Thyroid Cancer: Treatment Choices
Learning about your treatment options
If you have thyroid cancer, you probably have many questions and concerns about your treatment options. It's normal to want to learn all you can.
Your healthcare provider will plan your treatment on the type of thyroid cancer you have. Most thyroid cancers are slow to grow and spread (metastasize). But some thyroid cancer types are aggressive. This means that they can grow and spread quickly. Your provider will treat these differently. Your provider will also consider many things when helping you make treatment decisions. These include your age, overall health, the size and location of your tumor, your preferences, and other factors.
You may also want to know how you’ll feel and function after treatment. You may want to know if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices and goals of treatment are. Your provider can also tell you how successful these treatments are likely to be and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one, and ask you to decide. It can be hard to make this decision. It is important to take the time you need to make the best decision.
Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get another opinion before deciding on your treatment plan. In fact, some insurance companies may want you to see healthcare providers and use treatment centers covered in your insurance plan. In addition, you may want to involve your family and friends in this process.
Goals of treatment for thyroid cancer
Treatment can be used to cure or control the cancer. It can also improve your quality of life by helping to control the symptoms of the disease. The goal of treatment may be to:
Remove the thyroid cancer tumor
Kill or stop the growth or spread of thyroid cancer cells
Prevent or delay the cancer from coming back
If your thyroid cancer has spread to other parts of your body, you may only have treatments to help control your symptoms. These treatments, called palliative treatments, don’t kill the cancer. Palliative treatments may include pain medicine and treatments for tumor cells that may have spread to bones. They may also include ways to help you manage if you have trouble breathing or swallowing. Palliative treatments are commonly used with cancer treatment. For example, you may get medicine to help prevent nausea when you are getting chemotherapy.
Types of treatment for thyroid cancer
Treatments for thyroid cancer may be local or systemic, or both.
Local treatments. These remove, destroy, or control cancer cells in one area. For thyroid cancer, the most common local treatment is surgery.
Systemic treatments. These destroy or control cancer cells in your entire body. For thyroid cancer, radioactive iodine therapy and chemotherapy are the main types of systemic treatments.
These are the main treatments for thyroid cancer:
Surgery. Surgery is the most common treatment option for thyroid cancer. Surgery is done to remove the tumor as well as some of the nearby healthy tissue. The type of surgery done depends on the size of the nodule.
Radioactive iodine. This treatment kills any thyroid cells that were not taken out in surgery. It also finds and destroys thyroid cells that have spread beyond the thyroid. This treatment is an option for most people with papillary and follicular thyroid cancer.
Thyroid hormone treatment. This type of treatment is needed after the thryoid gland has been removed. Thyroid hormone medicine is given to replace hormones that your body needs. The medicine also slows down the growth of other cancer cells that are left.
External radiation therapy. This treatment destroys cancer cells using strong X-rays from a machine. For thyroid cancer, it is used only in certain cases, such as when later stage cancer doesn’t respond to radioactive iodine treatment.
Chemotherapy. This treatment uses medicines to stop cancer cells from growing. It may kill the cells or stop them from dividing. It's not commonly used to treat thyroid cancer, but it may be used if other treatments aren't working.
Targeted therapy. These newer medicines target specific changes found on some thyroid cancer cells. If your cancer cells have these changes, a targeted medicine can be used to kill those cells, while causing little to no damage to healthy cells. These medicines may be used if other treatments aren't working.
You may have just one treatment or a combination of treatments. Most people with thyroid cancer have surgery, followed by radioactive iodine therapy.
Clinical trials for new treatments
Health experts are always looking for and finding new ways to treat cancer. It may be helpful to be referred to a cancer treatment center. There, thyroid cancer experts may be doing research studies, called clinical trials, on promising new treatments. Talk with your provider to find out if there are any clinical trials you may want to take part in.
Talking with your healthcare provider
Your healthcare provider is the best person to answer your questions about treatments. Here are some questions you might ask your provider before beginning treatments.
Which treatments are best for me?
What's the goal of each treatment?
How successful will treatment be?
What are the risks and side effects of each treatment?
How long will it take to recover from treatment?
What are the chances that the cancer will come back after treatment?
May 19, 2018
Differentiated thyroid cancer: Overview of management. UpToDate.
Hurd, Robert, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS