Thyroidectomy

You may have surgery to remove part or all of the thyroid gland. This is called a thyroidectomy. It will depend on the size of the cancer and your health.

About thyroidectomy

The main treatment for follicular and papillary thyroid cancer and for medullary thyroid cancer is surgery. It is occasionally used to treat anaplastic thyroid cancer.

During surgery, part or all of the thyroid gland is removed. This is called thyroidectomy.

The type of operation you have will depend on the stage of the cancer and your general health. Your doctors will look at the results of scans and biopsies you have had. These results and your preferences help them decide which operation you need. Your surgeon or specialist nurse can talk to you about what to expect before and after your operation.

Total thyroidectomy

In this operation, the surgeon removes the whole thyroid gland. It is the most common surgery for thyroid cancer.

If it is not possible to remove the whole thyroid gland, the surgeon will remove most of it. This is called a near-total thyroidectomy.

If the cancer has started to spread outside the thyroid gland, the surgeon may need to remove some of the tissue in the area around it. Your doctor will discuss this with you before the operation.

Thyroid lobectomy

In this operation, the surgeon removes the lobe of the thyroid gland that contains the cancer. The isthmus (bridge of tissue between the left and right lobe) may also be removed.

Sometimes, if the FNA result is not clear, a lobectomy is used to diagnose thyroid cancer. Your doctor or specialist nurse will discuss this with you. If a cancer is found, your doctor may then suggest you have another operation to remove the remaining lobe of the thyroid gland.

Surgery to the lymph nodes near the thyroid

Your surgeon may remove lymph nodes in the front, or the front and side, of your neck. This is called a neck dissection. How much surgery you need depends on the stage of the cancer. It is done to:

  • remove suspicious or cancerous lymph nodes
  • help reduce the risk of the cancer coming back.

Removing the lymph nodes also gives your doctor information to help them plan further treatment.

Some people with a small thyroid cancer may not need to have any lymph nodes removed. Your surgeon will discuss the benefits and disadvantages of this treatment before your surgery.

Side effects of thyroidectomy

Thyroid hormones

If you have all of your thyroid gland removed, your body will no longer produce thyroid hormones. You will need to replace them by taking tablets for the rest of your life.

If you have had a lobectomy, you may also need to take thyroid hormones. Your doctor or specialist nurse can tell you if you will need to.

Hoarse voice

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.

Change in calcium levels

There is a risk that surgery to remove the thyroid gland will damage the parathyroid glands. These are 4 very small glands behind the thyroid gland. They make parathyroid hormone, which helps to control the level of calcium in your blood. We have more information about parathyroid glands in our information about parathyroid gland cancer.

If your parathyroid glands are damaged, the level of calcium in your blood may become low (hypoparathyroidism). This 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 your calcium level is low, they will give you calcium either as a tablet or through a drip in your arm. They will check your calcium levels every day until they improve.

Your doctor will prescribe calcium, and sometimes vitamin D supplements, for you to take at home. They will arrange for you to have regular blood tests to check your calcium levels. You should take the calcium tablets at least 4 hours before or after taking thyroid hormone replacement tablets.

You often only need these supplements for a short time. Your doctor will tell you how long you need to take them for. If the calcium level in your blood continues to be low, your GP or a doctor specialising in hormones (endocrinologist) will check it regularly.

Scar

After your operation, you will have a small scar on the front of your neck. The scar is usually in one of your natural skin folds, and fades as it heals. If you have more extensive surgery to remove lymph nodes, you may have a bigger scar.

We have more information about covering scars.

Neck stiffness

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 have had more extensive surgery to remove some of your lymph nodes. Your doctor will prescribe painkillers to help and may refer you to a physiotherapist.

Tiredness and mixed emotions

It is normal to feel tired for a few weeks after your thyroid gland has been removed. Many people also find they have a mixture of emotions after surgery. This is natural as your body adjusts to the effects of the surgery. You can contact your specialist nurse if you feel you need support.

About our information

  • References

    Below is a sample of the sources used in our thyroid cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    British Medical Journal. Best Practice Guidelines, Thyroid cancer. 2020.

    European Society Medical Oncology (ESMO): Thyroid cancer, Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up. 2019.

    National Institute for Health and Care Excellence (NICE). TA535: Lenvatinib and Sorafenib for treating differentiated thyroid cancer after radioactive iodine. 2018. www.nice.org.uk/guidance/ta535 [accessed May 2021].

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.