After a thyroid cancer diagnosis, our
multidisciplinary team works with patients to create a personalized plan for
treatment. At UT Southwestern Medical Center, we offer expertise in thyroid
cancer treatment that few other institutions can match. Our surgeons perform
hundreds of thyroid cancer procedures a year, and research shows that
experience leads to better outcomes when treating thyroid cancer.
Treatment plans depend on several factors, such
as:
- Type of thyroid cancer
- Tumor size
- Patient’s age and health
- Stage of cancer
Treatment plans often involve surgery and
thyroid hormone therapy. Treatment with radioactive iodine, which has little to
no side effects, is also sometimes used. External beam radiation therapy and
chemotherapy are not commonly used in the treatment of thyroid cancer, but they
might benefit some patients who do not respond to other therapies.
Surgery
for Thyroid Cancer
Surgery is frequently part of the treatment plan
for thyroid cancer. Depending on the case, either part or all of the thyroid can
be removed. Thyroidectomy might also be a good option for large nodules that
interfere with breathing, swallowing, or blood flow.
We can usually accomplish thyroid surgery
with very few side effects. One of the main risks of the procedure is injury or
damage to the nerves that control vocal cord function. During surgery, we use
recurrent laryngeal nerve monitoring to valuate vocal cord function.
There is also a risk to the blood supply that
feeds the parathyroid glands that help control calcium levels in the blood.
Because of these potential hazards, surgery by experienced, skilled thyroid
surgeons is recommended.
Thyroid
Hormone Treatment
After the thyroid has been removed, the body
can no longer make the thyroid hormone it needs, so patients must take a
thyroid hormone pill to replace the natural hormone. Taking thyroid hormone might
also help prevent some thyroid cancers from recurring.
We are able to estimate the dose patients
will need based on their body weight, and then we can quickly fine-tune the
dose as needed.
Radioiodine
Therapy
Radioiodine (radioactive iodine) treatment is
sometimes used after a thyroidectomy to destroy any remaining normal thyroid
cells, as well as microscopic areas of thyroid cancer that were not removed
during surgery. It can also help us detect whether the cancer has spread.
It’s an effective treatment when indicated
and is rarely associated with side effects. The patient often has to be
isolated afterward to prevent others from being exposed to the radiation.
After
Treatment
Long-term management after initial treatment
for thyroid cancer is different for each patient. Once a patient has completed
treatment, follow-up visits are necessary once or twice a year. We might need
to order blood tests between doctor visits to fine-tune the thyroid hormone
dose, and if adjustments are needed, we can usually make those without a
separate doctor visit.
During the follow-up appointments, we will
perform a physical exam and might order blood tests to measure the thyroid
hormone levels or surveillance imaging tests.
Depending on the type of thyroid cancer, it
often is very important to have follow-up neck ultrasounds, usually on a yearly
basis for the first 10 years after initial treatment. Follow-up is needed to
check for cancer recurrence or spread, as well as possible side effects of
certain treatments.