After a thyroid cancer diagnosis, our multidisciplinary team works with patients to create a personalized plan for treatment. At UT Southwestern Medical Center, we offer expertise in thyroid cancer treatment that few other institutions can match. Our surgeons perform hundreds of thyroid cancer procedures a year, and research shows that experience leads to better outcomes when treating thyroid cancer.
Treatment plans depend on several factors, such as:
- Type of thyroid cancer
- Tumor size
- Patient’s age and health
- Stage of cancer
Treatment plans often involve surgery and thyroid hormone therapy. Treatment with radioactive iodine, which has little to no side effects, is also sometimes used. External beam radiation therapy and chemotherapy are not commonly used in the treatment of thyroid cancer, but they might benefit some patients who do not respond to other therapies.
Surgery for Thyroid Cancer
Surgery is frequently part of the treatment plan for thyroid cancer. Depending on the case, either part or all of the thyroid can be removed. Thyroidectomy might also be a good option for large nodules that interfere with breathing, swallowing, or blood flow.
We can usually accomplish thyroid surgery with very few side effects. One of the main risks of the procedure is injury or damage to the nerves that control vocal cord function. During surgery, we use recurrent laryngeal nerve monitoring to valuate vocal cord function.
There is also a risk to the blood supply that feeds the parathyroid glands that help control calcium levels in the blood. Because of these potential hazards, surgery by experienced, skilled thyroid surgeons is recommended.
Thyroid Hormone Treatment
After the thyroid has been removed, the body can no longer make the thyroid hormone it needs, so patients must take a thyroid hormone pill to replace the natural hormone. Taking thyroid hormone might also help prevent some thyroid cancers from recurring.
We are able to estimate the dose patients will need based on their body weight, and then we can quickly fine-tune the dose as needed.
Radioiodine Therapy
Radioiodine (radioactive iodine) treatment is sometimes used after a thyroidectomy to destroy any remaining normal thyroid cells, as well as microscopic areas of thyroid cancer that were not removed during surgery. It can also help us detect whether the cancer has spread.
It’s an effective treatment when indicated and is rarely associated with side effects. The patient often has to be isolated afterward to prevent others from being exposed to the radiation.
After Treatment
Long-term management after initial treatment for thyroid cancer is different for each patient. Once a patient has completed treatment, follow-up visits are necessary once or twice a year. We might need to order blood tests between doctor visits to fine-tune the thyroid hormone dose, and if adjustments are needed, we can usually make those without a separate doctor visit.
During the follow-up appointments, we will perform a physical exam and might order blood tests to measure the thyroid hormone levels or surveillance imaging tests.
Depending on the type of thyroid cancer, it often is very important to have follow-up neck ultrasounds, usually on a yearly basis for the first 10 years after initial treatment. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments.
