NCCN Guidelines for Patients
Thyroid Cancer, Version 1.2017
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
Some are local treatments like surgery or radiation
to a specific area. For example, SBRT (
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.
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
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.