Thyroid Cancer

How is thyroid cancer treated?

Treatment for thyroid cancer depends on several factors, such as staging of the cancer, other existing health conditions the patients may have and their personal preferences.

Thyroid cancer is usually treated with surgical removal of the thyroid. Some patients may require more than one type of treatment, such as surgery in combination with chemotherapy or radiation therapy.

Surgery for thyroid cancer

This is the preferred primary treatment option for patients who are fit for surgery.

• Thyroidectomy (removing all or most of the thyroid)
  Doctors usually recommend removing the entire thyroid to treat the thyroid cancer. This is done via an incision at the front of the neck. In suitable cases, the thyroid may be removed via an advanced robotic approach, with the scar hidden behind the ear or the armpit.
  
• Thyroid lobectomy (removing a portion of the thyroid)
  Doctors may opt to remove only one side (lobe) of the thyroid if the cancer is very small. This is usually recommended if it is a slow-growing thyroid cancer in one part of the thyroid and no suspicious nodules are found in other areas of the thyroid.
  
• Removing lymph nodes in the neck
  When removing the thyroid, the doctor may also remove nearby lymph nodes in the neck.

Radioactive iodine treatment for thyroid cancer

Radioactive iodine treatment is often used after surgery to eliminate any remaining cancerous thyroid cells and target secondary tumour sites (in the event the cancer has spread to other parts of the body). This treatment may also be used to treat thyroid cancer that recurs after treatment.

Radioactive iodine is usually administered orally, either in a capsule or liquid form. It is primarily taken up by the thyroid cells and cancer cells, reducing the risk of harming healthy cells. The radioactionpatient will pass most of the radioactive iodine out in their urine within a few days, but the treatment will continue to be effective between one to three months.

Radiation therapy/ Radiotherapy for thyroid cancer

Radiation therapy uses targeted rays to kill cancer cells. This treatment option is used in cases where surgery cannot be performed or radioactive iodine treatment has been ineffective. It can also be used to slow the growth of cancer that has spread to the bones.

Thyroid hormone (thyroxine) therapy

After surgery to remove the thyroid, patients will need to take thyroid hormone medication for life. This is usually an oral medication that is taken once daily. This medication serves a dual purpose – it replaces thyroxine which would have been produced by the thyroid and it helps to significantly reduce the growth of cancer cells by suppressing the hormones that stimulate the thyroid.

Targeted therapy

Targeted therapy uses drugs that attack specific features of the thyroid cancer, for e.g., certain genetic mutations or the blood vessels that supply the cancer, in order to stop the growth and spread of the cancer cells. These treatments are offered when the thyroid cancer has spread to other parts of the body and are no longer responding to radioactive iodine treatment.