It is important to remember that thyroid cancer can often be successfully treated. Most people are completely cured.
If the tests showed that you have thyroid cancer, your healthcare team will discuss treatment with you.
The main treatment for thyroid cancer is surgery to remove the thyroid gland (thyroidectomy). The surgeon may also remove the lymph nodes in your neck. You will need to stay in hospital for a few days after this surgery.
You might need more treatment after surgery. Radioactive iodine treatment is given to help destroy any cancer cells that were not removed during the surgery. You will be looked after in hospital for a few days. You may also need to have external beam radiotherapy (high-energy x-rays).
If you have had your whole thyroid gland removed, you will need to take thyroid hormone replacement tablets. This is to replace the hormones that are usually produced by the thyroid gland. It also helps to reduce the chance of papillary or follicular thyroid cancer coming back. You will need to take the tablets for the rest of your life. You will have regular blood tests to check your hormone levels so that doctors can find the right dose for you.
Surgery to remove the whole thyroid gland is the main treatment for thyroid cancer. This operation is called a thyroidectomy.
Sometimes the surgeon will only need to remove the lobe of the thyroid that contains the cancer. This is called a lobectomy.
You may feel shocked and scared about having surgery. Your doctor and nurse will tell you more about it so that you know what to expect.
Try to remember that surgery is usually a very successful treatment for thyroid cancer.
We have more information about what happens when you go into hospital for an operation in the surgery section.
There are lymph nodes in the neck, close to the thyroid. These are part of the body’s immune system and help fight infection. The lymph nodes might contain cells that could become cancerous in the future. So sometimes, the surgeon might also remove some, or all, of the nodes. They may also remove some tissue from around the thyroid if they think it might contain cancer cells.
After your operation, the nurses on the ward will help you to lie in an upright position, supported by pillows. This helps to reduce swelling in your neck area.
You might have a low calcium level in your blood after the operation. This is because there is a small risk that surgery will damage the parathyroid glands. These are four very small glands behind the thyroid gland. They produce parathyroid hormone, which helps to control the level of calcium in your blood. The nurses will test your blood to check the calcium level.
You may have a hoarse voice after the operation. This is because the thyroid gland is near the nerves that control your vocal cords. These nerves can be bruised or damaged during surgery. This can make your voice sound hoarse and weak. Your doctor might check your vocal cords before and after the surgery.
You will probably need to spend one or two days in hospital after the operation. There will be a scar on your neck, usually just above the collarbone. It might look quite red at first, but will fade over time.
You may need to take tablets to replace the thyroid hormone. There is more information about thyroid hormone replacement therapy below.
The tissue that was removed during the operation will be looked at under a microscope. The results will help your doctors decide if you need more treatment. This could be another operation, radioactive iodine treatment or other treatments. Your doctor will explain the results of the operation to you.
If you want to know more about what happens when you have an operation, there is more information in the general surgery section.
If you have had the whole of your thyroid gland removed, your body won’t be able to produce thyroid hormones anymore. Without these hormones, your metabolism slows down. This can cause:
Thyroid hormones can be replaced by taking tablets. You will need to take them for the rest of your life. The most common long-term hormone replacement tablet is thyroxine (levothyroxine).
If you need to have radioactive iodine treatment, you might be given a different type of thyroid hormone. It is taken until the iodine treatment is finished, and then usually replaced with thyroxine.
As well as replacing the missing hormones, thyroxine can also help stop some types of thyroid cancer coming back. Some people are given the thyroid hormone tablets as part of your on-going cancer treatment.
You will need to have your blood checked regularly to monitor the hormone levels. It can sometimes take months to find the right dose of thyroxine for you. But when the right dose is found, you should not have any side effects. This is because they are just replacing normal thyroid hormones.
Remember to take your tablets every day. It can help to take them at the same time every day so you get into a routine.
Radioactive iodine is a type of radioisotope treatment that targets thyroid cells. Radioisotopes are radioactive substances given by mouth as a drink or capsules, or injected into a vein.
It is usually given:
Normally, the thyroid gland takes up (absorbs) iodine from our diet and uses it to make thyroid hormones. When you have radioactive iodine, the thyroid cells absorb the iodine and receive a very high dose of radiation. This destroys the thyroid cells and any cancer cells that may remain after surgery.
Radioactive iodine does not usually affect other parts of the body because other cells don’t absorb iodine the way thyroid cells do.
You can’t have this treatment if you are pregnant. If there is any chance of this, tell your healthcare team and they can test you.
You usually have radioactive iodine as a capsule. Sometimes it is given as a drink or as an injection into a vein in your arm through a cannula.
Radioactive iodine treatment does not work if you are taking thyroid hormone replacement tablets. To prepare your body for the treatment, you will need to stop taking your thyroid hormone tablets for 2 to 4 weeks. While you are not taking the thyroid hormones, you will have symptoms of low thyroid hormone, such as tiredness and lack of energy, poor concentration and constipation.
These symptoms should stop when you start taking thyroid hormone tablets again, but it can take some time.
Sometimes, instead of having to stop taking the hormone tablets, you are given two injections of a drug called thyrotropin alfa (Thyrogen®). Having this injection means you can keep taking your hormone replacement tablets, so you will not get the symptoms of low thyroid hormone. Thyrotropin is not suitable for everyone. Your doctor or specialist nurse can tell you if you can have this treatment.
Some people won’t start taking thyroid hormones until after radioactive iodine treatment.
For one or two weeks before radioactive iodine treatment, you will be asked to eat a low-iodine diet and avoid certain foods. This encourages the body to use up its stores of iodine. Having a very low amount of iodine in the body means that when the radioactive iodine is given, any remaining cancer or thyroid cells will absorb it. This can help make the treatment more effective.
You will be given information about a low-iodine diet. The following tables show which foods you can have on a low-iodine diet, and which ones you should limit or avoid.
Radioactive iodine treatment makes you radioactive for a few weeks. Your body will gradually get rid of the radioactivity through your wee, sweat and saliva. You will be kept in hospital when the radioactivity is highest, which is usually a few days. You will be looked after in a side room on the ward.
During this treatment, the amount of contact you can have with family, friends, and your healthcare team will be limited. This is to protect them from exposure to the radiation. Anyone who is pregnant or younger than 18 is not usually allowed to visit.
You will be able to keep in touch with your family and friends by phone, text and the internet. There may be books, magazines, DVDs, computer games or a TV in the room. You can take in some of your own things to help pass the time. Ask your team whether you can take your computer, tablet or phone into the room with you. Anything that comes back out of your room will be checked for radiation levels. Sometimes your things may have to be kept on the ward for a few days if the radiation levels are high. But they will be returned to you when they are safe again.
Once your radiation levels are safe, you will be allowed to go home. Check with the staff about what you can and can’t do when you get home. There will probably be some precautions you will need to take for a few weeks.
You will have a scan shortly after your treatment. This will help show the doctors if you need more radioactive iodine treatment. If you need more treatment, it is usually given after six months.
Your fertility won’t be affected by the treatment. But you should not become pregnant for six months, or make someone pregnant for four months, after radioactive iodine treatment. You should also avoid all sex and open-mouthed kissing for a few days after treatment.
After treatment, you might set off the alarms at the airport security gates for up to six months. If you are planning a holiday, discuss it with your healthcare team.
Some people have external beam radiotherapy, but it is used much less often than radioactive iodine treatment. External beam radiotherapy uses high-energy rays to destroy cancer cells. The rays are given from outside the body.
Radiotherapy is usually given as an outpatient. But sometimes you might be in hospital while you have it. You normally have radiotherapy as a series of short treatment sessions of about 10 to 20 minutes. You will have treatment Monday to Friday, with a rest at the weekend.
During the radiotherapy, you will need to lie still on a narrow bed that is under a radiotherapy machine. Radiotherapy machines are quite big, and look like large x-ray machines.
Radiotherapy is like having an x-ray, so it does not hurt and you cannot feel it.
We have more detailed information about radiotherapy that you might find helpful.
After your treatment is finished, you will see the doctor and have regular tests to monitor your condition.
Thyroglobulin is a protein that is normally made by the thyroid cells. It can also be made by some types of thyroid cancer cells. Levels of thyroglobulin can be detected in the blood, so you will have regular thyroglobulin blood tests.
After treatment there should not be any thyroglobulin in the body. It would only be found in your blood if a small amount of thyroid tissue is left, or if some thyroid cancer cells remain in your body. This means the thyroglobulin blood test is a useful way of detecting any remaining cancer cells.
This test is done 9 to 12 months after having radioactive iodine treatment. It is used to see if you need any more radioactive iodine treatment.
You may need to stop taking your thyroid hormone replacement a few weeks before the blood test. Your doctor or specialist nurse will give you information about this.
You may have regular ultrasound scans of your neck.
You may have a radioactive iodine scan a few months after treatment. This is to check whether there are any thyroid cancer cells in your body. Your doctor or nurse will give you more detailed information about this test if you need to have it.
If your thyroglobulin level is raised, or your scans shows any abnormal areas, you may have further tests. These may include:
Information about the different types of thyroid cancer, the symptoms and possible causes.
The thyroid is a small gland in the front of the neck, just below the voicebox (larynx).
You may have tests to help your doctors see whether you have thyroid cancer.
Read this webchat transcript, in which specialist nurses Geri and lngrid answered questions on thyroid cancer. Topics include treatment, hormone levels and emotion effects.
A place for people affected by thyroid cancer to support one another, ask questions, and share their experiences.
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