When a patient is confirmed as having thyroid cancer, via the tests that diagnose it, the treating doctor will refer the patient to a surgeon, who will determine how the cancer will need to be removed. If the cancer affects only one lobe of the thyroid (there are two lobes, one on each side), the surgeon may wish to perform what is called a “lobectomy”, (partial thyroidectomy) meaning there will be removal of only one side of the gland. If the surgeon feels removal of only one lobe, still places the patient at risk for the cancer returning, he may instead decide to remove the entire gland, which is referred to as a “total thyroidectomy”. The type surgery is also determined by considering the type of thyroid cancer that is involved. Some types of cancer are more aggressive than others and with these the surgeon will always recommend total thyroid removal. Surgeons also must determine at what stage the cancer is in, meaning how far it has progressed.

In order to decrease the risk of the cancer returning, the surgeon may also want to remove the lymph nodes in the neck, that are located near the thyroid gland. The lymph nodes may also be sent off for laboratory analysis to determine if they already contained cancer, which might then lead the surgeon to recommending further treatment.

Additional treatment after any type of thyroidectomy might also include Radio Active Iodine Therapy (RAI) or Chemotherapy, to destroy any remaining thyroid tissue that is capable of absorbing iodine in the body or any remaining cancer cells. Any remaining thyroid tissue that is capable of taking up iodine, which is what the thyroid mostly consists of, also has the ability to re-develop cancer cells and is the reason RAI is sometimes used following a Total Thyroidectomy. Chemotherapy is directed at any remaining cancer cells that might remain in the body after a Total Thyroidectomy.

Regardless of the type of thyroid surgery that is performed, thyroid hormone replacement therapy is always used following thyroid cancer surgeries. The goal of the hormone therapy is to suppress the patient’s TSH level (pituitary hormone that decreases when thyroid hormone is increased). This also helps prevent recurrence of cancer but also replaces any hormone the thyroid gland is not capable of producing following surgery. If a patient is given RAI after surgery, they may not be replaced with thyroid hormone for a month or two following the treatment. Most patients will need thyroid hormone replacement therapy following any type of thyroidectomy, as lifelong treatment.

It is very important to see your doctor if you discover any nodules (tumorous growths) on your thyroid gland or if you have difficulty swallowing or feel, that you might have a growth on the inside of your throat. Thyroid cancers have a very high treatment success rate but that success rate is even higher when thyroid cancers are diagnosed and treated early.
(This article was first featured on 5/01/08)


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