How is thyroid cancer treated?
Fortunately, most types of thyroid cancer can be diagnosed early and cured completely, but a thoughtful and comprehensive investigation is necessary. If thyroid cancer is suspected after review of all the information, referral to an experienced thyroid surgeon is recommended.
The usual approach is to remove the side of the thyroid containing the lump. If cancer is confirmed, further consultation with the endocrinologist is appropriate. Additional surgery to remove the remaining tissue and radioactive iodine treatment are usually recommended in order to destroy any remaining malignant thyroid cells and to reduce the risk of recurrence of this disease.
Radioactive iodine treatment should never be given to a pregnant woman! Small amounts of radioactive iodine will also be excreted in breast milk. Since radioiodine could permanently damage the infant’s thyroid, breast-feeding is not allowed. If radioiodine is inadvertently administered to a woman who is subsequently discovered to be pregnant, the advisability of terminating the pregnancy should be discussed with the patient’s obstetrician and endocrinologist. Therefore, prior to administering diagnostic or therapeutic radioiodine treatment, pregnancy testing is mandatory whenever pregnancy is possible.
After radioiodine therapy, thyroid medication (levothyroxine) should be started and dosed to replace the function of the thyroid and to decrease the likelihood of cancer recurrence. Periodic monitoring is supervised by the endocrinologist, and may include ultrasound examinations, radioiodine body scans, and periodic testing of a blood protein called thyroglobulin, which is found in normal thyroid cells but can also be produced by thyroid cancer cells.
The optimal frequency of further monitoring studies to be certain that the cancer has not recurred will be determined by your physician. Fortunately, most types of thyroid cancer have a very good prognosis when diagnosed early and treated by a physician who is familiar with its management.
