What are the treatments for Thyroid Cancer?
(1) Surgery
Most people with thyroid cancer will have surgery. The surgeon removes the whole thyroid gland or part of it, depending on the patient's conditions.
During the operation, surgeon will examine the lymph nodes close to the thyroid to see if they have been affected by cancer cells. If cancer has spread outside the gland, surgeon will remove the neighboring tissues as well.
After removal of entire or nearly all thyroid gland, patient needs to take thyroid hormone as replacement for the rest of his/her life. This also helps suppress the secretion of thyroid stimulating hormone (TSH). If the level of thyroid stimulating hormone is high, potential residual cancer cells may be stimulated, resulting in recurrence of cancer.
(2) Radioactive Iodine Therapy
Following the operation, treatment using radioactive iodine may be considered depending on surgery results and disease nature. This is one kind of internal radiotherapy. The radioactive substance is taken as a capsule or a drink. The thyroid cancer cells will absorb the radioactive iodine which will destroy them. Normal cells will remain unaffected.
Within 4 weeks before radioactive iodine therapy, patient should stop taking thyroid hormone because it will render radioactive iodine ineffective. He/she may be treated with recombinant human thyroid stimulating hormone (rhTSH) to overcome the potential problems of stopping thyroid hormone. Furthermore, patient should avoid food with high level of iodine, starting to do so at least 2 weeks prior to the therapy. The food includes seafood, iodine-added salt, cough medicines, eggs, cheese and milk.
Within first few days after the therapy, high level of radiation can be detected in urine, blood, saliva and sweat. Patient will stay in hospital to avoid contacting other people. When the radiation level drops to the safety level, the patient can then be discharged.
Radioactive iodine therapies rarely entail long term influence and female patients can have normal pregnancy. However, within one year after the therapy, a female patient is not recommended to become pregnant or to breastfeed a baby.
(3) External radiation therapy
Should cancer cells still remain in the neck after the operation or the cancer cannot be removed by surgery, external radiation therapy is considered. This type of treatment is more commonly used in patients suffering from medullary thyroid cancer or anaplastic thyroid cancer. Another indication for this therapy is recurrence of cancer in the neck.
Prior to the therapy, a transparent mask which fits the patient's head and neck is prepared. This mask helps immobilize the head during the therapy. The whole course of treatment usually takes six to seven weeks.
(4) Targeted therapy
This is used when other treatments like surgery or radioactive iodine are no longer effective.