NCCN Guidelines for Patients
Thyroid Cancer, Version 1.2017
Not all the side effects of surgery are listed here.
With any surgery, there is risk of infection, bleeding,
or pain. Your treatment team can give you a
complete list of side effects.
After surgery, you will stay in the hospital for a
couple of days and then be discharged to home. It is
important that you follow your doctor’s orders when
it comes to healing. Call your doctor or nurse if you
have any side effects, especially if they continue, get
worse, or come on suddenly.
Plan and schedule your follow-up appointments so
your doctor knows how you are feeling. He or she will
tell you when you can return to your normal activities.
Ask your doctor about your next steps of care.
Many cancers that come from the thyroid gland
take up iodine in your body. Papillary and follicular
cancers usually “eat” iodine and use it in the cancer
cells. Thus, RAI (
odine) can be given
as treatment. The cancer cells that eat enough
radioactive iodine are killed by the radiation. This
treatment is also known as 131-I or 131-I ablation.
If this is the case, this type of treatment may be an
option. RAI is given as a treatment for papillary and
follicular thyroid cancer. RAI may not work for Hürthle
cell cancer. RAI does not work for medullary or
anaplastic thyroid cancer.
Radioactive iodine treatment will target the thyroid
cancer cells in the neck. It will also go after those
cells that have moved from the thyroid to other areas
of the body. The doses are higher with this treatment
than those given during a radioactive imaging scan.
The goal is to treat only the thyroid cells and avoid
harming your healthy tissue. RAI is usually given
after thyroid cancer surgery.
RAI is not effective to destroy the cancer without
first having a surgeon remove the thyroid gland and
cancer that can be surgically removed. Radioactive
iodine treatment is effective when used for two
reasons: 1) to get rid of any remaining thyroid tissue;
and 2) to destroy any thyroid cancer cells that remain
after surgery (adjuvant therapy).
RAI therapy comes in liquid or pill form and is taken
by mouth. You may be asked to eat a diet low in
iodine for 1 to 2 weeks before getting this treatment.
This type of treatment works best when the TSH
level is high and Tg is present. Hormone injections
may be given to increase the TSH several days
before giving RAI. This treatment is typically given
if thyroid cancer is growing beyond the thyroid, the
main tumor is more than 4 cm, and Tg is 5 to 10
RAI therapy is recommended for those at higher risk
for the cancer to come back, such as some cancers
of smaller size with extension outside the thyroid
gland (1–4 cm), or cancer in the lymph nodes. Your
doctor will gather information and decide if RAI is an
option for you. If your doctor and you decide RAI will
follow surgery, here are some side effects that may
Nausea and vomiting
Dry mouth or eyes
Change in taste or smell
RAI can affect both a man and woman’s