Follow-up

You will have regular check ups and tests after your treatment. How often you have these will depend on your individual situation. You may feel anxious about these appointments, but this is natural.

Tests you may have include:

  • thyroglobulin blood test
  • ultrasound scan
  • radioactive iodine scan
  • further tests – you may have an MRI, a CT or a PET-CT scan.

Many people survive differentiated thyroid cancer, but it may take time to get back to the things you used to do.

Once you have recovered you may wish to make some changes to your lifestyle. Small, achievable changes such as eating more healthily, taking more exercise and giving up smoking can make a difference.

Follow-up

After your treatment is completed, you may need to have regular check-ups at the hospital. How often you have these check-ups and tests will depend on the stage of your cancer and the treatment you’ve had.

You may find you get anxious in the time leading up to your appointments. This is natural and it may help to get support from family, friends or another organisation during this time.

If you have any problems, or notice any new symptoms between follow-up appointments, let your doctor know as soon as possible.


Follow-up tests

Thyroglobulin test

Thyroglobulin is a protein that is normally made by the healthy thyroid gland. It can also be produced by papillary or follicular thyroid cancer cells. Levels of thyroglobulin can be detected in the blood.

When your thyroid gland has been removed and you have had radioactive iodine to destroy any remaining thyroid cancer cells, thyroglobulin should no longer be produced. If a small amount of thyroid tissue is left, or some thyroid cancer cells remain in your body, thyroglobulin will be detectable in your blood. The thyroglobulin blood test is a useful way of detecting any remaining papillary or follicular cancer cells. You will normally have this blood test at regular intervals after your treatment.

You may need to stop taking your thyroid hormone replacement before your blood test. Or you may be given recombinant human thyroid-stimulating hormone (rhTSH) before your blood test. If you have rhTSH, you won’t need to stop taking your thyroid hormone replacement tablets.

Your doctor or nurse will give you information about this.

Ultrasound scan of the neck

You may have a regular ultrasound scan of your neck.

Radioactive iodine scan

Some people may have a radioactive iodine scan a few months after treatment to check whether there are any thyroid cancer cells in their body. Your doctors will tell you if you’ll need to have a scan.

This test uses radioactive iodine, which is injected into a vein in your arm. After about 20 minutes, you’ll be asked to lie on a couch and a machine called a gamma camera will be positioned over your neck. The scan itself is painless.

If you have been given rhTSH to test the thyroglobulin level in your blood, you may be able to have the radioactive iodine scan 48–72 hours later. The thyroglobulin blood test is done 72 hours after your second injection of rhTSH. In this way, you won’t have to stop your thyroid hormone replacement tablets before the radioactive iodine scan.

To make the scan more sensitive you may be asked to stop taking your thyroid tablets and have a low iodine diet for a few weeks before your scan. Or you may be given recombinant human thyroid-stimulating hormone (rhTSH).

Your doctor or nurse will give you more detailed information about this test if you need to have it.

Other scans

If your thyroglobulin level is raised or your scan shows any abnormal areas, you may have further tests. These may include:

  • MRI (magnetic resonance imaging) scan
  • CT (computerised tomography) scan
  • PET-CT (positron emission tomography) scan.


Well being and recovery

Many people survive differentiated thyroid cancer. However, it may be some time after treatment before you feel fit and well again. Some people experience treatment side effects that gradually improve over time, while others may have ongoing side effects. You may have a range of other effects, such as trouble sleeping, weight gain, or feeling weaker and more tired than usual, rather than specific treatment side effects.


Lifestyle – positive choices, helping yourself

Some people want to make changes to their lifestyle after cancer. You might choose to make just a few changes or completely change the way you live. Adopting a healthy lifestyle doesn’t have to be very difficult or expensive.

It can sometimes appear that living a healthy lifestyle involves a lot of hard work and denying yourself all of the pleasures in life. However, it’s about making small, achievable changes to the way you live that will improve your health and well-being. Your healthy lifestyle will be individual to you, and what is right for you may not be right for someone else. A healthy lifestyle can include having a well-balanced diet, getting some exercise, reducing stress and being involved in your healthcare. You’ll need to think about any side effects of treatment when planning changes to your diet and exercise. Don’t try to do too much too soon.

A well-balanced diet should include:

  • plenty of fresh fruit and vegetables (at least five portions a day)
  • foods high in fibre, such as beans and cereals
  • plenty of water or other non-alcoholic fluids.

Try to reduce your intake of:

  • red meat and animal fats
  • alcohol
  • salted, pickled and smoked foods.

Before making major changes to your diet, it’s a good idea to discuss your plans with your specialist or with a dietitian at the hospital.

If you are a smoker, you may want to stop smoking. This has many health benefits and reduces your risk of other diseases such as heart disease and stroke.

Exercise doesn’t have to be particularly strenuous. You can start gently and build up the amount of physical activity you do. Whatever your age or physical health, there will be some kind of exercise you could try, such as walking, hiking, cycling or swimming. Activities like gardening, dancing and playing sport are also good to try.