Treatment Overview

The goal of treatment for thyroid cancer is to get rid of the cancer cells in your body. How this is done depends on your age, the type of thyroid cancer you have, the stage of your cancer, and your general health.

Most people have surgery to remove part or all of the thyroid gland. Sometimes a suspicious lump or nodule has to be surgically removed before you will know if you have cancer or not.

After surgery, you may need treatment with radioactive iodine to destroy any remaining thyroid tissue. When you no longer have all or part of your thyroid gland, you will probably need to take thyroid hormone medicines for the rest of your life. These medicines replace necessary hormones that are normally made by the thyroid gland and prevent you from having hypothyroidism—too little thyroid hormone. For more information on hypothyroidism, see the topic Hypothyroidism.

Initial treatment

Your treatment for thyroid cancer may include:

• Surgery to remove the part of the thyroid gland that contains cancer. Removing one part (lobe) is called a lobectomy. Removing both lobes is called a total thyroidectomy. Removing all but a very small part of the thyroid is called a near-total thyroidectomy. Lymph nodes may also be removed during surgery.
• Radioactive iodine, which is used after surgery to destroy any remaining thyroid tissue. After you have your thyroid surgically removed, you may have to wait several weeks before having radioactive iodine treatment to destroy any remaining thyroid tissue. During the waiting period, you may have symptoms of hypothyroidism such as fatigue, weakness, weight gain, depression, memory problems, or constipation.
• Thyroid-stimulating hormone (TSH) suppression therapy. TSH suppression therapy reduces the TSH in your body, which may help prevent the growth of any remaining cancer cells.

If thyroid cancer is advanced when it is diagnosed, initial treatment may also include chemotherapy or radiation therapy.

Ongoing treatment

After treatment for thyroid cancer, you may need to take thyroid hormone medicine for the rest of your life to replace the hormones that your body no longer makes. You will also need follow-up visits with your doctor every 6 to 12 months. In addition to scheduling regular visits, be sure to call your doctor if you notice another lump in your neck or if you have trouble breathing or swallowing.

At your follow-up visits, your doctor may order a blood test to measure your thyroid-stimulating hormone (TSH) level. This test helps your doctor know if you are taking the right amount of thyroid hormone medicine. Your doctor may order other tests, such as a radioiodine scan, X-rays, or a CT scan.

Side effects of treatment

The side effects of surgery for thyroid cancer are usually mild and last a couple of days. Your doctor will talk to you about medicine you can take if you are having pain. You will likely need to take thyroid hormone medicine for the rest of your life to replace the hormones that your body no longer makes.

The most important side effect of radioactive iodine therapy (RAI) is that you will become radioactive for a period of time. Your doctor will give you written instructions to follow to prevent exposing others to radiation. For more information, see Radioactive Iodine.

Thyroid hormone therapy rarely causes side effects when you have the right dose. Too much or too little thyroid hormone can cause side effects. For more information, see Medications. Taking high doses of thyroid hormone may cause a rapid or irregular heartbeat. High doses taken over time may also cause weakness in your bones (osteoporosis).

Home treatment may help you manage your side effects. For more information, see Home Treatment.

Treatment if the condition gets worse

Thyroid cancer may come back (recur). If thyroid cancer does recur, it may be found during a physical exam, on an ultrasound, or as a result of increasing thyroglobulin levels. Unlike other types of recurrent cancer, recurrent thyroid cancer is often cured, especially if it has spread only to the lymph nodes in the neck.

Recurrent thyroid cancer or thyroid cancer that has spread (metastasized) to other parts of the body may be treated with surgery, radioactive iodine, or chemotherapy.

Clinical trials

Your doctor may talk to you about being in a clinical trial. For some people with thyroid cancer, taking part in a clinical trial may be the best treatment choice. Clinical trials for thyroid cancer are looking at targeted therapy with tyrosine kinase inhibitors.

Palliative care

Your doctor may talk to you about palliative care. This is medical care that provides an extra layer of support for people with serious and chronic illnesses. With palliative care, you have the help of a medical team to manage your symptoms, pain, and stress. For more information, see the topic Palliative Care.

For more information about thyroid cancer treatments, see the topics:

Thyroid Cancer – Health Professional Information [NCI PDQ]

Thyroid Cancer – Patient Information [NCI PDQ]