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MSK Surgeon Ashok Shaha

A thyroidectomy is the surgical removal of all or part of the thyroid. It is the main treatment for most people with thyroid tumors. Your thyroid surgery options may include the partial removal of the thyroid (also called a thyroid lobectomy or hemithyroidectomy), a total thyroidectomy, or a total thyroidectomy with lymph node removal. Which approach is right for you depends on such factors as the size, stage, location, and type of thyroid tumor you have.

Memorial Sloan Kettering is a leading center for the treatment of thyroid tumors. Our thyroid surgeons perform over 800 thyroid surgeries each year. They are nationally and internationally recognized for their expertise.

MSK’s thyroid surgeons place a high value on the concept that less is more, tailoring therapy to each person’s individual circumstances. They bring extraordinary skill to their care of people with advanced or invasive thyroid cancer. This personalized approach provides the best option for control of the disease and quality of life after treatment.

MSK thyroid surgeons have been leaders in assessing risk from thyroid cancer. Because of this, our surgeons have determined that not every patient requires a total thyroidectomy, and that thyroid lobectomy may be sufficient for less-aggressive cancer. This may allow for preservation of some thyroid function and reduces the extent of the surgery.

MSK’s thyroid surgeons are available for consultations at our locations across New Jersey as well as on Long Island, in Westchester, and in Manhattan. Surgeries usually take place at our state-of-the-art Josie Robertson Surgery Center in Manhattan.

Here, you can find an in-depth overview of the different types of surgeries used to treat thyroid tumors as well as information on MSK’s expertise.

Total Thyroidectomy

A total thyroidectomy is an operation to remove all of the thyroid gland. The surgery is done through an incision in the lower part of the front of your neck. Your surgeon will inspect your thyroid tumor, decide how much of the gland needs to be removed, and check the lymph nodes next to your thyroid.

Thyroid Lobectomy

In a thyroid lobectomy, only one of the two lobes that make up the thyroid gland is removed. Another name for a thyroid lobectomy is hemithyroidectomy.

Candidates for a thyroid lobectomy are most often people with less-aggressive, early-stage disease.

Lymph Node Removal

You will undergo imaging prior to surgery to carefully assess if your thyroid cancer has spread to lymph nodes. In some cases, additional needle biopsies may be needed. If your tumor has spread or is likely to spread to your lymph nodes, your surgeon will remove the lymph nodes in your neck during your thyroid surgery. MSK thyroid surgeons have extensive experience in this complex procedure, called a lymphadenectomy or lymph node dissection.

The goal is to remove the lymph nodes that have been shown to contain or are likely to contain cancer while minimizing complications.  

Minimally Invasive Thyroid Surgery

Minimally invasive surgery involves the removal of a thyroid tumor through a very small incision in the neck.

MSK’s thyroid surgeons have studied minimally invasive techniques extensively. We typically remove thyroid tumors through very small incisions in the neck that fall into natural skin creases. In some cases, a thyroid tumor may be removed using scopes to keep the incision even smaller. The priority remains the complete removal of the tumor with preservation of the laryngeal nerves and parathyroid glands. The incisions we use for open thyroid surgery are only slightly larger than those used for minimally invasive surgery. Open surgery enhances our ability to completely remove the tumor.

Laryngeal Nerve Monitoring

Thyroid surgery requires tremendous precision on the part of your entire surgical team. To prevent nerve damage, your surgeon may need to locate and work around the laryngeal nerves. These include the recurrent laryngeal nerves and the superior laryngeal nerves. The laryngeal nerves run near the thyroid and are important in producing the sound of your voice.

The complete removal of your tumor, combined with the preservation of the laryngeal nerves, is a top priority of MSK’s surgical team. Our surgeons have extensive experience in using advanced nerve-monitoring technology to prevent the nerve damage that can result from thyroid surgery or from progression of the thyroid cancer.

Parathyroid Preservation

MSK’s thyroid surgeons place a priority on preserving the parathyroid glands — four tiny glands that lie next to the thyroid and control your body’s calcium balance. In some cases, you surgeon may re-implant a parathyroid gland that needed to be removed during thyroid cancer surgery.

Surgery for Locally Advanced and Invasive Thyroid Cancer

Locally advanced and invasive thyroid disease includes those cancers that have invaded the larynx, trachea, esophagus, and great vessels, which bring blood to and from the heart.

Such cancers can be a challenge to remove. MSK’s thyroid surgeons have a great deal of experience with these operations. Oftentimes, we may team up with surgeons from different specialties to address the complexities of invasive thyroid cancers.

For example, if the disease has spread to the lymph nodes in the upper chest, we may collaborate with our highly skilled thoracic surgeons to ensure that we perform the most complete tumor removal possible. Other patients may benefit from reconstructive surgery. We work with our plastic surgeons to achieve a positive cosmetic outcome for you.

Thyroid Surgery Recovery

Recovery from thyroid surgery is different for everyone. Most people notice their energy gradually return in the weeks after surgery. Some people find that their energy level varies for a month or two.

MSK’s quality-of-life specialists provide comprehensive follow-up care to help you recover from thyroid surgery.

  • Wellness therapies from integrative medicine specialists can relieve emotional or physical symptoms after surgery and potential side effects.
  • Rehabilitation and exercise therapies can help you heal and recover your strength, flexibility, and stamina.
  • Find emotional support through our Counseling Center or our Patient and Caregiver Support Program, which connects you with other thyroid cancer survivors who understand your challenges and concerns.

Thyroid Hormone Therapy after Surgery

Thyroid surgery often has an effect on the body’s production of hormones. Normal hormone levels are important for your health, including your metabolism, and for preventing certain thyroid cancers from coming back.

If a total thyroidectomy is part of your care, you’ll have to take thyroid pills to ensure that your body maintains normal levels of hormones.

Your thyroid may be able to function normally after a thyroid lobectomy. However, there’s still a strong chance that you will need to take thyroid hormone replacement pills. This is particularly true for people whose level of thyroid hormone is low before the lobectomy procedure.

Your MSK thyroid surgeon works closely with your endocrinologist to provide the careful monitoring necessary to achieve hormone balance after thyroid surgery.

Radioactive Iodine after Thyroidectomy

Radioactive iodine (RAI) treatment is used to destroy abnormal thyroid tissue that might have been left behind or missed during surgery. RAI therapy is most commonly recommended after a thyroidectomy for people with follicular thyroid cancer or advanced papillary thyroid cancer.

MSK’s experts are world leaders in the use of RAI therapy for thyroid cancer. Our researchers helped develop the standards used around the world for giving this treatment to patients safely and effectively.

Learn more about our radioactive iodine expertise.

Radiation Therapy after Thyroidectomy

Postoperative radiation therapy is typically recommended for patients with:

  • anaplastic thyroid cancer
  • locally advanced, invasive, or recurrent thyroid cancer
  • cancer that could not be removed completely during surgery

We treat your thyroid cancer using two techniques: intensity-modulated radiation therapy (IMRT) or proton therapy. These approaches allow us to deliver more-precise doses of radiation than conventional approaches while keeping healthy tissue safe.

Memorial Sloan Kettering is one of a limited number of centers nationwide offering proton therapy.

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