How is thyroid cancer treated?
Thyroid cancer is highly treatable, and most people diagnosed with it have an excellent outlook if the cancer hasn’t spread. Treatments vary based on your case and health history. For example, if you have a small papillary cancer, your care team may recommend a watchful waiting approach to assess if there are any changes before recommending surgery or other treatment. Your condition could be monitored through blood tests and ultrasound a couple of times a year.
For cancer that requires treatment, surgeons may perform a thyroidectomy to remove the thyroid gland. More than one type of treatment may be required, including chemotherapy, targeted therapies, and radiation. Overall, your thyroid cancer treatment options depend on the type and stage of your thyroid cancer, your overall health, and your preferences.
Penn Medicine’s medical and radiation oncologists are experts in treating advanced thyroid cancer. Our research led to FDA approval of treatments that have become the standard of care for thyroid patients and deliver successful outcomes.
Who treats thyroid cancer?
A multidisciplinary thyroid cancer care team combines the expertise of various specialists to provide you with the best possible care. This team includes:
- Endocrinologists and oncologists: These doctors diagnose and treat thyroid cancer using medication, radiation, and other therapies. Some may specialize in specific areas like medical oncology or surgical oncology.
- Endocrine surgeons and otorhinolaryngologists: These surgeons are highly skilled in performing thyroid cancer removal procedures and have extensive experience managing head and neck cancers.
- Pathologists and radiologists: These specialists provide critical diagnostic support by analyzing tissue samples and using imaging techniques to assess the cancer.
By bringing together specialists from different disciplines, your Penn Medicine care team can offer a more well-rounded perspective on your care. This ensures all aspects of your treatment are considered, from diagnosis and surgery to ongoing management.
Surgery for thyroid cancer
Surgery is the primary treatment for most thyroid cancers. During an operation, our surgeons remove thyroid tumors and may also remove any affected lymph nodes. They focus on preserving as much of your thyroid as possible, using minimally invasive techniques that spare healthy tissue.
For a thyroidectomy (thyroid removal surgery), surgeons determine how much of the thyroid to remove depending on the tumor’s location, size, and stage.
Doctors make a small incision (less than two inches) to remove all or part of the thyroid gland. The incision is usually placed in line with your natural neck creases, so any scar is less visible.
There are two types of thyroidectomies: total thyroidectomy, in which the entire thyroid gland is moved, and partial thyroidectomy, which only removes the part of the thyroid that contains the cancer. Depending on how much of the thyroid we remove and your hormone levels, thyroid hormone medication may be needed post-surgery.
Thyroid cancer may occur in the tissue that connects the gland’s two lobes over the windpipe (isthmus). In an isthmusectomy, your surgeon may remove only this bridge of tissue.
When thyroid cancer spreads to lymph nodes, surgeons remove the affected nodes (lymphadenectomy). Sometimes, experts remove all the lymph nodes next to the thyroid (central compartment neck dissection). When the cancer has spread to the lymph nodes on the side of the neck, surgeons remove these nodes through a slightly longer incision. This surgery helps reduce the risk of thyroid cancer returning.
Side effects of thyroid surgery
Our surgeons are experts in preserving critical structures in the neck during thyroid surgery, including the laryngeal nerve (controls vocal cord muscles), parathyroid glands (regulates calcium and phosphorous), voice box (produces sound), and windpipe (warms and moistens air). This minimizes the risk of side effects, which could include:
- Hoarseness
- Loss of voice
- Nerve weakness
- Tingling (due to low calcium)
- Trouble swallowing
However, if you do experience any of these side effects, you’re not alone. Penn Medicine’s speech-language pathology experts provide specialized speech and swallowing therapy to help regain strength and restore function after surgery.
Nonsurgical thyroid cancer therapies
Thyroid cancer therapies include a variety of treatments designed to target and manage the disease.
Our experts use radioactive iodine therapy (RAI) when thyroid cancer has spread to other parts of the body (metastasized). You may also have RAI after thyroid surgery to ensure no cancer cells remain.
Penn Medicine’s nuclear medicine specialists perform radioactive iodine therapy with the I-131 isotope (a form of iodine). The American Board of Nuclear Medicine has certified our highly trained experts.
We may treat some thyroid cancers with thyroid hormone therapy. With this method, a thyroid hormone (levothyroxine) is used to help block other hormones that help tumors grow. We also use thyroid hormone replacement after total thyroidectomy to replace the hormones your thyroid was making. These hormones help regulate body processes you need to stay healthy.
Our expert endocrinologists work with you to ensure your thyroid hormone levels are right for you.
Radiation therapy uses high-energy rays to destroy cancer cells in the body. We may use radiation therapy to treat metastatic thyroid cancer or to ensure no cancer cells remain after thyroid cancer surgery.
Penn Medicine radiation oncologists use sophisticated techniques such as external beam radiation therapy, intensity-modulated radiation therapy (IMRT), and stereotactic body radiotherapy (SBRT). We may also recommend proton therapy for some thyroid cancers.
Systemic therapies are drugs used to treat aggressive or metastatic thyroid cancers. Our specialists use chemotherapies (drugs that eliminate cancer cells) and targeted therapies (drugs that find and fight changes inside cancer cells).
Thyroid cancer treatment follow-up care
After treatment for thyroid cancer, you’ll have follow-up exams with our experts which may include:
- Blood tests to monitor thyroid hormone and certain protein levels
- Imaging tests of your neck (ultrasound) to look for suspicious nodules, lumps, or lymph nodes
- A radioiodine scan to look for remaining thyroid cancer cells
We offer cancer support services for thyroid cancer during and after treatment to help you heal and recover. These services include education about what to expect after treatment, support groups, and counseling.
Comprehensive treatment for thyroid cancer
Many thyroid cancers are highly treatable when detected early. Our skilled thyroid specialists offer a range of thyroid cancer treatments.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.