Treatment of thyroid cancer involves a combination of surgery, hormone therapy, radioactive iodine (radioiodine) therapy, radiation therapy, and chemotherapy in case the case the cancer has spread.
Surgery is the best treatment for thyroid cancer. The most performed surgery in the treatment of thyroid cancer is thyroidectomy. During the procedure, your surgeon can remove part or the entire thyroid gland. Depending on the aggressiveness of the tumor, the thyroid and lymph nodes can be completely removed.
In some cases of thyroid cancer, the surgeon may also remove lymph nodes from your neck located near the thyroid to prevent the cancer from spreading. He can also do so to remove a tumor that has already spread into nearby lymph nodes.
After the surgery
Although surgery is often successful in combating thyroid cancer, it is not without side effects. The parathyroid glands can be damaged during surgery, and lead to calcium deficiency in your blood. In addition, your vocal cords may be affected, which usually leads to vocal cord paralysis, hoarseness, soft voice or difficulty breathing. However, these are rare and are often transient. The scar resulting from the operation is very discrete, even invisible.
Thyroid hormone therapy
Your thyroid gland being removed, you will have no thyroid hormones. To substitute your natural thyroid hormones, you will be prescribed a thyroid hormone replacement therapy; Levothyroxine Sodium (Synthroid, Levoxyl, Levothroid, Unithroid) are the most common drugs prescribed. This hormone replacement therapy should be taken daily, often for life. The drugs can maintain the TSH (pituitary hormone thyroid stimulating) to low levels to prevent growth of cancer cells. In most patients, these drugs improve quality of life and prevent the risk of complications.
Radioactive iodine (radioiodine) therapy
After the operation of thyroid cancer, you will be prescribed a radioactive iodine treatment to destroy or reduce cancerous cells remaining after the surgery. The therapy may also be recommended to treat recurring thyroid cancers. Radioactive iodine treatment is available in capsule or liquid form.
Before the treatment, you will be recommended to temporarily stop all thyroid hormone therapy, avoid medications containing iodine or perform radiological examinations using iodinated contrast agents. In addition, you should consume a diet low in iodine for 6 weeks, and avoid pregnancy if you are a woman.
The treatment may require hospitalization for 4 days to prevent other people from exposing to the radiation. In case, you are not hospitalized, you’ll need to take precautions to protect your family and friends from the radiation.
Side effects are often transitory, and may include:
- neck or/and chest pain
- dry mouth
- dry eyes
- Altertion of taste or smell.
External Radiation Therapy
External beam radiation can also be used in the treatment of thyroid cancer. During the therapy, high-energy rays pass through your skin into the tumor, thus destroying the cancer cells. In general, external radiotherapy does not require hospital stay or special care, unlike radioactive iodine (radioiodine) therapy. External radiation therapy is more often used in the treatment of medullary thyroid cancer and anaplastic thyroid cancer.
The therapy can destroy nearby healthy tissue along with the cancer cells, which can lead to several side effects:
- skin burn-related changes
- trouble swallowing
Chemotherapy involves administration of powerful chemical agents that act by preventing the reproduction or spread of cancer cells. However, chemotherapy is rarely used to treat patients with thyroid cancer. Unlike radiotherapy and surgery, chemotherapy attacks all cells in the entire organism that multiply quickly, which often causes side effects:
- loss of appetite
- hair loss
- Increased risk of infection.