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16

NCCN Guidelines for Patients

®

:

Thyroid Cancer, Version 1.2017

TSH

A blood test to check the TSH (

t

hyroid-

s

timulating

h

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.

Thyroglobulin

Tg (

t

hyro

g

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

needed.

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

back.

CEA

A tumor marker known as CEA (

c

arcino

e

mbryonic

a

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

diagnosis.

Calcitonin

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

calcitonin.

2

Testing

Blood tests

Your medical

records:

ü

Your doctors will order tests and

schedule visits to talk about

your care plan.

ü

It is helpful to keep track of your

test results at all times. Ask

your doctors questions about

the results.