Surgery

Most people with thyroid cancer have surgery to remove the cancer. You may have part or all of your thyroid removed.

The kind of surgery you have may depend on your age, the type of cancer you have, how much the cancer has spread, and your general health.

Surgery Choices

• Thyroid lobectomy removes only one part (lobe) of the thyroid gland. This surgery is an option if your cancer is small and is only in one lobe of your thyroid gland.
• Near-total thyroidectomy removes all but a very small part of the thyroid gland. This is done in special cases with smaller tumors or if an experienced surgeon is not available.
• Total thyroidectomy removes the entire thyroid gland. This is the most common type of surgery, because most people have cancer in both parts (lobes) of the thyroid gland. This type of surgery provides the highest rates of cure and also makes radioactive iodine treatment and thyroid hormone therapy work better.

During surgery, lymph nodes in the neck may also be removed and tested for cancer cells (lymphadenectomy). If thyroid cancer has spread to the lymph nodes, radioactive iodine will be used to destroy the remaining cancer cells.

Most thyroid cancers grow and spread so slowly that you can delay surgery for a short time if you need to. If you choose to postpone surgery, your thyroid cancer should be watched closely by an endocrinologist.

Surgery to remove only the part of the thyroid gland that contains cancer (lobectomy) is less complicated than total thyroidectomy and less likely to lead to hypothyroidism. But thyroid cancer comes back (recurs) after lobectomy more often than it does after total thyroidectomy.

If you and your doctor decide that you need surgery, it is important to have the procedure done by a highly skilled surgeon at a hospital that has a good success rate. There are fewer problems from surgery when a person has a skilled and experienced surgeon.²