Treatment of Thyroid Cancer by Type and Stage
- 3 years ago
Treatment of Thyroid Cancer, by Type and Stage
The type of treatment your doctor will recommend depends on the type and stage of the cancer and on your overall health. Talk to your doctor if you have any questions about the treatment plan he or she recommends.
Papillary cancer and its variants
Most cancers are treated with removal of the thyroid gland (thyroidectomy), although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor (lobectomy). If lymph nodes are enlarged or show signs of cancer spread, they will be removed as well.
In addition, recent studies have suggested that people with micro-papillary cancers (very small thyroid cancers) may safely choose to be watched closely with routine ultrasounds rather than have immediate surgery.
Even if the lymph nodes aren’t enlarged, some doctors recommend central compartment neck dissection (surgical removal of lymph nodes next to the thyroid) along with removal of the thyroid. Although this operation has not been shown to improve cancer survival, it might lower the risk of cancer coming back in the neck area. Because removing the lymph nodes allows them to be checked for cancer, this surgery also makes it easier to accurately stage the cancer. If cancer has spread to other neck lymph nodes, a modified radical neck dissection (a more extensive removal of lymph nodes from the neck) is often done.
Treatment after surgery depends on the stage of the cancer:
Radioactive iodine (RAI) treatment is sometimes used after thyroidectomy for early stage cancers (T1 or T2), but the cure rate with surgery alone is excellent. If the cancer does come back, radioiodine treatment can still be given.
RAI therapy is often given for more advanced cancers such as T3 or T4 tumors, or cancers that have spread to lymph nodes or distant areas. The goal is to destroy any remaining thyroid tissue and to try to treat any cancer remaining in the body. Areas of distant spread that do not respond to RAI might need to be treated with external beam radiation therapy, targeted therapy, or chemotherapy.
People who have had a thyroidectomy will need to take daily thyroid hormone (levothyroxine) pills. If RAI treatment is planned, the start of thyroid hormone therapy may be delayed until the treatment is finished (usually about 6 to 12 weeks after surgery).
Recurrent cancer: Treatment of cancer that comes back after initial treatment depends mainly on where the cancer is growing, although other factors may be important as well. The recurrence might be found by either blood tests or imaging tests such as ultrasound or radioiodine scans.
If cancer comes back in the neck, an ultrasound-guided biopsy is done to confirm that it is cancer. If the tumor appears to be resectable (removable), surgery is often used. If the cancer shows up on a radioiodine scan (meaning the cells are taking up iodine), radioactive iodine (RAI) therapy may be used
The type of treatment your doctor will recommend depends on the type and stage of the cancer and on your overall health. Talk to your doctor if you have any questions about the treatment plan he or she recommends.
Papillary cancer and its variants
Most cancers are treated with removal of the thyroid gland (thyroidectomy), although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor (lobectomy). If lymph nodes are enlarged or show signs of cancer spread, they will be removed as well.
In addition, recent studies have suggested that people with micro-papillary cancers (very small thyroid cancers) may safely choose to be watched closely with routine ultrasounds rather than have immediate surgery.
Even if the lymph nodes aren’t enlarged, some doctors recommend central compartment neck dissection (surgical removal of lymph nodes next to the thyroid) along with removal of the thyroid. Although this operation has not been shown to improve cancer survival, it might lower the risk of cancer coming back in the neck area. Because removing the lymph nodes allows them to be checked for cancer, this surgery also makes it easier to accurately stage the cancer. If cancer has spread to other neck lymph nodes, a modified radical neck dissection (a more extensive removal of lymph nodes from the neck) is often done.
Treatment after surgery depends on the stage of the cancer:
Radioactive iodine (RAI) treatment is sometimes used after thyroidectomy for early stage cancers (T1 or T2), but the cure rate with surgery alone is excellent. If the cancer does come back, radioiodine treatment can still be given.
RAI therapy is often given for more advanced cancers such as T3 or T4 tumors, or cancers that have spread to lymph nodes or distant areas. The goal is to destroy any remaining thyroid tissue and to try to treat any cancer remaining in the body. Areas of distant spread that do not respond to RAI might need to be treated with external beam radiation therapy, targeted therapy, or chemotherapy.
People who have had a thyroidectomy will need to take daily thyroid hormone (levothyroxine) pills. If RAI treatment is planned, the start of thyroid hormone therapy may be delayed until the treatment is finished (usually about 6 to 12 weeks after surgery).
Recurrent cancer: Treatment of cancer that comes back after initial treatment depends mainly on where the cancer is growing, although other factors may be important as well. The recurrence might be found by either blood tests or imaging tests such as ultrasound or radioiodine scans.
If cancer comes back in the neck, an ultrasound-guided biopsy is done to confirm that it is cancer. If the tumor appears to be resectable (removable), surgery is often used. If the cancer shows up on a radioiodine scan (meaning the cells are taking up iodine), radioactive iodine (RAI) therapy may be used