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NCCN Guidelines for Patients



Thyroid Cancer, Version 1.2017

It is helpful to learn all you can about

treatment. Ask your doctor which options

you have. Part 4 will discuss different

treatment types for thyroid cancer.

Surgery is the main treatment for thyroid



Surgery is the main treatment for thyroid cancer.

Typically, either a lobe of the thyroid gland (thyroid

lobectomy) or the whole thyroid (total thyroidectomy)

will be performed with or without removal of neck

lymph nodes. This depends on the type of thyroid

cancer, size of the cancer, location of disease, and if

you are able to have surgery. Surgery may follow an

FNA biopsy that had unclear results. It is the primary

treatment in almost all cases. Primary treatment is

the first treatment used to rid your body of cancer.

Surgical treatment is recommended for most types

of thyroid cancer. It may not be an option for some

people with anaplastic thyroid cancer, due to the

extent of disease. The type of doctor that performs

surgery is called a surgeon. He or she is a specialist

in the field of surgery. Thus, it is important that the

surgeon has experience with thyroid surgery and

performs it frequently.


A thyroid lobectomy removes one lobe of the thyroid

(about half of the thyroid gland), which contains the

nodule. The isthmus is usually removed, too. You

may have a lobectomy after an FNA that did not have

clear results. This type of surgery is usually done

for smaller papillary and follicular types of thyroid


Total thyroidectomy

A total thyroidectomy involves removing the whole

thyroid gland. The surgery itself generally takes

1 to 3 hours. You will be placed under general

anesthesia. An incision will be made in the front

of your neck for removal of the thyroid. It is helpful

to ask your doctor for more information about the

surgery itself and what you can expect.

Keep in mind, other treatment may be given soon

after this surgery. The hope is to treat any cancer

cells that could remain after surgery. Other treatment

like radioactive iodine therapy (see page 32) may be

given for papillary and follicular thyroid cancers. After

treatment, you will take hormone pills to replace the

hormones made by the thyroid.

Sometimes lymph nodes are also removed if they

are cancerous or are a concern for cancer. This

is called a neck dissection. A neck dissection may

be done with the goal to treat or relieve symptoms

caused by the lymph nodes. This surgery can

remove lymph nodes on the same side as the thyroid

nodule (ipsilateral), opposite side of the nodule

(contralateral), or both sides of the neck (bilateral).

Other tissue, besides lymph nodes, in the neck may

also be removed during a neck dissection.

Any treatment can have side effects. Side effects

happen when healthy tissue is damaged during

treatment. Some people have one side effect, others

have more than one, and others have none at all.

Possible side effects of thyroid surgery may include:



Hypoparathyroidism (low levels of calcium in

the blood)



Damage to the nerves that lead to the voice

box, which control your voice and swallowing


Cancer treatment