If you have been diagnosed with thyroid cancer, a multidisciplinary team will normally decide on your best possible treatment plan. Thyroid surgery is the most common treatment for thyroid cancer which may be coupled with other treatments after the surgery.
Common Types of Thyroid Cancer Treatments
Different types of thyroid cancer are treated differently. The treatment you have will depend on the following:
- Type and grade of thyroid cancer
- The stage of the cancer (how big it is and whether it has spread)
- Your general health
- Where your cancer is
Differentiated thyroid cancers are treated using a combination of surgery and radiotherapy. The thyroid gland is removed, and radiotherapy is subsequently used to destroy any remaining cancer cells and prevent the thyroid cancer from returning. Because medullary thyroid carcinomas tend to spread faster than other thyroid cancers, it is often necessary to remove both the thyroid gland and any nearby lymph nodes.
How Is Papillary And Follicular Thyroid Cancer Treated?
Surgery is the main treatment for these types of thyroid cancer. During surgery, you will either have all of the thyroid gland removed (total thyroidectomy) or part of the thyroid gland (lobectomy or partial thyroidectomy). If the cancer has possibly spread, the lymph nodes and tissue around the thyroid gland may also be removed.
Thyroid Replacement Therapy
After surgery to remove part or all of your thyroid gland, you will probably need to take thyroid replacement therapy to replace the thyroid hormones you no longer make. You will normally take thyroxine (levothyroxine) tablets which is a type of thyroid hormone (T4). These hormones may also stop follicular and papillary thyroid cancer from returning as they stop your body from producing thyroid stimulating hormone (TSH) which encourages thyroid cancer cells to grow.
If you have all your thyroid removed, your doctor may suggest you have radioactive iodine after your thyroid cancer surgery.
External beam radiotherapy is occasionally used to treat follicular and papillary thyroid cancer. It is given before or after radioactive iodine treatment.
Targeted therapies are cutting-edge drugs that can differentiate between cancer cells and normal cells. They are used when the cancer has spread and is no longer responding to radioactive iodine treatment.
Chemotherapy is rarely used to treat follicular or papillary thyroid cancer although your doctor may suggest it if your cancer recurs.
How Is Anaplastic Thyroid Cancer Treated?
Treatment options for anaplastic thyroid cancer depend on the stage of the cancer and your general health.
Possible treatments include:
- Targeted therapies and immunotherapies
When someone has been diagnosed with this more aggressive cancer, it has normally already spread. Treatment, therefore, aims to slow the growth of the cancer.
Alongside the cancer treatment, you may also be offered supportive (palliative) care, with medicines to manage any symptoms. Very rarely, someone may be able to have surgery to remove the cancer if it has not spread beyond the thyroid gland.
How Is Medullary Thyroid Cancer Treated?
Surgery is the main treatment for medullary thyroid cancer. The entire thyroid gland (total thyroidectomy) is usually removed. Sometimes surrounding lymph nodes are also removed. The extent of your surgery depends on the results of your scans and blood tests (calcitonin level).
After your thyroid gland has been removed, you must take thyroid hormone tablets (levothyroxine) permanently. You may be given external beam radiotherapy after your surgery to kill off any remaining cancer cells. A targeted drug might be used if you cannot have surgery to remove your medullary thyroid cancer or if the cancer has spread outside of the thyroid gland.
How Often Does Thyroid Cancer Recur?
Cancerous cells will return in around 5% - 20% of people with a history of thyroid cancer. In about 10% - 15% of people, the cancerous cells will return to other parts of their body, such as their bones.
Cancerous cells can return long after surgery or radioactive iodine treatment. For this reason, it is vital to attend regular check-ups so any cancerous cells that return can be rapidly treated.