When you have thyroid cancer, it is important to be treated by experts with a high level of expertise. Our program is one of the most active, which means MD Anderson's physicians are some of the most skilled and experienced in the nation.
Surgery is often part of the treatment for thyroid cancer. Like all surgeries, thyroid cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. For some patients, robotic surgery and minimally invasive approaches may help maintain appearance.
Because we are one of the nation’s foremost cancer centers, we offer a number of clinical trials of innovative new therapies.
If you are diagnosed with thyroid cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:
- Type of thyroid cancer
- Size of the nodule
- Your age and health
- Stage of cancer
Your treatment will be customized to your particular needs. In most cases of differentiated (papillary and follicular) thyroid cancer, two or more of the following methods may be used. Most patients with medullary thyroid cancer are treated with surgery only. Patients with anaplastic thyroid cancer may be treated with chemotherapy and radiation therapy, or they may be candidates for a clinical trial.
Thyroid Cancer Surgery
Most people with thyroid cancer are treated with surgery. Many also are treated with additional methods.
Most thyroid cancer surgery will likely be one of the following:
- Total thyroidectomy: The entire thyroid is removed
- Lobectomy: Only the side of the thyroid where the tumor is located is removed. This type of surgery may be used for papillary cancers smaller than 1 centimeter (about ½ inch) that have not spread.
- Lymph nodes in the area of the tumor or in the neck and/or chest also may be removed.
If your entire thyroid gland is removed, you will take thyroid hormone replacement pills daily for the rest of your life.
Surgical teams at MD Anderson offer a variety of minimally-invasive techniques for thyroid cancer surgery, including minimally-invasive video-assisted thyroid (MIVAT) surgery and robotic thyroid surgery through transaxillary and facelift incisions.
New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Depending on the type of thyroid cancer and its stage, you may be treated with one of the following types of radiation:
Radioactive iodine: You drink a liquid or swallow a pill that contains radioactive iodine, which collects in thyroid tissue and destroys cancer cells. This method also is used to eliminate any thyroid cells in other parts of the body remaining after thyroidectomy or thyroid cancer.
If radioactive iodine is used after surgery, you may be asked to discontinue your thyroid hormone medicine to make the iodine more effective. This can sometimes be uncomfortable. A newer method gives thyroid stimulating hormone (TSH) by injection and does not require stopping thyroid medicine. Women should not become pregnant for six months to a year after radioactive iodine treatment.
External beam radiation: This type of therapy is most effective for thyroid cancers that do not absorb iodine, including anaplastic thyroid cancer. It may be used to fight thyroid cancer cells remaining after surgery or if cancer spreads to the bones.
Thyroid Hormone Therapy
This treatment uses thyroid hormone pills to stop the growth of cancer cells. In papillary or follicular thyroid cancer, hormone treatment may be used to lower the level of thyroid stimulating hormone (TSH), which may help stop the cancer from coming back. In other thyroid cancers, it may be used to keep thyroid hormone levels normal.
Chemotherapy often is used in combination with external beam radiation therapy to treat anaplastic thyroid cancer. It is usually not effective in other types of thyroid cancer.
Ablation therapy uses heat or cold to destroy, or ablate, cancer tumors without the need for more invasive surgery. Special probes are used to deliver ablative treatments directly to the tumor. The surgeon relies on computer imaging to guide the probes to the correct position and monitor the progress of the treatment.
Our Clinical Trials
Because we are one of the world’s premier cancer centers, MD Anderson participates in many clinical trials (research studies) for thyroid cancer. Sometimes they are your best option for treatment. Research studies may also help researchers learn how to treat cancer and improve the future of cancer treatment.
MD Anderson patients have access to clinical trials offering
promising new treatments that cannot be found anywhere else.
Find the latest news and information about thyroid cancer in our
Knowledge Center, including blog posts, articles, videos, news
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BY Devon Carter
Hearing you have a thyroid nodule can be scary, but it doesn’t always mean you have cancer. In fact, only about 10% of thyroid nodules are malignant.
But if you’ve been diagnosed with thyroid cancer, you may be feeling anxious about the next steps, which almost always include surgery.
Below, Mark Zafereo, M.D., shares what to consider before undergoing thyroid cancer surgery.
Get an accurate diagnosis
It’s important that you’re comfortable with the evaluation of your thyroid nodule before undergoing surgery. Since most nodules aren’t cancerous, many patients don’t need surgery at all.
There are four types of thyroid cancer. About 95% of thyroid cancers are either papillary thyroid cancer or follicular thyroid cancer. Patients with these cancers typically have a good prognosis.
The remaining 5% are medullary thyroid cancer and anaplastic thyroid cancer, which can be more aggressive and may require more extensive treatment.
There are different types of thyroid cancer surgery
The type of surgery your doctor recommends will be based on a risk assessment that includes the tumor pathology, size and location.
The simplest thyroid tumor surgery is a lobectomy. This procedure removes half the thyroid gland. When a thyroid tumor is more likely to spread, a total thyroidectomy (removal of the entire thyroid gland) may be performed.
If the cancer has spread beyond the thyroid gland to surrounding lymph nodes, a more extensive surgery removing these lymph nodes may be needed.
In rare cases, thyroid cancers may spread to other important structures of the neck, which may require more complex surgeries that are best performed by an expert thyroid and neck surgeon.
Ask the right questions
When you meet with your surgeon, make sure you have a clear understanding of your diagnosis, surgical plan and expected recovery. Here are some questions to ask:
- How many thyroid cancer surgeries do you perform each year? The most experienced thyroid cancer surgeons perform more than 100 thyroid/neck surgeries annually.
- What type of thyroid cancer surgery do I need? How much experience do you have performing this specific type of surgery? If the surgeon hasn’t performed many surgeries like yours, seek a second opinion from someone who has.
- How many of your newly diagnosed patients have to undergo a second thyroid/neck surgery within a year? This number should be less than 1%.
- How closely do you work with an endocrinologist, radiologist and pathologist? It’s important that your doctors collaborate and are all confident in the diagnosis and care plan. This minimizes surprises during and after surgery.
- Will the surgery affect my metabolism regulation? If part of your thyroid gland is removed, it may still produce enough of the hormone that regulates your metabolism. But if you have the whole gland removed, you’ll need to take a daily thyroid hormone pill for the rest of your life.
- What are the risks of this thyroid surgery?
- How much discomfort will I have after surgery?
Every patient’s recovery from thyroid cancer surgery is different
Every patient’s recovery is different. Most people take a week or two off work to recover, but can talk and eat a few hours after surgery. All patients will have a scar after surgery. With surgeries limited to the thyroid, the scar is usually about 2 inches long and will look like a natural crease in the neck over time. But ask your doctor what to expect after your particular surgery.
Don’t rush into surgery
With thyroid cancer, you’re not in a race to remove the tumor as soon as possible. Except for the most aggressive thyroid cancers (such as anaplastic thyroid cancer), these cancers are typically slow-growing. Even when the cancer has spread to the lymph nodes, there’s generally not an urgent need for surgery. So, take time to research your options, and find the right cancer center with the right surgeon to perform the right surgery the first time.
Since there’s more urgency with anaplastic thyroid cancer, we encourage these patients to seek proper care soon after diagnosis. At MD Anderson, our specialized clinic called Facilitating Anaplastic Specialized Treatments, or FAST, enables us to quickly finalize treatment plans for patients with suspected anaplastic thyroid cancer.
Specialized care has benefits
Receiving thyroid cancer care at a major cancer center like MD Anderson can make a significant difference in your outcome. At MD Anderson, we have care teams studying every aspect of thyroid cancer, which gives you access to the most cutting-edge care and clinical trials. In fact, MD Anderson has the most clinical trials in the world for medullary and anaplastic thyroid cancers. No matter what type of thyroid cancer you have, a specialized team can help ensure you have a well-thought-out care plan that reduces your chances of recurrence and the need for another surgery.
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