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
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
Damage to the nerves that lead to the voice
box, which control your voice and swallowing