Thyroid Cancer: Treatment Choices

There are many treatment choices for thyroid cancer. The one that’s best for you depends on things such as:

• The type of thyroid cancer

• The size of the tumor and if it has spread (the stage of the cancer)

• Your overall health

• Your personal concerns and preferences

Learning about your treatment choices

You may have questions and concerns about your treatment choices. You may want to know how you’ll feel, how you'll look, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. They can explain what your treatment choices are, how well treatment is expected to work, what the risks and side effects may be, and what the goals of treatment are.

Your provider may advise a specific treatment. Or they may offer more than one, and ask you to decide which one you'd like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your choices. You may want to get a second opinion before deciding on your treatment plan. You may also want to include your partner, spouse, family, or friends in this process.

Goals of treatment for thyroid cancer

Treatment may cure or control the cancer. It can also improve your quality of life by helping to control the symptoms of the disease. The goal of thyroid cancer treatment is to do one or more of these things:

• Remove the cancer tumor while doing as little damage as possible to nearby areas

• Kill cancer cells or keep them from growing and spreading

• Keep the cancer from coming back or delay its return

• Ease symptoms of the cancer, such as pain and pressure on nearby tissues

If the thyroid cancer has spread to other parts of your body, treatments may be focused on helping to control your symptoms. These treatments, called palliative treatments, don’t kill the cancer. They may include pain medicine and treatments for tumor cells that may have spread to bones like radiation. They may also include ways to help you manage problems breathing or swallowing. Palliative treatments are also commonly used along with cancer treatment. For instance, you may get medicine to help prevent nausea when you're getting chemotherapy. 

Types of treatment for thyroid cancer

Treatments for thyroid cancer may be local or systemic. You may have both:

• Local treatments. These remove, destroy, or control cancer cells in a certain place in the body. For thyroid cancer, the most common local treatment is surgery.

• Systemic treatments. These destroy or control cancer cells all over your body. Radioactive iodine therapy and chemotherapy are systemic treatments.

Commonly used treatments for thyroid cancer

These are the main treatments for thyroid cancer:

• Surgery. This is the treatment used for most people with thyroid cancer. It's done to take out the tumor along with an edge of healthy tissue around it. The type of surgery done depends on the size of the tumor and the type of thyroid cancer. All or part of the thyroid gland may be removed.

• Radioactive iodine (RAI). Your thyroid absorbs iodine. This treatment can find and destroy thyroid cells that were not taken out in surgery or that spread beyond the thyroid. You swallow the RAI. It's a cchoice for many people with papillary, follicular, and Hurthle cell thyroid cancer.

• Thyroid hormone medicine. This type of treatment is needed after the thyroid gland has been removed or if it's no longer making enough of the hormones that your body needs. Thyroid hormone medicines replace the hormones your thyroid made. They can also slow down the growth of cancer cells that are still in your body.

• External radiation therapy. Strong X-rays or other beams of energy can be used to kill cancer cells. It's used only in certain cases, such as when later stage cancer doesn’t respond to other treatments. Or when later stage cancer has spread to key tissues, such as the voice box or the esophagus (swallowing tube).

• Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells and keep them from growing. It's not often used to treat thyroid cancer, but it may be used if other treatments aren't working.

• Targeted therapy. These medicines target specific changes found on some thyroid cancer cells. If your cancer cells have these changes, targeted therapy can be used to kill those cells, while causing little to no damage to healthy cells. These medicines may be used if other treatments aren't working or the cancer comes back after treatment.

You may have just one treatment or a combination of treatments. Most people with thyroid cancer have surgery.

Clinical trials for new treatments

Researchers are always finding new ways to treat cancer. These new methods are tested in clinical trials. Taking part in a clinical trial means you get the best treatment available today, and you might also get new treatments that are thought to be even better. Before starting treatment, talk with your healthcare provider to find out if there are any clinical trials you should think about.

Talking with your healthcare provider

At first, thinking about treatment choices may seem overwhelming. Talk with your healthcare providers, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each choice. Discuss your concerns with your healthcare provider before making a decision.