Thyroidectomy

Your doctors will look at the results of your scans and biopsies to advise you on which operation is best for you. This might mean having either:

• all the thyroid removed – called a total thyroidectomy
• half of the thyroid removed – called a lobectomy or hemithyroidectomy.

If you were diagnosed with thyroid cancer during surgery for other thyroid problems, you may need further treatment.

Some thyroid doctors think that some very small, low risk thyroid cancers could be monitored with tests rather than removed with surgery straight away. You and your doctor can talk about the possible risks and advantages of this approach. Then you can decide if this is right for you.

You might have a lobectomy if:

• the cancer is small and has a low risk of coming back
• repeated tests on the thyroid cells do not clearly show if the cells are cancerous, but your doctor suspects cancer.

The surgeon removes the lobe of the thyroid containing cancer or where cancer is suspected. The isthmus, which is the tissue between the left and right lobe, may also be removed.

If cancer has not already been confirmed this operation can diagnose it. Doctors sometimes call this a diagnostic lobectomy. It also tells the doctor if you need more surgery to remove all the thyroid.

After a total thyroidectomy you will need to take thyroid hormone replacement therapy to replace the hormones your thyroid used to make.

After a lobectomy you might not need to take thyroid hormones. The remaining thyroid may produce enough hormones.

Your neck may feel stiff and uncomfortable after surgery. This usually gets better after a few weeks. But it may continue for longer if you had surgery to remove some lymph nodes.

If you had a neck dissection you will usually be given exercises to help strengthen your neck and shoulder muscles. You usually do these for up to 3 months after surgery. 

You can take painkillers 30 minutes before you start the exercises to make sure you are comfortable and do not have any pain. Your doctor may refer you to a physiotherapist if you have problems with neck stiffness.

We have more information about managing neck and shoulder problems after treatment.

After your operation, you will have a scar on the front of your neck. The scar is usually in a natural skin fold. It is usually about 4 to 6cms.

If you have white skin the scar will be red to begin with. If your skin is brown or black the scar will usually be darker than the surrounding skin. 

The colour of the scar fades as it heals so that eventually the scar should be much less noticeable.

If you have more surgery to remove lymph nodes you will still have 1 scar, but it will extend up the neck towards your ear.

Your nurse can show you how to gently massage your wound. This can help to help flatten the tissue. They might suggest creams or oils that might also help. We have more information on managing scars.

The thyroid gland is close to the nerves that control your vocal cords. Sometimes, these nerves can be bruised or damaged during surgery. This can make your voice sound hoarse and weak. Your doctor may check your vocal cords before and after your surgery.

A hoarse, weak voice is usually temporary, but may be permanent in a very small number of people. You may be referred to a speech and language therapist for specialist advice.

If your parathyroid glands are damaged, the level of calcium in your blood may become low. This is called hypoparathyroidism. It can cause:

• tingling in your hands or feet, or around your mouth
• unusual muscle movements, such as jerking, twitching, spasms or muscle cramps.

Your doctor or nurse will check the calcium level in your blood after your operation. If it is low, they will give you calcium either as a tablet or through a drip in your arm. They check your levels every day until they improve.

You might need to take calcium tablets for a short time when you go home. After this your GP or hospital doctor will check your calcium levels regularly.

When lymph nodes are removed as part of your thyroid operation there is a risk that fluid might build up in the tissues of the neck. This is called lymphoedema.

It is common to get swelling (oedema) near the surgery scar in the first few days after the operation. This can take several weeks to go away completely. This type of swelling is not the same as lymphoedema.

Lymphoedema usually happens a few months or years later. Taking care of the skin in the area can help reduce the risk of lymphoedema.

If you are worried about any swelling, talk to your doctor or specialist nurse straight away.

Macmillan is here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line for free on 0808 808 00 00.
• Chat to our cancer information specialists online.
• Visit our Online Community thyroid cancer forum to talk to people who have been affected by thyroid cancer, share your experience, and ask an expert your questions.