Thyroid Cancer Health Center

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis, but you will have time to talk with your doctor about treatment choices and get a second opinion.

The choice of treatment depends on:

• the type of thyroid cancer (papillary, follicular, medullary, or anaplastic)
• the size of the nodule
• your age
• whether the cancer has spread

You and your doctor can work together to develop a treatment plan that meets your needs.

Surgery

Most people with thyroid cancer have surgery. The surgeon removes all or part of the thyroid. The type of surgery depends on the type and stage of thyroid cancer, the size of the nodule, and your age.

• Total thyroidectomy: This surgery can be used for all types of thyroid cancer. The surgeon removes all of the thyroid through an incision in the neck. If the surgeon is not able to remove all of the thyroid tissue, it can be destroyed by radioactive iodine therapy later.
• Nearby lymph nodes also may be removed. If cancer has invaded tissue within the neck, the surgeon may remove nearby tissue. If cancer has spread outside the neck, surgery, radioactive iodine therapy, or external radiation therapy may be used to treat those areas.
• Lobectomy: Some people with follicular or papillary thyroid cancer may have only part of the thyroid removed. The surgeon removes one lobe and the isthmus. Some people who have a lobectomy later have a second surgery to remove the rest of the thyroid. Less often, the remaining thyroid tissue is destroyed by radioactive iodine therapy.

Thyroid Hormone Treatment

After surgery to remove part or all of the thyroid, nearly everyone needs to take pills to replace the natural thyroid hormone. However, thyroid hormone pills are also used as part of the treatment for papillary or follicular thyroid cancer. Thyroid hormone slows the growth of thyroid cancer cells left in the body after surgery.

Thyroid hormone pills seldom cause side effects. Your doctor gives you blood tests to make sure you're getting the right dose of thyroid hormone. Too much thyroid hormone may cause you to lose weight and feel hot and sweaty. It may also cause a fast heart rate, chest pain, cramps, and diarrhea. Too little thyroid hormone may cause you to gain weight, feel cold and tired, and have dry skin and hair. If you have side effects, your doctor can adjust your dose of thyroid hormone

Radioactive Iodine Therapy

Radioactive iodine (I-131) therapy is a treatment for papillary or follicular thyroid cancer. It kills thyroid cancer cells and normal thyroid cells that remain in the body after surgery.

People with medullary thyroid cancer or anaplastic thyroid cancer usually do not receive I-131 therapy. These types of thyroid cancer rarely respond to I-131 therapy.

Even people who are allergic to iodine can take I-131 therapy safely. The therapy is given as a liquid or capsule that you swallow. I-131 goes into the bloodstream and travels to thyroid cancer cells throughout the body. When thyroid cancer cells take in enough I-131, they die.

External Radiation Therapy

External radiation therapy (also called radiotherapy) is a treatment for any type of thyroid cancer that can't be treated with surgery or I-131 therapy. It's also used for cancer that returns after treatment or to treat bone pain from cancer that has spread.

External radiation therapy uses high-energy rays to kill cancer cells. A large machine directs radiation at the neck or other tissues where cancer has spread

Chemotherapy

Chemotherapy is a treatment for anaplastic thyroid cancer. It's sometimes used to relieve symptoms of medullary thyroid cancer or other thyroid cancers.

Chemotherapy uses drugs to kill cancer cells. The drugs are usually given by injection into a vein. They enter the bloodstream and can affect cancer cells all over the body.