Before your operation for thyroid cancer

If you are having surgery for:

you may visit a pre-assessment clinic before your operation.

At the clinic, you will have some tests to check your general health. These may include:

You will see a member of the surgical team and, in some hospitals, a specialist nurse. They will talk to you about your operation. This is a good chance to ask questions and talk about any concerns you have.

You will see the doctor who gives you your anaesthetic (the anaesthetist) either at a clinic or when you are admitted to hospital.

You will usually be admitted to hospital the day before or on the morning of your operation.

Checking your vocal cords

Before and after surgery, a doctor will check your vocal cords. This is because the nerves that control your vocal cords are close to the thyroid gland. The doctor may use a local anaesthetic spray to numb your nose and throat.

Then they will pass a thin, flexible tube with a small camera at the end (nasendoscope) through your nose to look at how your vocal cords move. This can be a little uncomfortable, but it should not be painful.

You may be asked to avoid eating or drinking for a few hours after the test, until the local anaesthetic wears off.

Smoking

If you smoke, it is important to try to give up or cut down before your operation. This will help reduce your risk of problems such as a chest infection. It will also help your wound heal after the operation. Your GP can give you advice on how to stop smoking if you need support.

Needing help at home

If you think you might need help when you go home after your operation, let the nurses know at the pre-assessment clinic. They can then help you make arrangements in plenty of time.

Stockings to prevent blood clots

The nurses will give you elastic stockings (TED stockings) to wear during and after the operation. These help prevent blood clots forming in your legs.

After your operation for thyroid cancer

After your operation, the nurses on the ward will help you to lie in a fairly upright position, supported by pillows. This helps to reduce swelling in your neck area. They will take your blood pressure and pulse, and check your oxygen levels at regular intervals.

Between 6 and 24 hours after your operation, they will take a sample of your blood to check the calcium levels.

The nurses will encourage you to start moving about as soon as possible. You should have a nurse with you the first time you get out of bed, as you may feel drowsy and dizzy. If you have to stay in bed, they will encourage you to do regular leg movements and deep-breathing exercises. A physiotherapist or nurse will explain these exercises.

Drips and drains

While you are unable to drink, you may have a drip (intravenous infusion) going into your arm to give you fluids. This can be removed as soon as you are drinking enough.

You may have one or two tubes (drains) to drain fluid from your wound. These are usually removed within 24 to 48 hours.

Your surgeon may use stitches or clips to close your wound. Sometimes they use dissolvable stitches. If you have stitches or clips that need to be removed, the nurses will tell you when and where this will happen.

Pain and discomfort

You will probably have some pain or discomfort after your operation, and your doctor will prescribe painkillers for you. If you find they are not helping, let your nurse know as soon as possible so that they can change your painkillers.

The skin on your neck up to your jaw line might feel numb after surgery. This is caused by the local anaesthetic used during surgery.

Your neck will also feel stiff after surgery. Your nurse, surgeon or physiotherapist will show you some neck exercises to help with this. The physiotherapist may give you some exercises to continue at home.

Eating and drinking

You should be able to start drinking an hour or so after your operation. You may find it painful to swallow solid foods at first, and may need to start off eating soft foods. Over the next 2 to 3 days you should find it easier to swallow, and you can start eating solid foods. The nurses or a dietitian will discuss this with you before you go home.

It is important to keep having a balanced diet. If you are finding it difficult to eat, nutritious drinks are a good way to supplement your diet.

Going home

Most people are ready to go home about 1 to 3 days after their operation. If you think you might have problems when you go home, let your nurse or the social worker know when you are admitted to the ward. For example, you might have problems if you live alone or you have several flights of stairs to climb. The nurse or social worker can arrange help before you leave hospital.

Some people take longer than others to recover from their operation. If you have any problems, you may find it helpful to talk to someone who is not directly involved with your illness. Our cancer support specialists can talk to you, and tell you how to contact a counsellor or local cancer support group. You can call them on 0808 808 00 00.

Appointment

Before you leave hospital, you will be given an appointment for a post-operative check-up. Some hospitals will post this appointment to you after you have left hospital.

At this appointment, your doctor will discuss with you the results of your surgery and whether you need any further treatment. It is also a good time to ask any questions and discuss any concerns you may have.

Driving

Your doctor will tell you when it is safe for you to start driving after your surgery. When you start driving, you should make sure that you do not have any side effects of painkillers. You should also make sure you can turn your neck in all directions.

You may need to let your insurance company know you have had thyroid surgery, as some policies give time limits for not driving after surgery.

Getting back to work

Everyone recovers from surgery at their own pace. Most people can return to work within a few weeks of having thyroid surgery. But if your work involves heavy lifting, standing for long periods or walking around a lot, you may need more time before you can return to work.

If you are not sure, you may find it helpful to speak to an occupational health nurse or your GP.