately 10% of thyroid cancers develop during pregnancy or within the first year after childbirth. Experts believe fluctuating hormone levels during pregnancy may trigger the cancer.
If you receive a thyroid cancer diagnosis during pregnancy, your healthcare provider can discuss treatment options. Depending on the cancer type and severity, your provider may recommend delaying treatment until after you deliver your baby. If treatment cant wait, most women can safely undergo surgery to remove the cancerous gland. You shouldnt have radioactive diagnostic tests or treatments when youre pregnant or breastfeeding.
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Papillary Cancer And Its Variants
Most cancers are treated with removal of the thyroid gland , although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor . If lymph nodes are enlarged or show signs of cancer spread, they will be removed as well.
In addition, recent studies have suggested that people with micro-papillary cancers may safely choose to be watched closely with routine ultrasounds rather than have immediate surgery.
Even if the lymph nodes arent enlarged, some doctors recommend central compartment neck dissection along with removal of the thyroid. Although this operation has not been shown to improve cancer survival, it might lower the risk of cancer coming back in the neck area. Because removing the lymph nodes allows them to be checked for cancer, this surgery also makes it easier to accurately stage the cancer. If cancer has spread to other neck lymph nodes, a modified radical neck dissection is often done.
Treatment after surgery depends on the stage of the cancer:
People who have had a thyroidectomy will need to take daily thyroid hormone pills. If RAI treatment is planned, the start of thyroid hormone therapy may be delayed until the treatment is finished .
Non Cancerous Thyroid Disease
Some non cancerous conditions of the thyroid increase your risk of thyroid cancer. These include:
- an enlarged thyroid
- a condition where the immune system attacks the thyroid gland
Its important to remember that although having a lump or nodule increases the risk, thyroid cancer is rare. Thyroid lumps are common. But only about 5 out of 100 thyroid lumps are cancer.
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Will I Be Cared For Mainly By One Provider Or Will There Be Multiple Ones
Thyroid cancer care is a team sport. Dr. Lieb says you can expect to be cared for by many people during your cancer treatment, including your primary care physician, your endocrinologist, and your surgeon. There will also be pathologists and social workers. Depending on the type of thyroid cancer, you may also see a nuclear medicine team, vascular surgeon, voice specialist, and imaging professionals.
Signs Of Thyroid Cancer
Please get in touch with your doctor if you have any of the following symptoms:
- A lump in your neck, called a nodule
- Swollen lymph nodes in your neck
- Changes in your voice, including hoarseness
- Trouble swallowing or breathing
- Throat or neck pain that can extend to your ears
- Coughing thats not related to an upper respiratory infection
- Coughing that is not related to a cold
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Final Thoughts On Reasons Why People Develop Thyroid Issues And How They Can Avoid Them
Thyroid problems are the first step in a vast host of other diseases. It is wise to start now in living a healthier lifestyle, so your risk for developing this condition is much, much lower.
You dont have to be the perfect model citizen just take care of yourself and make sure you eat well, exercise smartly, are careful about X-rays, and never miss an annual check-up!
What Else Should I Know
Most thyroid nodules are not cancer. If your child has a nodule, the doctor will do regular thyroid exams and ultrasounds to check its size. If the nodule changes, the doctor might recommend fine-needle aspiration biopsy to learn more.
Thyroid cancers are uncommon in children. But if your child has a thyroid nodule, it’s a good idea to meet with a team of doctors who have experience caring for children with thyroid cancer.
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What Will Happen After Treatment
Most people do very well after treatment, but you may need follow-up care for the rest of your life. This is because most thyroid cancers grow slowly and can come back even 10 to 20 years after treatment. Your cancer care team will tell you what tests you need and how often they should be done.
Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back. At first, your visits may be every 3 to 6 months. Then, the longer youre cancer-free, the less often the visits are needed.
Sometimes treatments may not cure your cancer. You many need to keep getting treatment and care. From time to time tests will be done to see how your treatment is working.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life.
Where Can I Find Thyroid Cancer Support
Your biggest sources of support can be your friends and family. Consider taking a trusted friend or relative to your appointments to take notes and ask questions you might not think of right away.
Additionally, hospitals will often have information on support groups in your area both virtual and IRL . The doctor treating your cancer may also be able to suggest some of these.
The Thyroid Cancer Survivors Association has information and support for both newly diagnosed people and those who have been on their cancer journey for longer.
You can also visit and join the American Cancer Societys Cancer Survivors Network.
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Causes Of Thyroid Cancer
Thyroid cancer happens when there’s a change to the DNA inside thyroid cells which causes them to grow uncontrollably and produce a lump.
It’s not usually clear what causes this change, but there are a number of things that can increase your risk.
These include:
- other thyroid conditions, such as an inflamed thyroid or goitre but not an overactive thyroid or underactive thyroid
- a family history of thyroid cancer your risk is higher if a close relative has had thyroid cancer
- radiation exposure in childhood such as radiotherapy
- a bowel condition called familial adenomatous polyposis
- acromegaly a rare condition where the body produces too much growth hormone
What Is The Thyroid Gland
Your thyroid gland is one of many glands that make up your endocrine system. Endocrine glands release hormones that control different bodily functions.
The pituitary gland in your brain controls your thyroid gland and other endocrine glands. It releases thyroid-stimulating hormone . As the name suggests, TSH stimulates your thyroid gland to produce thyroid hormone.
Your thyroid needs iodine, a mineral, to make these hormones. Iodine-rich foods include cod, tuna, dairy products, whole-grain bread and iodized salt.
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How Is Thyroid Cancer Treated In Children
Your childâs care will vary depending on the specific type of thyroid cancer they have. Components of thyroid cancer treatment may include the following.
Surgery is the first and most important treatment for thyroid cancer. Thoroughly and safely removing as much of the tumor as possible is important to ensure the best possible long-term outcome. This often includes removing the entire thyroid gland, and if necessary any lymph nodes in the neck that may contain thyroid cancer. This allows your doctors to form a complete diagnosis of the cancer type and obtain information on the stage of the disease, which will help determine if any further treatments are necessary.
Thyroid surgery is generally safe but rarely can have serious complications. For this reason, it is important that the procedure be performed by an experienced thyroid surgeon. Our thyroid surgeons have extensive experience in pediatric thyroid surgery and work closely with the rest of the Thyroid Center team to provide seamless, coordinated care before, during, and after surgery.
Hormone therapy is used to replace normal hormones and slow the growth of cancer cells. If the entire thyroid was removed, lifelong treatment with thyroid medication is needed. In patients with high-risk thyroid cancer, giving a slight excess of thyroid medication may improve outcomes and reduce the risk of thyroid cancer recurrence.
Why Do You Think People Get Thyroid Cancer
This question doesn’t have a right or wrong answer, but I think it’s the most human thing to do when you ask yourself how you developed cancer, and specifically thyroid cancer. I heard that the biggest risk for developing thyroid cancer is receiving radiation directly to the chest area. The only thing closest I’ve had to that was getting x-rays from my dentist and those two summers where I got sunburn each time. So unless my dentist gave me cancer, I don’t know really know how I got cancer.
I don’t know why I developed papillary-follicular thyroid cancer for sure, but I have a feeling that it’s a combination of genetic predispositions, trauma and unhealthy stressors. I grew up as a chubby kid, but many times my weight would just fluctuate back and forth to me being “okay” and then to me being heavy, multiple times up to now, almost 25 years old.
I came from a very toxic household. There was a lot of violence at home, which permeated into my adult-college life. When I went to college, I majored in architecture, which meant very little opportunity for sleep. Which led to weight gain, fatigue, and depression. I often drank energy drinks to compensate for my lack of sleep to keep up with classes. I also had to deal with infrequent bouts of homelessness, which made it difficult for me to pass classes. I also had to take on part-time jobs which weren’t no fun when you’re already an overbooked college student, trying to avoid homelessness.
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Needing Second Thyroid Cancer Surgery: Persistent Or Recurrent Thyroid Cancer
Persistent or recurrent papillary thyroid cancer in residual thyroid tissue is much more concerning for the potential for the cancer to spread directly into the breathing tube or voice box. Only the most skilled and experience thyroid cancer surgery experts should manage such circumstances. The purpose of this specific thyroid cancer surgery is to maintain vocal and swallowing function, parathyroid function, and airway control. These are the most complicated and complex of all thyroid cancer surgeries.
Just Diagnosed With Thyroid Cancer: Time For Surgery
Thyroid surgery for thyroid cancer is the mainstay of treatment and cure. So, once you have been diagnosed with thyroid cancer, you can bet there is surgery in your future. There are different types of thyroid surgery performed for thyroid cancer. The training, qualifications, and experience of your thyroid surgeon and their team are crucial for achieving excellent outcomes and almost eliminating complications. Below are the most common and effective surgeries to treat thyroid cancer and what you should expect afterwards.
The thyroid lobectomy or thyroid lobectomy with isthmusectomy is typically the “smallest” operation performed on the thyroid gland for thyroid cancer. This surgery involves removing half of the thyroid gland or half of the thyroid and the entire isthmus and is appropriate for many thyroid cancers. The surgery is brief, usually lasting no more than 30-45 minutes, and spares all parathyroid glands as well as all important nerves to the voice box . Even for larger thyroid cancers, the incision is small and cosmetically designed to be almost unnoticeable.
Recovery after thyroid cancer surgery
Additional Treatment for Thyroid Cancer
Some people need radioactive iodine treatment after thyroid cancer surgery. We discuss radioactive iodine, how it works, and who needs it in another blog.
Follow- Up After Thyroid Cancer Treatment
Summary
Additional Resources
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How Is Thyroid Cancer Diagnosed
If you have an enlarged thyroid nodule or other signs of thyroid cancer, your healthcare provider may order one or more of these tests:
- Blood tests: A thyroid blood test checks hormone levels and gauges whether your thyroid is functioning properly.
- Biopsy: During a fine-needle aspiration biopsy, your healthcare provider removes cells from your thyroid to test for cancer cells. A sentinel node biopsy can determine if cancer cells have spread to lymph nodes. Your provider may use ultrasound technology to guide these biopsy procedures.
- Radioiodine scan: This test can detect thyroid cancer and determine if cancer has spread. You swallow a pill containing a safe amount of radioactive iodine . Over a few hours, the thyroid gland absorbs the iodine. Your healthcare provider uses a special device to measure the amount of radiation in the gland. Areas with less radioactivity need more testing to confirm the presence of cancer.
- Imaging scans:Magnetic resonance imaging , computed tomography and positron emission tomography scans can detect thyroid cancer and cancer spread.