Treatment for thyroid cancer is based on the type of thyroid cancer you have and its stage, your overall health and treatment preferences. This may involve surgery, thyroid hormone replacement therapy, radioactive iodine treatment, targeted therapies, chemotherapy and/or radiation therapy.
Surgery is often the primary form of treatment, where a section or the entire thyroid gland is removed (partial or total thyroidectomy, respectively).
- Active surveillance – involves closely monitoring the cancer through ultrasounds, physical examinations and blood tests rather than receiving immediate treatment. This is only suitable for small, low-risk papillary thyroid cancers confined within the thyroid
- Surgery – may involve removing part of the thyroid affected by cancer (partial thyroidectomy) or more commonly the entire thyroid (total thyroidectomy). If the cancer has spread to the lymph nodes, they may also need to be removed (neck dissection)
- Thyroid hormone replacement therapy – replaces the thyroxine (T4) hormone and reduces the risk of cancer returning after the thyroid is removed. The thyroxine hormone is produced by the thyroid to help maintain the body’s metabolism. Thyroid hormone replacement therapy continues throughout a person’s life once the thyroid is removed, taking a hormone tablet every day
- Radioactive iodine treatment – a radioisotope treatment which involves swallowing a pill containing the radioactive substance I131 (RAI). This works by destroying thyroid cells (as the thyroid absorbs iodine from the body) while leaving other cells unharmed, and is often used following surgery to treat any remaining cancer cells or healthy thyroid tissue left behind. It is typically recommended for the treatment of papillary or follicular thyroid cancers that have spread to the lymph nodes or have a high risk of returning. For RAI treatment you will need to stay at the hospital for a few days
- Targeted therapies – focuses specifically on treating the thyroid cancer through targeting cancer cells, and not healthy cells. Targeted therapies may be used for advanced thyroid cancer that does not respond to radioactive iodine treatment. The most common targeted therapies used for thyroid cancer treatments are tyrosine kinase inhibitors (TKI). These drugs (e.g sorafenib, lenvatinib or vandetanib) are given as daily pills
- Chemotherapy – involves the use of anti-cancer drugs which are taken orally (by mouth) or injected into the body (intravenously). Chemotherapy may be used to treat advanced thyroid cancer that does not respond to other treatments, or in combination with radiation therapy to treat anaplastic thyroid cancer
- Radiation therapy – uses high-energy particles to target and destroy cancer cells. Radiation therapy may be delivered after surgery and radioactive iodine treatment for cancer that cannot be completely removed or has a high risk of returning, or to help control certain types of thyroid cancer that do not respond to other treatments (such as medullary or anaplastic thyroid cancer)