Treatments For Thyroid Cancer
Treatment for thyroid cancer depends on the type of thyroid cancer you have and how far it has spread.
The main treatments are:
- surgery to remove part or all of the thyroid
- radioactive iodine treatment you swallow a radioactive substance that travels through your blood and kills the cancer cells
- external radiotherapy a machine is used to direct beams of radiation at the cancer cells to kill them
- chemotherapy and targeted therapies medicines used to kill cancer cells
After treatment, you’ll have follow-up appointments to check whether the cancer has come back.
Read more about how thyroid cancer is treated.
How Well It Works
Success of a thyroidectomy to remove thyroid cancer depends on the type of cancer and whether it has spread to other parts of the body. You may need follow-up treatment to help prevent the cancer from returning or to treat cancer that has spread.
If a large noncancerous nodule causes symptoms, such as pain or problems breathing or swallowing, surgery may help relieve symptoms. All or part of the thyroid gland may be removed. Surgery may also help relieve symptoms if other treatments, such as draining a cyst , have not worked. Surgery may also be an effective treatment if you have a thyroid nodule that makes too much thyroid hormone.
What Are The Risk Factors For Thyroid Nodules
Risk factors for developing thyroid nodules include:
- Family history. Having parents or siblings who have had thyroid nodules or thyroid or other endocrine cancers increases your chance of developing nodules.
- Age: The chance of developing nodules increases as you get older.
- Gender: Women are more likely than men to develop thyroid nodules.
- Radiation exposure: A history of radiation exposure to the head and neck increases your risk of developing nodules.
Risk factors for developing cancerous thyroid nodules include:
- Family history of thyroid cancer
- A nodule that is hard or is stuck to a nearby structure
- Male gender
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Management Of Thyroid Cancer
Malignant diagnoses require surgical intervention. Papillary thyroid carcinoma and medullary thyroid carcinoma are often positively identified on the basis of FNAB results alone. Cervical metastases discovered preoperatively or intraoperatively should be removed by means of en bloc lymphatic dissection of the respective cervical compartment while sparing the nonlymphatic structures.
Patients with follicular neoplasm, as determined with FNAB results, should undergo surgery for thyroid lobectomy for tissue diagnosis. The extent of surgical therapy for well-differentiated neoplasms is controversial. Primary treatment for papillary and follicular carcinoma is surgical excision whenever possible. Total thyroidectomy has been the mainstay for treating well-differentiated thyroid carcinoma. Modifications to total thyroidectomy include subtotal thyroidectomy to reduce the risk of recurrent laryngeal nerve injury and hypoparathyroidism.
A 2015 consensus statement from the American Thyroid Association on the management of patients with differentiated thyroid cancer who have recurrent/persistent nodal disease stated the following :
HÃ¼rthle cell carcinomas
Medullary thyroid carcinomas and familialmedullary thyroid carcinomas
Anaplastic thyroid carcinoma, primary thyroid lymphoma, thyroid sarcoma
The treatment for thyroid sarcomas is total thyroidectomy. Radiation therapy may be used in an adjunctive setting.
Evaluation And Management Of The Solitary Thyroid Nodule
The key to the workup of the solitary thyroid nodule is to differentiate malignant from benign disease and, thus, to determine which patients require intervention and which patients may be monitored serially. History taking, physical examination, laboratory evaluation, and fine-needle aspiration biopsy are the mainstays in the evaluation of thyroid nodules. Imaging studies can be adjuncts in select cases.
A 2015 consensus statement from the American Thyroid Association on preoperative imaging for thyroid cancer surgery stated the following :
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Graves Disease Diagnosis And Treatment
A simple physical exam can reveal an enlarged thyroid, enlarged bulging eyes, and signs of increased metabolism, including rapid pulse and high blood pressure. Your doctor will also order blood tests to check for high levels of T4 and low levels of TSH, both of which are signs of Graves disease. A radioactive iodine uptake test might also be administered to measure how quickly your thyroid takes up iodine. A high uptake of iodine is consistent with Graves disease.
Theres no treatment to stop the immune system from attacking the thyroid gland and causing it to overproduce hormones. However, the symptoms of Graves disease can be controlled in several ways, often with a combination of treatments:
- beta-blockers to control rapid heart rate, anxiety, and sweating
- antithyroid medications to prevent your thyroid from producing excessive amounts of hormone
- radioactive iodine to destroy all or part of your thyroid
- surgery to remove your thyroid gland, a permanent option if you cant tolerate antithyroid drugs or radioactive iodine
Successful hyperthyroidism treatment usually results in hypothyroidism. Youll have to take hormone-replacement medication from that point forward. Graves disease can lead to heart problems and brittle bones if its left untreated.
Cancers Linked To Treatment With Tamoxifen
Taking tamoxifen lowers the chance of hormone receptor-positive breast cancer coming back. It also lowers the risk of a second breast cancer. Tamoxifen does, however, increase the risk for uterine cancer . Still, the overall risk of uterine cancer in most women taking tamoxifen is low, and studies have shown that the benefits of this drug in treating breast cancer are greater than the risk of a second cancer.
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After Radioactive Iodine Treatment For Thyroid Cancer
Having radioactive iodine treatment means you will be radioactive for several days afterwards. You will be able to go home from hospital when the radiation level in your body is at a safe level. As you will still have some radioactivity in your body you may still have to take some precautions when you go home. Your healthcare team will explain everything to you.
How Is Thyroid Disease Diagnosed
Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:
- Blood tests.
- Physical exams.
One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm. Thyroid blood tests are used to see if you have:
The specific blood tests that will be done to test your thyroid can include:
These tests alone arent meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.
Additional blood tests might include:
Talk to your healthcare provider about the ranges for these thyroid blood tests. Your ranges might not be the same as someone elses. Thats often alright. If you have any concerns or worries about your blood test results, talk to your provider.
An ultrasound typically takes about 20 to 30 minutes.
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Cancers Linked To Radiation Treatment
Lung cancer: The risk of lung cancer is higher in women who had radiation therapy after a mastectomy as part of their treatment. The risk is even higher in women who smoke. The risk does not seem to be increased in women who have radiation therapy to the breast after a lumpectomy.
Sarcoma: Radiation therapy to the breast also increases the risk of sarcomas of blood vessels , bone , and other connective tissues in areas that were treated. Overall, this risk is low.
Certain blood cancers: Breast radiation is linked to a higher risk of leukemia and myelodysplastic syndrome . Overall, though, this risk is low.
What Is A Thyroid Ultrasound
A thyroid ultrasound is a sound wave picture of the thyroid. It is usually the best test to evaluate the size and structure of the thyroid. Since the test uses sound waves it is very safe and can be used repeatedly without complications.
In addition to evaluating the thyroid gland, ultrasonography is now commonly used during follow up to detect recurrent thyroid cancer in the neck.
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Can I Get Hypothyroidism From My Hyperthyroidism Treatment
You can get hypothyroidism from hyperthyroidism treatments. This is sometimes the goal of a healthcare provider. In hypothyroidism, the amount of thyroid hormone needs to be boosted. This can be done with medications that you regularly take. Adding hormones to your body is more manageable than trying to get your body to decrease the amount of thyroid hormone it creates.
Can hyperthyroidism cause female infertility?
One of the symptoms of hyperthyroidism in women can be irregular menstrual cycles . The imbalance of thyroid hormone can impact all parts of your body. Some women actually start reaching out to their healthcare provider because of issues becoming pregnant and then learn about a thyroid condition.
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What Is The Prognosis For People Who Have Thyroid Cancer
Eight out of 10 people who have thyroid cancer develop the papillary type. Papillary thyroid cancer has a five-year survival rate of almost 100% when the cancer is in the gland . Even when the cancer spreads , the survival rate is close to 80%. This rate means that, on average, youre about 80% as likely to live for at least five years after diagnosis as someone who doesnt have metastatic papillary thyroid cancer.
Five-year survival rates for other thyroid cancer types include:
- Follicular: Close to 100% for localized around 63% for metastasized.
- Medullary:Close to 100% for localized around 40% for metastasized.
- Anaplastic: Close to 31% for localized 4% for metastasized.
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What Is Thyroid Cancer
Thyroid cancer is a disease that you get when abnormal cells begin to grow in your thyroid gland. The thyroid gland is shaped like a butterfly and is located in the front of your neck. It makes hormones that regulate the way your body uses energy and that help your body work normally.
Thyroid cancer is an uncommon type of cancer. Most people who have it do very well, because the cancer is usually found early and the treatments work well. After it is treated, thyroid cancer may come back, sometimes many years after treatment.
Biochemical Testing For Mtc
Because MTC cells produce calcitonin, elevated serum calcitonin levels are diagnostic of MTC. Although routine measurement of serum calcitonin has low yield in managing the solitary thyroid nodule because of the uncommon nature of MTCs, it is useful in the surveillance of patients with a history of MTC and in managing familial forms. Stimulating calcitonin release by using intravenous pentagastrin increases the sensitivity of the test. For pentagastrin-stimulated calcitonin evaluation, a baseline plasma calcitonin level is measured, followed by the intravenous administration of pentagastrin 0.5 mg/kg and serial measurements of calcitonin 1.5 and 5 minutes after injection. Elevated basal or stimulated calcitonin levels above the normal range for the laboratory strongly suggest MTC.
Plasma calcitonin levels are commonly increased before clinical evidence of MTC appears. Although this finding was once the mainstay in diagnosing familial forms of MTC, results of genetic testing have largely supplanted it. Plasma calcitonin testing is now used for the early detection of MTC in patients already known to be at risk for MTC because of their family history and genetic results. This level is most commonly used as a tumor marker to identify residual and metastatic disease after thyroidectomy to treat MTC.
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Doctor Visits And Follow
Your health care team will explain what tests you need and how often they should be done. Your schedule of doctor visits, exams, and tests will depend on the original extent of your cancer, the specific type of thyroid cancer you had, how it was treated, and other factors.
Papillary or follicular cancer: If you have had papillary or follicular cancer, and your thyroid gland has been completely removed or ablated, your doctors may consider at least one radioactive iodine scan after treatment, especially if you are at higher risk for recurrence. This is usually done about 6 to 12 months later. If the result is negative, you will generally not need further scans unless you have symptoms or other abnormal test results.
Your blood will also be tested regularly for TSH and thyroglobulin levels. Thyroglobulin is made by thyroid tissue, so after total thyroid removal and ablation it should be at very low levels or not be found in your blood at all. If the thyroglobulin level begins to rise, it might be a sign the cancer is coming back, and further testing will be done. This usually includes a radioactive iodine scan, and may include PET scans and other imaging tests.
For those with a low-risk, small papillary cancer that was treated by removing only one lobe of the thyroid, routine physical exams by your doctor, thyroid ultrasounds and thyroid blood tests are typical.
When To See A Healthcare Provider
If you feel a new swelling or lump in your neck, or if an imaging test incidentally reveals a thyroid growth, it’s important to schedule an appointment with your healthcare provider right away.
During your appointment, your healthcare provider will:
- Perform a physical examination, including a neck examination
- Order an ultrasound of your thyroid
- Check blood tests that may include a thyroid-stimulating hormone , free thyroxine , and thyroid antibodies
Depending on the results of these tests, your primary care or family healthcare provider may refer you to a healthcare provider who specializes in thyroid care . An endocrinologist may take another look at the thyroid nodule with ultrasound in his or her office and perform a fine-needle aspiration biopsy to see whether cancer cells are present.
Thyroid Cancer Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
The diagnosis of thyroid cancer has been on the rise both in the United States and worldwide, due in large part to the sophistication of high-resolution imaging tests. In other words, these thyroid nodules that would never have been found years ago are now being identified.
While the majority of these small nodules end up not being cancer, determining which ones are is keyâthis is because most thyroid cancers are curable, especially those that are small and have not spread.
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What Surgery May Be Indicated For Hurthle Cell Cancer
thyroid lobectomy surgeryto change the surgery to a total thyroidectomy due to findings noted at the time of surgery
Many surgeons prefer the older method of removing the entire thyroid for all thyroid cancers. How much surgery is performed has an important impact on how you are managed afterwards, how much thyroid hormone you need and many other factors. Because there are many choices to make, it is important that you have a surgeon that understands every option and how it will affect your overall cure rate, whether more surgery will be needed in the future, and many other things. Get the best thyroid cancer surgeon that you can!
If Treatment Does Not Work
Recovery from thyroid cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life.
You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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How To Manage The Most Common Symptoms Of Graves Disease
About 10% of all women have an underactive thyroid the condition affects about only 3% of men.What increases the risk of thyroid disease? The types and frequency of thyroid disease vary around the world, based on the amount of iodine in the diet. Smoking also increases risk. Dont we get enough iodine in our diets from iodized salt? Overall, Americans have been getting enough iodine since salt iodization was started in the 1920s. But the amount in the American diet has decreased by about half since the 1970s. Thats partially due to a decline in the amount of salt we eat.But theres also less iodine in certain foods than before, particularly cows milk and bread. Thats because iodate dough conditioners are used less often by many bread manufacturers. Also, federal legislation in the 1980s limited the amount of iodine in cattle feed, which may be one reason why milk has less iodine.
Do You Have Thyroid Disease?Always cold or hot? Heart racing a mile a minute? Whether underactive or overactive, a thyroid problem can make your body feel out of whack. Knowing the symptoms can help your doctor diagnose the problem and get you feeling better fast.