Surgery
A Patient's Story Read about Helen's battle with early-stage thyroid cancer 
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Surgery is the main type of treatment for thyroid cancer. Most patients can be successfully treated with surgery, after which no further curative treatment is necessary.
The extent of surgery depends on the "risk group" in which you are classified. Patients classified in the low-risk group are usually young (ages 20 to 50) and have a favorable, small thyroid cancer that is confined to the thyroid gland. The majority of young patients have low-risk thyroid cancer. Patients in the high-risk group typically are individuals who are over the age of 50 and have an extensive or aggressive thyroid cancer, which may have spread beyond the thyroid gland.
Your surgeon will most likely perform a procedure called thyroidectomy. This may be either a lobectomy, in which half of the thyroid gland is removed, or a total thyroidectomy, in which the entire thyroid is removed.
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Minimally Invasive Surgery
For patients with small thyroid tumors, our surgeons also offer a less invasive surgical option called minimally invasive video-assisted thyroidectomy (MIVAT). In this operation the thyroid gland is removed through a small skin incision (1.5cm wide) with the assistance of an endoscope, which is a thin, lighted tube with a camera on its tip. This operation is also used to remove parathyroid tumors in patients with hyperparathyroidism.
If your cancer has spread or is at risk of spreading to the lymph nodes, your surgeon may perform a lymphadenectomy. A lymphadenectomy is a procedure in which the lymph nodes in the neck are surgically removed. A lymphadenectomy is also called a neck dissection or a lymph node dissection.
In cases where all the cancer cells are not able to be surgically removed, surgery may be followed by radioactive iodine therapy or external radiation.
Hormone Treatment
Without the thyroid gland, the body stops producing thyroid hormone, which is essential for proper metabolism and functioning. If you have surgery to remove your thyroid, you will need to begin thyroid hormone therapy.
Thyroid hormone therapy replaces the hormones that the thyroid gland usually produces. Thyroid hormone is also used to decrease the pituitary gland's production of thyroid-stimulating hormone (TSH). Because TSH could potentially cause any remaining cancer cells to grow, sufficient thyroid hormone is given to reduce TSH to desired levels.
Radioactive Iodine Therapy
Some patients may need radioactive iodine treatment after surgery. Patients with medullary thyroid cancer or anaplastic thyroid cancer are not treated with radioactive iodine.
Radioactive iodine is given in either liquid or pill form. Radioactive iodine is given to destroy any normal thyroid tissue. This allows your physicians to maintain your surveillance with blood tests to check a blood marker called thyroglobulin. As the radioactive iodine travels through the body, it is able to find and destroy any thyroid cells that were not removed by surgery or those thyroid cancer cells that have spread beyond the thyroid. Usually only one or two treatments with radioactive iodine are necessary.
In preparation for radioactive iodine treatment, most patients must stop taking thyroid replacement pills for an appropriate period of time before beginning radioactive iodine treatment to help their bodies produce more natural TSH. This approach causes cancer cells to "wake up," making them soak up more radioactive iodine.
Many patients may receive synthetic, or "man-made," human TSH before radioactive iodine therapy to increase TSH levels. This allows patients to continue taking their thyroid pills, which will help them to feel more energetic and alert.
Treatment Options for Recurrent Thyroid Cancer
Some patients may have recurrent thyroid cancer. Recurrent thyroid cancer means that the cancer has come back after you appeared to be cancer free, or in remission.
Recurrent thyroid cancer can be difficult to treat. If you have recurrent thyroid cancer, you may be treated with one or more of the following treatments:
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Surgery With or Without Radioactive Iodine Therapy
Surgery for recurrent thyroid cancer depends on the site of recurrence. Recurrence or spread to lymph nodes in the neck is the most frequent site of spread and may require an operation called neck dissection. Recurrence that involves other vital structures in the neck may require more extensive surgery.
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External Radiation Therapy
In patients with recurrent thyroid cancer, radioactive iodine therapy may not work as a treatment. Selected patients may be given external radiation therapy. Radiation uses powerful x-rays to kill thyroid cancer cells. Each treatment usually lasts just a few minutes, although setup time is also required.
Two types of external radiation therapy are commonly used to treat recurrent thyroid cancer:
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External-beam Radiation Therapy
The most common type of radiation treatment is called external-beam radiation therapy. External beam radiation uses doses of radiation delivered from outside the body, focusing on the region of the thyroid tumor. External beam radiation is usually administered as outpatient therapy five days a week for about five to six weeks.
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Intensity-Modulated Radiation Therapy (IMRT)
IMRT is a kind of radiation therapy that uses computer images to show the size and shape of the tumor. Thin and precise beams of radiation are then aimed at the tumor from many angles from outside the body. IMRT targets tumors so efficiently that it leaves healthy tissue unharmed.
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Systemic Therapies
Chemotherapy is the use of drugs to kill cancer cells. It is sometimes used to treat thyroid cancer. Chemotherapy stops the growth of cancer cells, either by killing the cells or by stopping them from multiplying. The use of chemotherapy for the treatment of thyroid cancer is determined on an individual basis and is most often given as part of a clinical trial. Many of these studies test new drugs that target the genetically defective cancer-causing proteins present in thyroid cancer.
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Bisphosphonate Therapy
If thyroid cancer has spread to your bones, you may be treated with a class of drugs called bisphosphonates, which are used to prevent bone loss, reduce the risk of fractures, and decrease pain.
