Surgery for Thyroid Cancer

An MSK head and neck surgeon and 2 colleagues, all wearing surgical gear, during a surgery.
MSK has more than 70 head and neck cancer experts, including surgeon Dr. Babak Givi (right) and his surgical team.
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If you or someone you love is facing a thyroid cancer diagnosis, MSK experts can help. 

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Overview of thyroid cancer surgery

If you want to learn about surgeries to treat thyroid cancer, this is a place to start. We’ll explain surgeries such as a thyroid lobectomy and a total thyroidectomy.

Surgery is the most common treatment for thyroid cancer.  

Your surgeon will talk with you about which surgery is best for you, based on:     

  • The type of thyroid cancer.  
  • The stage.  
  • The tumor’s size, location, depth, and spread. 
  • Whether the tumor has spread to lymph nodes.   
  • The tumor’s genetic information.  

MSK is a leading center for treating thyroid tumors with surgery. MSK's thyroid surgeons do about 800 thyroidectomies each year. They do almost 1,000 thyroid cancer surgeries each year, including nodal dissections. 

These are common surgeries to treat thyroid cancer:

  • Total thyroidectomy  
  • Thyroid lobectomy 
  • Lymph node dissection
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Talk with an MSK Care Advisor. We're here 24 hours a day, 7 days a week. 

Types of surgery for thyroid cancer

A thyroidectomy (THY-roy-DEK-toh-mee) is surgery to remove part or all of the thyroid gland. Most people with thyroid cancer have surgical removal of the tumor.  

A thyroidectomy is done through an incision (cut) in the lower part of the front of your neck. A thyroidectomy removes the parts of your thyroid gland that have cancer.  

This section explains these 2 surgeries:   

  • A total thyroidectomy, which removes the whole thyroid gland. 
  • A thyroid lobectomy (hemithyroidectomy), which removes half (1 lobe) of your thyroid. 

Lymph node removal also is done during surgery. We remove any nodes that have cancer or may have cancer.

Thyroid cancer surgery takes about 1.5 to 3 hours.  

We’ll talk with you about the type of surgery that’s best for you. This could be removing the whole thyroid or just a part of it.  

Total thyroidectomy at MSK

A total thyroidectomy removes your whole thyroid. 

Your surgeon makes an incision in the lower part of the front of your neck. We remove the thyroid, and any lymph nodes that have or may have cancer cells.  

Your doctor may recommend a total thyroidectomy if: 

  • You have tumors on both side of the thyroid. 
  • You have an aggressive thyroid cancer that will need radioactive iodine treatment. 
  • You have a lot of metastases (spread) from thyroid cancer. 
  • Your thyroid is very large and putting pressure on nearby areas. 

Thyroid lobectomy at MSK

A thyroid lobectomy removes only half (1 lobe) of the thyroid gland. A thyroid lobectomy is also called a hemithyroidectomy. 

Your doctor may recommend a thyroid lobectomy if: 

  • The cancer is less aggressive. 
  • The cancer is at an early stage and has not metastasized (spread). 
  • The cancer only spread a little to the lymph nodes.  
  • There are no abnormal (not normal) growths in other parts of the thyroid. 

For some people, a lobectomy may be a good choice instead of a total thyroidectomy. A lobectomy keeps some thyroid tissue. Some people may be able to avoid taking hormone pills after surgery. 

MSK research compared treatment results from a lobectomy with results from a total thyroidectomy and radioactive iodine. It found a thyroid lobectomy had similar results for survival and recurrence (the cancer came back), but with fewer side effects. 

 Lymph node removal

Before thyroid removal surgery at MSK, you’ll have imaging to check if the cancer has spread to nearby lymph nodes. Your doctor may also do a needle biopsy to check for cancer cells.  

During your thyroid surgery we’ll remove any lymph nodes in your neck that have cancer, or may have cancer.  

MSK doctors are experts in lymph node removal, also called a lymphadenectomy or lymph node dissection. 

MSK RECOMMENDS

 Your caregiver is a very important part of your care team. They need support, too. Our nurse liaisons are here to help your caregiver when you have surgery. They’ll offer updates about your progress during and after surgery.  We also have a Caregivers Clinic to help your loved ones cope with cancer. 

At MSK, we support caregivers at every step. We offer clear communication, real-time updates, and compassionate guidance when it matters most. I make sure caregivers feel informed, supported, and connected. 
  Perioperative nurse liaison Carmen D. Méndez supports caregivers before, during, and after surgery. 
 How thyroid surgery can affect your voice

The laryngeal (luh-RIN-jee-ul) nerves are near your thyroid and help make the sound of your voice.   

  • The recurrent laryngeal nerve runs behind your thyroid to your larynx (voice box). If the tumor is close to this nerve, your vocal cords could be harmed. Your voice can sound hoarse.  
  • The superior laryngeal nerve helps raise the volume and tone of your voice. If it's injured, it may be harder to speak loudly or sing high notes. 
 What happens if a nerve is injured?

If these nerves are injured during thyroid surgery, your voice may not sound the same. That’s why MSK surgeons use advanced tools to monitor (watch) the nerves and keep them safe. MSK doctors are very experienced in using these tools and working around the laryngeal nerves.  

Surgery or an injection (shot) into your vocal cord can treat your voice if your nerves are injured. But the best approach is to avoid injury during surgery. Research studies show that there’s less chance of nerve injury if your surgeon has a lot of experience. MSK surgeons are very experienced in all thyroid surgeries. 

Dr. Gao is standing in front of a window at MSK in NYC.
My goal is to give you the best chance to recover your quality of life. I specialize in removing cancer, but also in restoring what matters most: your function, appearance, and your humanity.
Head and neck surgeon Dr. Rebecca Gao is an expert in reconstructive surgery
Video | 1:32 Meet Rebecca Gao: Head and Neck, Plastic & Reconstructive Surgeon at MSK

Dr. Rebecca Gao cares for people with head and neck cancers at MSK in Manhattan and MSK Monmouth, specializing in reconstructive surgery to restore function and appearance.

Long before I became a doctor, I was a journalist, drawn to people’s stories of struggle and resilience. But I realized I wanted to do more than tell stories. I wanted to help change them.

Hi, I’m Dr. Rebecca Gao, a head and neck cancer surgeon at Memorial Sloan Kettering Cancer Center. I specialize not only in removing cancer, but also in restoring what matters most: your function, your appearance, and your humanity. 

A cancer diagnosis of the head and neck can feel especially overwhelming because it may affect how you eat, speak, and how you present yourself to the world. I have expertise in using advanced techniques such as robotic surgery and microvascular reconstruction. That’s where I transplant healthy tissue and blood vessels to help rebuild after cancer surgery. My goal is to give you the best chance at recovering your quality of life.

At MSK, you’ll never face cancer alone. Here, an extraordinary team surrounds you with compassion, innovation, and the most advanced care available.

For me, medicine is about more than treating disease. It’s about restoring hope and dignity. 

Watch this video at https://customer-do46zy3q1cub6422.cloudflarestream.com/660dd20a462ceacf9a5899b03ad95eee/watch

 How does thyroid removal surgery affect my parathyroid glands?

The parathyroid glands are 4 small glands near your thyroid that make parathyroid hormone (PTH). The hormone PTH helps control calcium and phosphorus levels in your blood.   

After thyroid surgery, your parathyroid glands may not make enough PTH. This is called hypoparathyroidism, which can cause hypocalcemia.  

Hypocalcemia is when your calcium level is too low. Symptoms of hypocalcemia include numbness and tingling in hands, feet, and around your mouth. You may not feel anything, or you feel slight stinging or poking feelings in those areas.    

Call your healthcare provider right away if you have these signs because hypocalcemia can be harmful if not treated.    

After your surgery, we’ll check your calcium levels. If they’re low, we'll give you medicine. 

In some cases, your doctor may recommend an autotransplantation (AW-toh-tranz-plan-TAY-shun) during thyroid surgery. An autotransplantation is when we move 1 or 2 parathyroid glands to another area to lower your risk for hypoparathyroidism. 

The best way to minimize side effects from surgery is only use it when you need to. When patients come to MSK to see me about surgery, I really do make sure surgery is the right approach to take for that person.
MSK head and neck surgeon Dr. Thomas Ow sees patients in New York City and on Long Island. 

Treatments after a thyroidectomy

Many people will not need more treatment after thyroid cancer surgery. But your doctor may recommend some treatments to help your body work as it should.  

Here are some treatments you may have after surgery. 

Thyroid hormone therapy after surgery

Thyroid surgery can change the way your body makes hormones. If you have a total thyroidectomy, your body can no longer make the thyroid hormone it needs. You’ll need to take thyroid hormone pills to replace the hormone your thyroid made. 

You might still need to take thyroid hormone pills if you have a thyroid lobectomy. But some people do not need to take any thyroid hormone pills at all after their thyroid lobectomy. 

Normal thyroid hormone levels are important for your metabolism (how your body changes food into energy).  

Your MSK care team will work closely together to watch your hormone levels after thyroid surgery. 

When treating thyroid cancer, my goal is to provide the best care but also make sure that my patients feel heard, respected, and in control of their journey.
Head and neck surgeon Dr.  Babak Givi is an expert in treating thyroid cancer with surgery.   

Radioactive iodine after a thyroidectomy

Your doctor may recommend radioactive iodine (RAI) treatment after a total thyroidectomy (thyroid removal surgery).  

RAI treatment uses a type of iodine that’s radioactive. You swallow it as a pill or liquid, and the radioactive iodine travels in your bloodstream. It's absorbed (taken up) by your remaining thyroid cancer cells or normal thyroid tissue.   

We may recommend RAI therapy for: 

  • Thyroid cancer that’s aggressive and may grow or spread fast. 
  • Thyroid cancer that has spread a lot to other places. 
  • Cancer cells that remain or grow back after surgery. 

You may have RAI if you have follicular or papillary thyroid cancer.  

MSK endocrinology and nuclear medicine doctors helped develop standards for giving RAI treatment in a safe way. An endocrinologist (EN-doh-krih-NAH-loh-jist) is a doctor with special training in endocrine problems, including thyroid problems. A nuclear medicine doctor has special training in using radioactive drugs to diagnose and treat disease. 

Learn more about radioactive iodine therapy for thyroid cancer. 

 Radiation therapy after a thyroidectomy

We may recommend radiation therapy after a thyroid removal surgery if you have: 

  • Aggressive types of thyroid cancer. 
  • Cancer that’s locally advanced and invasive (it spreads). This includes cancers that have spread to the larynx, trachea, esophagus, and large vessels.  
  • Cancer that came back after treatment. 
  • Cancer that surgery cannot completely remove. 

We use intensity-modulated radiation therapy (IMRT) or proton therapy to treat thyroid cancer. Because they’re very precise, IMRT and proton therapy keep healthy tissue safe by limiting the amount of radiation.  

Learn more about radiation therapy for thyroid cancer. 

THE MSK DIFFERENCE

MSK has more than 70 head and neck cancer experts. We see more people with rare types of head and neck cancer than many other cancer centers. We’re experts in diagnosing and treating rare salivary gland, mouth, and thyroid cancers. That’s why many people with rare head and neck cancers come to MSK each year.  

Dr. Gao at MSK in NYC, wearing a business suit.
Successful cancer treatment isn’t just about eliminating the tumor. It’s about giving you good days with the people you love. Together, we’ll make it happen.
Head and neck surgeon Dr. Michael Pei-hong Wu has a special interest in microvascular reconstructive surgery. He sees patients in NYC and at MSK Bergen.
Video | 1:16 Meet Michael Wu: Head and Neck, Plastic & Reconstructive Surgeon at MSK

Dr. Michael Wu treats people with head and neck cancers at MSK in Manhattan and MSK Bergen, using advanced surgery and reconstruction to preserve function and quality of life.

Hi, I'm Dr. Michael Wu, a head and neck surgeon at Memorial Sloan Kettering Cancer Center. I have advanced training in surgery involving the larynx, lips, mouth, nose, salivary glands, and throat.

I also have a special interest in microvascular reconstructive surgery, which enables me to reconstruct a part of the head or neck that has been affected by cancer or non-cancerous tumors.

When we meet, I’ll help you understand your diagnosis and we’ll talk about what you enjoy most in life. You may have several treatment options to choose from, and I’ll walk you through each one to help you make an informed decision.

It’s important for me to really get to know you and what milestones matter the most to you. Is it returning to work? Singing in the choir again? Enjoying a meal with your family? Successful cancer treatment isn’t just about eliminating the tumor. It’s about giving you good days with the people you love. Together, we’ll make it happen.  

Watch this video at https://customer-do46zy3q1cub6422.cloudflarestream.com/8cfb86e97657416efb46c3db9d7d4b5e/watch

Common questions about thyroid cancer surgery

From 6 to 8 weeks after your surgery, you’ll have 2 thyroid function tests. The thyroid stimulating hormone (TSH) and free thyroxine (FT4) tests show if your blood has the right amount of thyroid hormone. Your care team will use the test results to adjust your thyroid medicine. 

If your whole thyroid was removed to treat papillary cancer: You’ll have a blood test called thyroglobulin after your surgery to watch for cancer coming back. 

If you have medullary thyroid cancer: You’ll have calcitonin and carcinoembryonic antigen (CEA) blood tests after your surgery to watch for cancer coming back.  

If your whole thyroid gland was removed, you must take medicine to replace the hormone your thyroid made. You must take it every day for the rest of your life. Most people take the hormone every morning on an empty stomach. 

There are many thyroid hormone medicines, such as Levothyroxine (Levoxyl® or Synthroid®).  

Your healthcare provider will prescribe you a thyroid hormone medicine and tell you how much to take. You may also need blood tests to make sure you’re getting the right amount of medicine. Your healthcare provider will change the dose as needed. 

After surgery, you may have low calcium or a problem with your parathyroid. If so, you may need to take a calcium supplement such as Tums® Ultra. You can get this at a pharmacy without a prescription. Your healthcare provider will tell you how much to take. 

You may also get a prescription for calcitriol (such as Calcijex® or Rocaltrol®) to help your body absorb the calcium.  

Calcium supplements can cause constipation (trouble pooping), most often if you’re also taking pain medicine. Talk with your care team if this happens. They may recommend a stool softener or laxative. 

Thyroid cancer survivor Annabel Gutherz, treated for cancer at MSK, is singing in front of a microphone in a recording studio.
I wanted to leave no stone unturned before jumping into a surgery that had the potential to change my life.
Canadian singer Annabel Gutherz, 25, traveled to MSK for a second opinion about a thyroid nodule. Her MSK surgeon saved most of her thyroid, and her singing career.  
Read her story
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Our Care Advisors can answer your questions and explain how MSK's surgery care team can help you. 

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