You’ve learned you have differentiated thyroid cancer and will soon need treatment. Most thyroid cancers are curable with treatment, so you’re very likely to fully recover from the disease. There are many treatments for this form of cancer, depending on the exact type you have, your overall health, and other factors.
Active Surveillance
Small papillary thyroid cancers – one type of differentiated thyroid cancer – have a lower chance of growing or spreading beyond your thyroid. So instead of treatment, your doctor might suggest watching the cancer closely. This is called active surveillance.
You’ll have blood tests and an ultrasound of your neck a couple of times a year. In some cases, slow-growing thyroid cancers never need treatment. If it does grow, you and your doctor will come up with a new plan.
Surgery
Surgery is the main treatment for the two types of differentiated thyroid cancer – papillary and follicular. A surgeon will remove either part of your thyroid or the entire organ. The surgery you have depends on:
- Your form of thyroid cancer
- The cancer’s size
- If the cancer has spread to your lymph nodes
- Your age
- Other illnesses you have
Here are the types of surgeries to treat thyroid cancer:
- Thyroidectomy. This surgery, also called total or near-total thyroidectomy, removes all or a majority of your thyroid. After the procedure, you’ll still have some parathyroid gland tissue to help balance your blood’s calcium levels.
- Thyroid lobectomy. This surgery removes half of your thyroid. Doctors reserve it for thyroid cancers that grow slowly and only affect part of your thyroid. Your doctor will also make sure you don’t have any concerning growths in other areas of your thyroid or cancer in your lymph nodes.
- Lymph node dissection. You might need this surgery in addition to a total thyroidectomy. Before surgery, you’ll have an ultrasound to show whether cancer cells have spread to the lymph nodes in your neck – an area where thyroid cancer tends to spread. Then a surgeon will remove those lymph nodes.
Post-Surgery Treatments
After thyroid surgery, your doctor might recommend more treatment. They’ll consider:
- The size of the tumor
- If the tumor has spread outside of the thyroid
- How many lymph nodes the cancer has affected
- If the cancer has spread to other parts of your body
There are two treatments you may have after thyroid surgery:
- Radioactive iodine (RAI). This treatment kills lingering thyroid cancer cells that may remain after surgery. Doctors mainly use RAI to treat differentiated thyroid cancers that are likely to spread beyond your thyroid. You’ll swallow this treatment as a liquid or pill. It targets thyroid cancer cells, so you don’t have to worry about the treatment damaging other cells.
- Thyroid hormone therapy. This daily pill adds to or replaces the hormones your thyroid makes. It blocks your pituitary gland from making thyroid-stimulating hormone (TSH), which can cause the growth of thyroid cancer cells. Whether you need it depends on how much of your thyroid is removed.
Advanced Thyroid Cancer Treatments
If you have advanced thyroid cancer that’s growing quickly, your doctor may suggest these treatments:
- Radiation therapy. During this treatment, doctors use X-ray, proton, or other high-energy beams on specific areas of your body to kill cancer cells. You may need radiation therapy if other treatments haven’t worked or if your cancer has returned.
- Chemotherapy. This treatment uses chemicals injected into your veins or taken by pill to kill cancer cells. It can help to keep aggressive thyroid cancers in check. Your doctor may also decide to use it along with radiation therapy.
After Thyroid Cancer Treatment
Once you’ve finished thyroid cancer treatment, you’ll still need to visit your doctor routinely. They’ll want to watch you for treatment side effects and signs that the cancer has come back or spread. These visits are also a time to ask your doctor questions and fill them in on any problems you’re having.
You’ll also need follow-up tests depending on the type of thyroid cancer you had and the treatment you received. If doctors have completely removed your thyroid or you’ve had radioactive iodine therapy, you could need one more course of RAI about 6 months to a year after treatment. Other post-treatment tests may include:
- Blood tests
- Physical exams of your neck
- Ultrasounds of your neck
- CT, MRI, and other imaging tests
It’s important to keep all of your follow-up appointments since most thyroid cancers grow slowly and can come back even decades after treatment.
Questions for Your Doctor
A cancer diagnosis can be overwhelming, and there are probably lots of things you want to know about your treatment plan. Here are some questions you might consider asking your doctor:
- What type of thyroid cancer do I have?
- What stage is my thyroid cancer?
- Which treatments do you suggest for my cancer type and stage?
- What are the pros and cons of each of my treatment options?
- How should I manage both thyroid cancer and my other health conditions?
- What will my daily life look like during cancer treatment?
- Is a second opinion necessary?
- Will I need to visit a specialist?
- How often do you treat thyroid cancer?
- What are my treatment goals?
- Do I need to make a decision about treatment right away, or do I have time to weigh my options?
- How likely is it that my cancer will come back after treatment?
- Will I be able to have children during or after treatment?
- What happens if treatment doesn’t work?
- How can I learn more about thyroid cancer and my treatment options?
- Are there clinical trials available that are right for me?
Show Sources
Photo Credit: DigitalVision/Getty Images
SOURCES:
Mayo Clinic: “Thyroid Cancer.”
American Cancer Society: “Questions to Ask About Thyroid Cancer,” “Living as a Thyroid Cancer Survivor.”
Lee K, Anastasopoulou C, Chandran C, Cassaro S. Thyroid Cancer. StatPearls Publishing, 2023.
National Cancer Institute: “Thyroid Cancer Treatment (PDQ®)–Patient Version.”
