How To Treat Thyroid Cancer

There are several ways to treat thyroid cancer, and not everybody needs the same treatment.

How we treat it depends on:

• which type of tumor you have
• how much the tumor has spread

In most cases, the first thing to do is remove the thyroid. This type of surgery is called “total thyroidectomy” — by removing the whole thyroid gland, we are also removing the tumor inside.

Sometimes, there are lymph nodes affected on your neck. If that’s your case, your surgeon will remove them during the same surgery, using a larger incision on your neck.

If the tumor was small and didn’t spread anywhere else, that would be it. But what if it did spread, say to some distant organs like the lungs?

In those cases we need some extra treatment.

The next steps depend on which type of cancer you have

As you may recall from this post, there are 4 types of thyroid cancer:

• papillary
• follicular
• medullary
• anaplastic

Treating papillary and follicular thyroid cancer

The first two (papillary and follicular) are sensitive to radioiodine, also called “I-131”. This is a very good option, because it allows us to treat the tumor selectively.

Because these tumors look very similar to thyroid cells, they “eat” iodine. We can take advantage of these by using radioactive iodine (that’s what I-131 is).

I-131 is like poison for the cells that eat it. Fortunately, the rest of your organs don’t eat iodine, so they are safe. Once the I-131 enters those malignant cells, it will destroy them.

How to treat medullary thyroid cancer

Now this one is a little bit trickier. If the tumor is only inside the thyroid, that’s fine: removing the thyroid will heal you.

However, if it has spread to other organs, we can’t use I-131, because it won’t work. Instead, we’ll need to use radiotherapy or chemotherapy.

How to treat anaplastic thyroid cancer

Anaplastic cancer is the most aggressive. It doesn’t respond to I-131, and also, it tends to grow fast and infiltrate the structures around it, in the neck.

During surgery, we must try to remove the whole tumor, but it’s usually impossible, because the tumor is already infiltrating vital structures (like the trachea or the carotid artery).

In that case, we need to use radiotherapy and chemotherapy after surgery, to try and destroy any remaining malignant cells.