Thyroid Cancer Treatment Options

Thyroid cancer treatment options - The most commonly used treatments for thyroid cancer are:

• Thyroid removal
• Neck gland removal
• Treatment with radioactive iodine
• Irradiation (radiotherapy)

A combination of these treatment options is possible. In thyroid cancer, it is almost always necessary to remove the thyroid gland surgically. Sometimes it is also necessary to remove (a part of) the lymph nodes in the neck.

After the surgery, thyroid cancer treatment using radioactive iodine almost always follows. This treatment provides more information about how the disease will be treated further. A second surgery may be necessary. External radiation (radiotherapy) is rare in thyroid cancer, but it is possible.



Thyroid removal or thyroidectomy
Usually, the entire thyroid gland is removed. However, the thyroid gland can also be partially removed. One half of the thyroid is then removed, this happens when:

• there is doubt as to whether the tumor is good or malignant. The pathologist examines the removed part under the microscope, the tumor appears malignant, then follows a second surgery where the other part of the thyroid gland is still removed;
• if the malignant tumor is smaller than 1 cm.

The surgery takes place under general anesthesia and takes about 2 hours. The surgeon makes a horizontal incision low in the neck to remove the thyroid gland. When suturing the wound one or more drains can be placed in the wound area to drain the wound fluid. These drains are removed after a few days. The pain after the surgery is generally noticeable and can be compared with a throat infection. You can return home a few days after the surgery.

There is a small chance that a vocal cord nerve will get damaged during the surgery. Then you can suffer from a hoarse, soft voice. The complaints are usually of a temporary nature. If that is not the case, speech therapy can bring solace.

If half of your thyroid was removed, it does not usually affect the production of thyroid hormones. the remaining lobe is capable of producing sufficient hormones.

If the entire thyroid gland is removed, the body no longer makes thyroid hormones. In order to maintain the metabolism, thyroid hormones have to be taken in the form of medication. It may take a while before it is clear what the right dose of the medication is for you.

If you undergo an iodine treatment, you can temporarily not take thyroid medication. During that period you will experience symptoms of hypothyroidism.

If the parathyroid glands were also removed during the surgery, a shortage of parathyroid hormone may occur. This is accompanied by tingling in the fingers and muscle spasms. These symptoms can be corrected with calcium tablets and sometimes vitamin D supplementation.



Removal of the neck lymph nodes
In the case of metastases, the lymph nodes are usually removed in the neck. This usually happens simultaneously with the removal of the thyroid gland.

Removal of the neck lymph nodes can sometimes have lasting consequences:

• numbness of the skin in the neck, sometimes deaf or changed feeling in the neck, although this can be transient
• a shoulder nerve can be damaged during surgery. This manifests itself in a painful and weaker shoulder, physical therapy may be required
• sometimes swelling occurs in the cheek or chin. The discharge of lymph (tissue fluid) from the cheek and chin is then disrupted. This is usually of a temporary nature

Thyroid cancer treatment radioactive iodine
With total thyroid removal, it is impossible to remove all thyroid tissue. Almost all of the tiny particles of the thyroid gland remain behind in the neck. There may also be invisible metastases in the lymph nodes or elsewhere in the body. Therefore, after a thyroidectomy, most patients receive treatment with radioactive iodine (I-131). The dose depends on the size of the tumor and any metastases.

Radiation
External radiation is little used in thyroid cancer, but it may be necessary in certain cases.

Thyroid cancer prognosis
Is thyroid cancer is curable? As with all cancers, thyroid cancer is often difficult to predict when someone is really cured. There is always a risk that the disease strikes again. In thyroid cancer, the prognosis depends on the type of tumor. The chances of survival in papillary and follicular thyroid carcinoma are on average good. Approximately 95% of all patients with papillary carcinoma are still alive 10 years after treatment. With follicular carcinoma, this is 70%.

*Image source : Healthline

References :

1. National Cancer Institute
2. Schildklierinfo
3. American Cancer Society