NCCN Guidelines for Patients
Thyroid Cancer, Version 1.2017
A blood test to check the TSH (
ormone) is recommended when a thyroid nodule is
present. Your doctor may also check this level during
a routine blood test. This hormone is made by the
pituitary gland. This gland is found near the base of
your brain and its purpose is to regulate the thyroid.
TSH tells the thyroid to make hormones that control
things like your metabolism. In general, when the
TSH is high it usually means that the thyroid levels
are low. Likewise, when the TSH is low, it usually
means that the thyroid levels are high.
If the TSH level is normal or high, your doctor may
suggest further testing of a nodule. This includes
an FNA biopsy. TSH is not used to diagnose thyroid
cancer. This level can be low or high because of
other thyroid disease. When TSH is tested along with
an ultrasound, your doctor can review the results and
decide which tests may be done next.
lobulin) is made by the thyroid. It is
a protein that can be measured after treatment
(surgery) and during follow-up care. If the protein is
present, there may still be cancer cells in the body.
If it becomes elevated, this could be a sign that
the cancer is coming back and more treatment is
Tg antibodies can be found in a small amount of
people with thyroid cancer. Antibodies are made by
plasma cells (a type of white blood cell) and in this
case, they respond to thyroglobulin. They are called
anti-Tg antibodies. These antibodies are found in
the blood and can interfere with the Tg level. If the
anti-Tg antibody goes from positive to negative
this may be a sign that treatment is working. If it
increases, this can be a cause for concern.
Further testing should be done to check for a
recurrence. A recurrence means the cancer came
A tumor marker known as CEA (
ntigen) can also be found in the blood of people
with medullary thyroid cancer. CEA is a protein and
may be measured at diagnosis and after treatment.
Doctors know this level can be high because of
other conditions, so this test is not used alone for a
The C cells in the thyroid make calcitonin. Medullary
thyroid cancer starts in the C cells. If you are at risk
for medullary thyroid cancer, you may have your
calcitonin level checked. It can also be measured
after treatment for medullary thyroid cancer.
Calcitonin may affect how calcium is made in the
body. Your calcium level may be checked along with
Your doctors will order tests and
schedule visits to talk about
your care plan.
It is helpful to keep track of your
test results at all times. Ask
your doctors questions about