Thyroid cancer: Treatments and drugs

Your thyroid cancer treatment options depend on the type and stage of your thyroid cancer, your overall health and your preferences.

Surgery
Most people with thyroid cancer undergo surgery to remove all or most of the thyroid. Operations used to treat thyroid cancer include:

• Removing all or most of the thyroid (thyroidectomy). Surgery to remove the entire thyroid is the most common treatment for thyroid cancer. In most cases, the surgeon leaves small rims of thyroid tissue around the parathyroid glands to reduce the risk of parathyroid damage. Sometimes surgeons refer to this as a near-total thyroidectomy.
• Removing lymph nodes in the neck. When removing your thyroid, the surgeon may also remove enlarged lymph nodes from your neck and test them for cancer cells.

Thyroid surgery is performed by making an incision in the skin at the base of your neck. Thyroid surgery carries a risk of bleeding and infection. Damage can also occur to your parathyroid glands during surgery, causing low calcium levels in your body. There's also a risk of accidental damage to the nerves connected to your vocal cords, which can cause vocal cord paralysis, hoarseness, soft voice or difficulty breathing.

Thyroid hormone therapy
After thyroid cancer surgery, you'll take the thyroid hormone medication levothyroxine (Levothroid, Synthroid, others) for life. This has two benefits: It supplies the missing hormone your thyroid would normally produce, and it suppresses the production of thyroid-stimulating hormone (TSH) in your pituitary gland. High TSH levels could conceivably stimulate any remaining cancer cells to grow.

You'll likely have blood tests to check your thyroid hormone levels every few months until your doctor finds the proper dosage for you.

Radioactive iodine
Radioactive iodine treatment uses large doses of a form of iodine that's radioactive. Radioactive iodine treatment is often used after thyroidectomy to kill any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren't removed during surgery. Radioactive iodine treatment may also be used to treat thyroid cancer that recurs after treatment or that spreads to other areas of the body.

Radioactive iodine treatment comes as a capsule or liquid that you swallow. The radioactive iodine is taken up primarily by thyroid cells and thyroid cancer cells, so there's a low risk of harming other cells in your body.

Side effects may include:

• Nausea
• Dry mouth
• Dry eyes
• Altered sense of taste or smell
• Pain where thyroid cancer cells have spread, such as the neck or chest

Most of the radioactive iodine leaves your body in your urine in the first few days after treatment. During that time you'll need to take precautions to protect other people from the radiation. For instance, you may be asked to temporarily avoid close contact with other people, especially children and pregnant women.

External radiation therapy
Radiation therapy can also be given externally using a machine that aims high-energy beams at precise points on your body. Called external beam radiation therapy, this treatment is typically administered a few minutes at a time, five days a week, over several weeks. During treatment, you lie still on a table while a machine moves around you.

Chemotherapy
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy is typically given as an infusion through a vein. The chemicals travel throughout your body, killing quickly growing cells, including cancer cells.

Clinical trials
Clinical trials are studies of new cancer treatments or new ways of using existing treatments. Enrolling in a clinical trial gives you the chance to try out the latest in cancer treatment options, but clinical trials can't guarantee a cure. Ask your doctor whether you might be eligible to enroll in a clinical trial. Together you can discuss the benefits and risks of a trial and decide whether participating in a clinical trial is right for you.