Thyroid cancer refers to the growth of abnormal (malignant or cancerous) cells in the thyroid gland. The thyroid is a butterfly-shaped gland located in the front of your neck. Although the hormones produced by the thyroid gland affect many organs of the body, its main function is to control the body’s metabolism (how fast sources of energy are used). It also helps control body temperature and the level of calcium in the blood. Cancer of the thyroid can be one of four types.

• Papillary carcinoma is the most common thyroid cancer. It usually grows very slowly and is associated with a very high cure rate. Papillary carcinoma is typically found in women of childbearing age. However, it can occur in men and other age groups.
• Follicular carcinoma is the second most common type of thyroid cancer. It typically grows slowly and is usually cured when diagnosed early.
• Medullary carcinoma is cancer of the thyroid cells that make a hormone to control the level of calcium in the blood. This type of cancer also tends to grow slowly, but can be difficult to treat once it spreads. The tendency to develop medullary carcinoma can be inherited.
• Anaplastic carcinoma is also known as giant and spindle cell cancer. It is uncommon, tends to occur in older people and spreads quickly.

Your healthcare provider will look for spread of the thyroid cancer to other areas of the body. This process is called “staging.” Metastatic thyroid cancer is cancer that started in the thyroid and has spread to other organs or tissues. In order to decide what type of surgical and non-surgical treatment is ideal for a specific cancer, your healthcare provider will need the following clinical information.

• What does the cancer look like under the microscope?
• Does the thyroid cancer invade outside the thyroid gland or is it limited to the gland itself?
• How large is the primary cancer in the thyroid?
• Has the cancer spread to lymph glands or anywhere else in the body?

A thyroidectomy is the removal of the thyroid gland through an incision in the neck. It can be done to treat thyroid cancer, an overactive thyroid, a noncancerous thyroid growth or swelling of the thyroid.

• You may need to take thyroid medication and iodine for a period prior to the surgery.
• You may have a drain placed in your neck during surgery. This will usually remain for one to two days to get rid of excess fluid from the area.

Thyroid cancer can develop at any age, but it is most common in women between forty and fifty years of age and men between sixty and seventy years of age. The risk factors for cancer of the thyroid include:

• Radiation exposure (such as from previous radiation treatment or nuclear accidents)
• Radiation therapy to the neck area (usually as a child)
• A low iodine diet
• A chronic thyroid goiter
• Hereditary conditions
• A family history of thyroid cancer

There are no known ways to prevent thyroid cancer. Being aware of your risk factors can result in the cancer being diagnosed and treated sooner, which improves your prognosis.

Often thyroid cancers do not cause symptoms and are discovered during periodic health exam. When symptoms do occur, they may include:

• Cough
• Swallowing difficulty
• Enlarged thyroid gland
• Lump on thyroid gland
• Changes or hoarseness in voice
• Swelling of the neck

Contact your healthcare provider if you have any of the above symptoms. He or she will review your symptoms and perform a physical examination. They may also recommend one of the following tests:

• Blood tests to check your calcitonin and thyroid hormone levels
• A laryngoscopy, an examination of your throat using a special instrument
• Removal of tissue from the thyroid for examination under a microscope (biopsy)
• A scan of your thyroid gland
• An ultrasound of your thyroid gland

Treatments for thyroid cancer are either local (only affects the area of the cancer) or systemic (affects all areas of the body). Local treatments include:

• Surgery to remove the cancer (thyroidectomy, or removal of the thyroid)
• Radiation to kill the cancer

Systemic treatments include:

• Chemotherapy to kill the cancer cells
• Targeted, or biologic, therapy to interfere with the changes in cells that help the cancer grow
• Internal radiation or radioactive iodine therapy, which is a solution given by mouth and absorbed by certain types of cancerous tissue

All three treatments target and kill cancer cells.

Treatment for thyroid cancer may involve a combination of local and systemic treatments, especially if the cancer has traveled to other parts of your body.

• If the cancer is only in the thyroid, surgery is usually the primary treatment.
• Chemotherapy is usually used to treat thyroid cancer that has spread.
• Oral targeted therapy has been approved for medullary thyroid cancer. Targeted therapy for other types of thyroid cancer also appears promising.
• Radioactive iodine therapy may be recommended after surgery for thyroid cancer that has a high chance of spreading or growing back. It may also be used for some thyroid cancers that have spread outside the thyroid.
• Radiation and chemotherapy are usually given in a clinic or hospital by specially trained medical personnel.
• In some cases, you may be able to receive chemo at home with the help of specially trained nurses.

After treatment, you will need to take a thyroid medication for the rest of your life.

To get a full range of opinions and perspectives, and depending of the specific clinical aspects of your case, you may want to consider input from a variety of doctors. This includes:

• Your primary care physician
• A medical oncologist (a doctor who specializes in the treatment of cancer)
• A surgeon with experience in thyroid cancer
• A radiation oncologist (a doctor who specializes in treating cancer with radiation therapy)
• A genetic counselor
• An endocrinologist

If your healthcare provider recommends a thyroidectomy, prior to the surgery you should tell him or her about any medications you are taking (including over-the-counter medications and supplements). You should also ask about specific instructions you should follow before and after the surgery. These include:

• Medications you may need to take before the surgery
• Medications you should not take before the surgery, such as blood thinners
• Regular medications you should continue to take on the day of your surgery
• How many hours you should stop eating and drinking before the surgery

If you are a smoker, you should quit smoking, as it can interfere with your recovery.

During your surgery, you will receive anesthesia to keep you comfortable and pain free.

• General anesthesia is the most common type of anesthesia for a thyroidectomy.
• With this type of anesthesia, you are put into a deep sleep and are unable to see, hear or feel anything.

Recovery from a thyroidectomy typically takes three to four weeks. You may need pain medication and help at home while you recover.

It is important to remember that the total cost of this care path does not include all possible medications, lab work, or imaging studies; those charges can add up. If your healthcare provider recommends any lab work or imaging studies, you may need to search for their costs separately.

Contact your healthcare provider if you have symptoms of thyroid cancer. Be prepared to discuss your symptoms and how long you’ve had them.

• Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
• Make a list of your medications (including over-the-counter).
• Write down any questions, symptoms or concerns you want to talk about.
• If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a thyroidectomy?

• What is my diagnosis? What specific type of thyroid cancer do I have?
• What tests are you recommending and why? Will the test results change my treatment plan? If not, then why do I need them?
• How will I feel after the surgery? Will I have to modify my activity?
• What are the possible complications for this surgery?
• What happens if I don’t go through with the surgery?
• What is your experience in doing this type of surgery? What is your complication rate?
• Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
• Will I be receiving other treatments before or after my surgery?

Before you go home, make sure you understand all home care instructions (including medications and side effects) and follow-up plans.

• Your surgeon should communicate with your primary care physician.
• Don’t forget to make arrangements for help at home.

Source UHC.com

Also known as:

Cancer

Cancer - Thyroid Removal

Cancer of Thyroid

Needle Biopsy

Removal of Thyroid

Thyroid Cancer

Thyroid Removal

Thyroidectomy