Why Might I Need A Thyroidectomy
Hyperthyroidism can be the result of an autoimmune problem, too much iodine in the diet, a benign tumor in the pituitary gland, too much thyroid medication, a swelling in the thyroid gland or an inflammatory process.
Are There Other Means Of Treatment
Surgery is definitely indicated to remove nodules suspicious for thyroid cancer. In the absence of a possibility of thyroid cancer, there may be nonsurgical options for therapy depending on your diagnosis. You should discuss other options for treatment with your physician who has expertise in thyroid diseases.
Can I Lower The Risk Of My Cancer Progressing Or Coming Back
If you have thyroid cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Unfortunately, its not yet clear if there are things you can do that will help.
Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight is important. We know that these types of changes can have positive effects on your health that can extend beyond your risk of cancer.
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How Should I Be Evaluated Prior To The Operation
As for other operations, all patients considering thyroid surgery should be evaluated preoperatively with a thorough and detailed medical history and physical exam including cardiopulmonary evaluation. An electrocardiogram and a chest x-ray prior to surgery are often recommended for patients who are over 45 years of age or who are symptomatic from heart disease. Blood tests may be performed to determine if a bleeding disorder is present.
Importantly, any patient who has had a change in voice or who has had a previous neck operation and/or who has had a suspected invasive thyroid cancer should have their vocal cord function evaluated routinely before surgery. This is necessary to determine whether the recurrent laryngeal nerves that control the vocal cord muscles are functioning normally.
Finally, in rare cases, if medullary thyroid cancer is suspected, patients should be evaluated for endocrine tumors that occur as part of familial syndromes including adrenal tumors and enlarged parathyroid glands that produce excess parathyroid hormone .
What Problems Can Occur With The Thyroid Gland
Hypothyroidism: An under-active thyroid is called hypothyroidism. The thyroid produces less thyroxine. This makes the pituitary gland send more TSH into the bloodstream to get the thyroid gland to make more hormone.
Common symptoms of hypothyroidism include:
- Weight gain
- Dry skin, hair, and nails
- Feeling tired
Hyperthyroidism: An over-active thyroid is called hyperthyroidism. The thyroid gland makes too much thyroid hormone. The pituitary gland decreases the amount of TSH in the blood.
Common symptoms of hyperthyroidism include:
- Heat intolerance
- Losing weight without dieting
- Muscle weakness, fatigue
Nodules: Thyroid nodules can be either solid or cystic . Most of the time, your thyroid works normally if you have nodules. Most nodules are not cancerous. However, your doctor might take a sample of the cells in the nodule. This is called a fine needle aspiration. This sample will be examined to make sure there are no cancer cells.
Goiter: This is an enlargement of the thyroid gland. You might feel swelling or enlargement in the neck. It can become larger because your thyroid is trying to make more thyroid hormone. Also, in hyperthyroidism the cells grow faster, which causes the thyroid to grow and make more thyroid hormone than the body needs.
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What Will Happen During A Partial Thyroidectomy
- General anesthesia is usually given before a partial thyroidectomy. This medicine will keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You may feel some pressure during surgery, but you should not feel any pain.
- After one or more incisions are made, your surgeon will remove part of your thyroid gland. If you have cancer, your surgeon may also remove the tissue and lymph nodes around your thyroid gland. If you are awake during surgery, you may be asked to speak to your healthcare providers.
- One or more drains may be placed into your incision to remove extra fluids from the surgery area. Your incision will be closed with stitches or surgical glue and covered with a bandage.
How Common Is Thyroid Cancer
Thyroid cancer is a rare form of cancer, accounting for less than 1% of all cancer cases in the UK. Each year, around 2,700 people are diagnosed with thyroid cancer in the UK.
Its most common in people aged 35 to 39 years and in those aged 70 years or over.
Women are 2 to 3 times more likely to develop thyroid cancer than men. Its unclear why this is, but it may be a result of the hormonal changes associated with the female reproductive system.
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Thyroid Removal When You Need To Be Concerned About Thyroid Nodules
May 24, 2019// by Dr Hagmeyer
So you have been having low thyroid symptoms and the visit to your doctor ended up where your doctor determined that you have thyroid nodules, if you are like most people that news was probably pretty scary. Thoughts of cancer or having to have your thyroid removed may have raced through your mind. The good news is that the vast majority are not cancerous, but that does not mean you should take this news lightly.
What Is Your Complication Rate
The answer you want to hear is the surgeons own complication rate for the procedurenot the average 1 percent reported in the medical literature. If the surgeon only does two thyroid surgeries a year and one patient had a problem, that makes it a 50 percent risk, said Roman. Dont be shy about asking for this information. Said Sosa, Its the ethical responsibility of the surgeon to report the truth and to know their own data.
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How Will You Partner With The Rest Of My Medical Team
After surgery, youll likely need monitoring of your thyroid hormone levels and, in the case of thyroid cancer, follow-up treatment and testing. You want to know that the people taking care of different aspects of your thyroid disease or thyroid cancer are working together and communicating as a team, said Sosa. At Duke, weve created a clinic where you, your surgeon and your endocrinologist can meet at the same time, in the same place.
What Happens During The Procedure
The surgeon will make a cut in the front of the neck, 2cm to 3cm above the collar bone. They will divide the muscles so they can reach the thyroid gland.
They will be very careful not to damage the vocal cords or the parathyroid glands that sit behind the thyroid. These glands control the bodys calcium levels.
The surgeon removes the thyroid gland. The muscles are then put together and the wound is stitched to close it up.
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How Do I Select A Surgeon
In general, thyroid surgery is best performed by a surgeon who has received special training and who performs thyroid surgery on a regular basis. The complication rate of thyroid operations is lower when the operation is done by a surgeon who does a large number of thyroid operations each year. Patients should ask their referring physician where he or she would go to have a thyroid operation or where he or she would send a family member.
Why Is A Thyroidectomy Performed
Someone might need part or all of their thyroid gland removed if:
- they have an enlarged thyroid that makes it difficult to swallow or breathe
- they have an overactive thyroid
The removal of part of the thyroid gland is called a partial thyroidectomy or hemithyroidectomy and the removal of the entire gland is called a total thyroidectomy.
If someone has a total thyroidectomy, they will need to take thyroxine tablets for the rest of their life. Some people also need to take thyroxine tablets after a partial thyroidectomy. It depends on how much of the thyroid gland is removed.
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Essential Tips To Cope Up With The Side Effects Of Thyroid Removal:
Here in this section we will talk about some of the tips so as to help you cope up with the side effects of thyroid removal procedures
- We discussed earlier that after your thyroid removal surgery, you may have difficulty in swallowing. It is essential for you to rely of soft and healthy foods.
- You can use more sauces and gravies, or the more of the moist foods after the surgery which would be easier to swallow as compared to the dry foods.
- Go for long and slow cooking so as to soften the meat and vegetables you prepare for your diet.
- Chop the vegetables or meat finely before or after cooking.
- Apart from this, take healthy and nutritious diet so as to help self with healing. Talk to a dietician for your appropriate diet after the thyroid removal.
- Using Aloe vera, Bio-oil to soften the skin around the wound and prevent dryness while its healing period can be beneficial.
- You can also use non scented moisturising cream to your scar once your wound is healed.
- Talk to your doctor and take prescribed medications in case you have high fever, swollen or painful neck and also in case of infection.
|Written, Edited or Reviewed By:Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc.This article does not provide medical advice. See disclaimerLast Modified On: April 6, 2018|
Long Term Monitoring And Treating Recurrent Or Persistent Disease
After your treatment, you will receive life-long monitoring. This is for two main reasons.
- First, long-term monitoring is important to make sure that your dose of thyroid hormone replacement is appropriate neither too low nor too high for your specific needs.
- Second, you will receive testing to find out if there is persistent disease or possible recurrence. Many people with differentiated thyroid cancer experience persistent disease or a recurrence, sometimes many years after the initial treatment. The prognosis for any person with a recurrence is better if it is discovered early. This is why life-long monitoring is important.
- The exact type of monitoring, and how often it takes place, depends on the size of the original tumor and whether the cancer had spread locally or distantly, as well as other factors.
- People free of disease receive less monitoring or testing than those with evidence of persistent disease.
- Also, testing is spread out and becomes less frequent when the patient becomes free of disease. You and your doctor should discuss a plan to fit your situation.
Monitoring will most likely include:
Also, for people in medium-risk or high-risk circumstances, long-term monitoring may sometimes include:
Treating Persistent or Recurrent Disease
If your testing shows persistent or recurrent disease, your treatment may include some or all of these treatments. Your treatment will be tailored to your own circumstances.
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Does This Treatment Follow Published Guidelines
Professional associations for medical specialtiessuch as the American Thyroid Association regularly review the latest research and set out treatment guidelines for achieving the best patient outcomes. You want to be sure your surgeon is familiar with and using the published guidelines, said Sosa. You can check the guidelines yourself theyre available on the ATA website.
Does Life Expectancy Change If You Lose Your Thyroid
Overall, people living without a thyroid or an underactive thyroid do not have a reduced life expectancy or shortened life span if they get treatment.
However, the reason you do not have a thyroid can affect how long you live. For example, people ages 45 and older who had a thyroidectomy to treat differentiated thyroid cancer may expect lower life expectancy. With that said, people younger than age 45 with DTC had no significant changes in life expectancy.
Treating an underactive or absent thyroid can improve your life quality and decrease your risk for preventable diseases like heart disease.
If you suffer from symptoms that may indicate your thyroid is not functioning optimally, it may be time to meet with a thyroid doctor.
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Why Is Thyroid Removal Surgery Performed
The main reasons a doctor may recommend thyroid removal surgery include:
- A nodule that could be thyroid cancer
- A diagnosis of thyroid cancer
- A nodule or goiter that is causing local symptoms
- Compression of the trachea
- Difficulty swallowing
- A visible or unsightly mass
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.
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What Are Types Of Thyroid Removal Surgery
Removal of the thyroid gland may be partial or total.
Types of thyroid removal surgeries include:
- Hemi-thyroidectomy or thyroid lobectomy: one lobe of the thyroid is removed
- Isthmusectomy: removal of just the bridge of thyroid tissue between the two lobes
- Performed only for small tumors located in the isthmus
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.
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Who Performs A Thyroidectomy
The following specialists perform a thyroidectomy:
Otolaryngologists specialize in the treatment of diseases and conditions of the ears, nose and throat.
General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions.
Pediatric otolaryngologists specialize in the treatment of diseases and conditions of the ears, nose and throat in infants, children and adolescents.
What To Expect After The Procedure
After the operation is finished, the pulse, blood pressure and other vital signs will be monitored for a while. There may be a tube in the neck to drain fluid. This will probably be removed the next day.
You may be drowsy after the anaesthetic and take a few days to recover. Your voice may be hoarse or weak and you may have some pain in your neck. These symptoms normally go away quickly.
You will probably be able to go home the same day or the next day. However, dont do anything strenuous for 10 days after the surgery.
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Questions To Ask Your Doctor Before Thyroid Surgery
Duke doctors perform thyroid surgery on a patient at Duke Raleigh Hospital.
Your doctor may recommend surgery to remove part or all of your thyroid gland if its overactive, has grown very large, or has nodules, cysts or other growths that areor could becancerous. Here are essential questions to ask before you schedule thyroid surgery.
Learn more about thyroid cancer treatment at Duke.
The Outlook After Surgery For Thyroid Cancer
Thyroid cancer is the most common reason for thyroid removal. Having cancer is a frightening, life-changing experience for most people. It helps to know that most types of thyroid cancer are curable with surgery and other treatments. Still, it may be hard to focus on your recovery after surgery.
Keeping track of all your medicines, instructions, and medical appointments can be overwhelming. Its helpful to bring a family member or close friend to your appointments to support you. Keep a list of questions to bring to your appointments, and write down the answers to keep on hand.
A common treatment for thyroid cancer after surgery is radioactive iodine. It destroys any remaining cancer cells. It involves taking the iodine in a drink or capsule while in a hospital setting. Advanced cancers may require , , or targeted drugs. Talk to your doctor about your type and stage of thyroid and ask about all your treatment options.
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