Management

THYROID CANCER –MANAGEMENT

The main goal is to

  • detect the disease early
  • prevent complications
  • educate the person to identify the early signs and symptoms of the disease

Although the specific treatment plan depends upon the type of cancer and the extent of spread, surgical removal is the treatment of choice for thyroid cancer. Highly skilled surgeons can perform near-total thyroidectomy with less than 1% rate of serious complications (i.e. hypoparathyroidism or recurrent laryngeal nerve damage)

Papillary and follicular carcinoma usually are treated with a combination of surgery, thyroid hormone therapy, and radioactive iodine.

  • Surgery: It usually involves near total thyroidectomy
  • Radioactive iodine therapy: After surgery a large dose of iodine is given (mainly in follicular carcinoma and sometimes in papillary carcinoma) in order to ablate (destroy) any remaining thyroid tissue (normal or malignant).
  • Thyroid hormone therapy: Long-term treatment is done with thyroxine in a dose (usually 0.05-0.1 mg/day) sufficient to suppress TSH as it is believed that TSH may stimulate thyroid cancers to grow rapidly.

Medullary carcinoma is treated with total thyroidectomy with removal of affected cervical (neck) lymph nodes. Suppression of TSH is done by thyroid hormone therapy as above.

Anaplastic carcinoma is generally treated palliatively. Surgery is usually required to relieve pressure symptoms. However, treatment with anticancer drugs (chemotherapy) and radiation therapy before and after surgery has been found beneficial.

Thyroid lymphomas usually resolve with external radiation therapy. Systemic lymphomas can also be treated with chemotherapy. Thyroidectomy is rarely required.

Death due to thyroid cancer is very uncommon as the tumor remains localized to the thyroid for many years.

When to consult the doctor

Contact your doctor immediately if there is:

  • a lump anywhere in your neck
  • persistent pain in neck
  • persistent cough
  • difficulty in breathing or swallowing
  • an alteration in voice (especially hoarseness of voice)