Treatment

Surgery is usually the first treatment needed for papillary, follicular and medullary thyroid cancers. It is unlikely to be recommended for thyroid lymphoma patients and is only occasionally suitable for patients with anaplastic thyroid cancer.

If thyroid cancer has been diagnosed before surgery it is usual for the whole thyroid gland to be removed during the operation (total thyroidectomy). If there has been difficulty diagnosing the reason for a thyroid lump or if cancer was not suspected before surgery then removal of only one lobe of the thyroid may be done (hemithyroidectomy or lobectomy).

If only one lobe has been removed and then cancer is discovered in it, it is usual to consider whether the other thyroid lobe needs to be removed at a second operation (a completion thyroidectomy). In some cases however (young patients with small follicular or papillary tumours) it might be suggested not to remove the remaining lobe.

Sometimes the lymph glands/nodes are also removed. The number of glands removed will depend on the size and type of the cancer, what the surgeon can see and feel at the time of the operation and the results of any scans performed before the operation.

Many patients are able to go home 1-3 days after their operation.

Because of where the thyroid gland lies in the neck it is possible for the following to occur after a thyroid operation:

Hoarse Voice

This can occur when the nerve that supplies the vocal cords is ‘bruised’ or damaged during the operation. The voice changes in this case are usually temporary.

Sometimes the nerve has to be cut in order to get the thyroid gland and the cancer out, this is rare however and your surgeon will talk to you about any expected risks before the operation.

Low calcium levels

This can happen when the parathyroid glands (there are 4 of them) that sit close to the thyroid gland are removed or get ‘bruised’ during the operation. These glands control the calcium levels in the blood. If they are not working normally the calcium level will be low. The calcium level will be checked by a blood test after your operation and if the levels are low you will be given extra calcium either as a tablet or through a drip. Your surgeon will talk to you about this in more detail.

Thyroxine

When the thyroid gland is removed, thyroid hormone medication is needed to replace the thyroid hormones that the body can no longer make. Thyroxine tablets need to be taken once a day and are usually best taken first thing in the morning.

It might take a little while to get the right dose for each patient. But once the dose is sorted you should feel your normal self as the tablets are replacing the hormones that your thyroid gland would have produced. The dose will be monitored by finding out how you feel and by checking blood tests (TFTs).

(If you are going to need radioactive iodine treatment you may be put on Tri-iodothyronine tablets to start with. This is given as a tablet 3 times a day). You will need to carry on with thyroid hormone medication for the rest of your life.

If you use any over the counter health supplements including multivitamins it is worth checking with your doctor whether the time of day you take these these tablets needs to be changed. Some tablets can reduce the amount of thyroxine you can absorb from you stomach into the bloodstream so leaving at least a 2 hour gap can be helpful.

Thyroid Cancer Forum UK