Thyroid cancer treatment depends on the person’s general health and the type and stage of the thyroid cancer. Typical treatments include surgery, radioactive iodine, and thyroid hormone replacement therapy.

The aim of thyroid cancer treatment is to kill as many cancer cells as possible and stop them from spreading, growing, or returning.

This article explores different treatments for thyroid cancer and answers frequently asked questions about thyroid cancer treatments.

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Surgery is the main treatment approach for most thyroid cancers. The extent of surgery depends on the tumor size and how much the cancer cells have spread beyond the thyroid gland.

People who undergo surgery often go home within a day of the operation.

Thyroidectomy

Thyroidectomy involves the removal of the entire thyroid gland. This is the most common type of surgery for thyroid cancer. There are two subtypes: near-total thyroidectomy and total thyroidectomy.

Near-total thyroidectomy involves removing nearly all of the thyroid gland but preserving a tiny portion of it.

Total thyroidectomy involves removing the entire thyroid gland. A doctor may recommend this if there is cancer in both lobes or the cancer has advanced beyond the gland.

Lobectomy

Lobectomy involves the removal of a thyroid gland lobe that contains cancer, usually along with the isthmus, or the small piece of the gland that bridges the left and right lobes.

This is the preferred treatment for people with cancer cells smaller than 1 centimeter (cm) in one of the lobes without any signs of the cancer cells spreading to adjacent lymph nodes or locations beyond the gland.

Some people who undergo lobectomy may not need to take thyroid hormone medication afterward since a part of the gland remains.

Lymph node removal

Doctors will also remove nearby lymph nodes in the neck during the surgery if the cancer cells have spread to these structures, especially in medullary and anaplastic cancer. They may also remove the nearby lymph nodes if the tumor has spread beyond the thyroid capsule.

Doctors may remove the enlarged lymph nodes and treat any remaining cancer cells with radioactive iodine in differentiated cancers such as papillary thyroid cancer or follicular thyroid cancer.

Risks of thyroid cancer surgery

As with any surgery, there are some potential risks associated with thyroid cancer surgery. Some potential risks and side effects include:

  • temporary or permanent voice hoarseness
  • loss of voice
  • damage to the parathyroid glands, which may cause muscle spasms, numbness, and tingling
  • excessive bleeding
  • hematoma in the neck
  • infection

A doctor will be able to explain the possible risks so that a person can make an informed decision about their treatment plan.

People who have their thyroid gland removed will need to take thyroid hormone (levothyroxine) medication because their body can no longer produce the thyroid hormones it needs. Thyroid hormones are necessary for maintaining the body’s typical metabolism.

Hormone replacement therapy (HRT) may also slow down the growth of any remaining cancer cells and help prevent some cancer cells from returning.

A doctor will be able to explain the possible side effects of thyroid hormone therapy and advise on ways to minimize or reduce the risk of any side effects that occur.

Radioactive iodine (RAI) therapy, or radioiodine therapy, is a type of internal radiation therapy. It is standard practice in treating follicular or papillary thyroid cancer that has spread to the neck or other body parts.

Doctors typically perform RAI therapy in a hospital’s nuclear medicine radiology department. A doctor may inject it into a person’s vein as a liquid, or they may have a person take it as a pill.

Since nearly all the iodine gets absorbed into the thyroid gland, a doctor can use RAI therapy to destroy the thyroid gland or any remaining residual thyroid tissue and cancer cells not removed by surgery.

RAI therapy also eliminates some thyroid cancer types that have spread to other body parts.

A doctor will typically recommend that a person maintains a low iodine diet for 1–2 weeks before they begin RAI therapy.

It is also important for a person to have a high level of thyroid-stimulating hormone (TSH) before receiving RAI treatment. A doctor can advise whether a person needs to raise their TSH level and if needed, how to do so.

Learn about where to stay after radioactive iodine therapy.

External beam radiation therapy may be suitable for treating thyroid cancer.

It uses a machine outside the body that sends radiation to the area of the body with cancer.

A doctor may recommend chemotherapy for rapidly progressive cancer or cancer that spreads even after other therapies. Chemotherapy uses drugs to stop the growth of cancer cells by stopping their division or killing them.

According to the American Cancer Society, chemotherapy is typically not necessary for most types of thyroid cancer.

A person will typically receive chemotherapy orally or via injection. Common chemotherapy drugs used to treat medullary and anaplastic thyroid cancer include:

  • carboplatin
  • cyclophosphamide
  • dacarbazine
  • docetaxel
  • doxorubicin
  • fluorouracil
  • paclitaxel
  • streptozocin
  • vincristine

As chemotherapy can cause significant side effects, doctors typically only consider this treatment when the benefits exceed the risks. Common side effects include:

Side effects typically resolve once a person finishes treatment.

Targeted drug therapy uses drugs or substances to look for and attack specific cancer cells. The main type of drugs doctors use in this treatment are kinase inhibitors.

A doctor may recommend targeted therapy if other treatments have not been effective.

Here are some frequently asked questions about thyroid cancer treatments.

What is the most common treatment for thyroid cancer?

Surgery is the most common treatment for thyroid cancer. Most people with thyroid cancer that requires treatment will undergo surgery to remove all or part of their thyroid gland.

How treatable is thyroid cancer?

Thyroid cancer a doctor diagnoses and treats early is highly curable. Papillary and follicular cancers, the most common types of thyroid cancer, have a 5-year relative survival rate of more than 99.5%.

What is the survival rate for thyroid cancer?

According to the National Cancer SEER Program, the 5-year relative survival rate for thyroid cancer is 98.5%, based on data from 2013–2018.

The survival rate refers to the proportion of people who are still alive for a length of time after receiving a particular diagnosis. For example, a 5-year survival rate of 50% means that 50%, or half, of the people are still alive 5 years after receiving the diagnosis.

It is important to remember that these figures are estimates and are based on the results of previous studies or treatments. A person can consult a healthcare professional about how their condition is going to affect them.

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How urgent is thyroid cancer surgery?

In the United States, many doctors suggest immediate biopsy and surgery for thyroid nodules suspected or confirmed to contain cancer cells.

However, the Memorial Sloan Kettering Cancer Center points out that active surveillance may be a suitable option for some people. This involves closely monitoring the cancer over a period of time rather than immediately treating it.

It is best for a person to discuss their treatment plan and options with their doctor.

The aim of thyroid cancer treatment is to kill as many cancer cells as possible and stop them from spreading, growing, or returning.

Possible treatments include surgery, thyroid hormone therapy, and radiation therapy. A doctor may also recommend chemotherapy or targeted therapy.

It is best for a person to discuss their options with their doctor so that they can make an informed decision about their thyroid cancer treatment.