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54

NCCN Guidelines for Patients

®

:

Thyroid Cancer, Version 1.2017

5

Treatment guide

Review

If the disease is persistent and continues to grow, or

spreads to other areas whether local or distant, more

treatment can be given. It may be treatment you had

before or a new option. The treatment options are

listed in

Guide 18

.

Some are local treatments like surgery or radiation

to a specific area. For example, SBRT (

s

tereotactic

b

ody

r

adiation

t

herapy) may be considered for

metastatic disease when RAI therapy is not possible.

Other options are systemic treatment with drugs like

lenvatinib, sorafenib, or other kinase inhibitors. For

example, when disease is in the bone, doctors give

drugs like a bisphosphonate or denosumab to slow

down damage to bones.

The treatment offered depends on the location of

disease and whether or not it is slow growing. Your

doctor will assess how far and how quickly the

cancer is growing. Ask your doctor questions so you

understand what options are available to you.

Review

†

†

Differentiated thyroid cancers include papillary,

follicular, and Hürthle cell.

†

†

Surgery is the preferred primary treatment

option for papillary thyroid cancer.

†

†

Surgery is the most common treatment for

follicular and Hürthle cell thyroid cancer.

†

†

Hürthle cell cancer also often does not take up

iodine, so treatment with RAI may not work as it

will for other thyroid cancer types.

†

†

When the thyroid cancer takes up (eats)

radioiodine, RAI therapy will be considered for

treatment.

†

†

After any treatment, the surveillance and

maintenance phase will start. This will include

follow-up care with blood tests, imaging tests,

and physical exams.

†

†

If the disease is persistent and continues to

grow, or spreads to other areas whether local or

distant, more treatment can be given.