NCCN Guidelines for Patients
Thyroid Cancer, Version 1.2017
The results from your TSH, ultrasound, and FNA will
determine your next steps of cancer care. Tests may
happen while a nodule is being watched for change.
They can continue during treatment and after
treatment is over. Blood tests may be done more
often. Imaging tests will be done at a certain time.
Doctors can use NCCN treatment guidelines to
make a care plan. This plan is then based on
recommendations from science and the experience
of NCCN experts. Ask your doctors for more
information when it comes to having a biopsy and
Thyroid cancer changed my life.
Finding thyroid nodules
Thyroid nodules may only be seen on an imaging test
like an ultrasound. Most often thyroid nodules are not
cancer. If a nodule is found, it is recommended that 2
tests be done:
Blood test for the TSH level
Ultrasound of the thyroid and neck
TSH controls the hormones made by the thyroid
and may be normal or abnormal for people with
thyroid cancer. If the TSH is low (which may
indicate hyperthyroidism), your doctor may order a
radioiodine imaging uptake test.
You will be given a small amount of radioactive
iodine about 3 to 6 hours before a scan of the
thyroid. The test itself only takes about 10 minutes.
It will show how much of the thyroid takes up iodine.
Too much or too little could indicate other thyroid
problems, like hyperthyroidism (overactive thyroid) or
hypothyroidism (underactive thyroid).
A radioiodine imaging test could find that the thyroid
nodule is autonomously functioning. This means it is
functioning on its own without the need for TSH. This
is also sometimes called a “hot nodule.” If the nodule
is “hot” it most likely is not cancer. You may have an
FNA if the nodule is hypofunctional (low functioning)
If the nodule is most likely not cancer, it may be
followed by an ultrasound in 6 to 12 months. If no
change is seen, then you will have an ultrasound
in 1 to 2 years, and if still no change then every 3
to 5 years after that. You may have an FNA with or
without an ultrasound if the nodule is hypofunctional.