Thyroid Cancer: Is Surgery the Only Solution?

Thyroid cancer is cancer that starts in the thyroid gland. The thyroid gland is located in the front of your neck, just below your Adam’s apple. Surgery is often seen as the only solution to thyroid cancer. However, there are other treatment options available that you may not be aware of.

Thyroid cancer occurs when abnormal cells grow in the thyroid gland. These abnormal cells can spread to other parts of the body if not treated.

There are a few things to consider when deciding on treatment for thyroid cancer. The type and stage of cancer, your age and health, and your personal preferences all play a role in deciding which treatment is best for you.

The following will put light on some of the other thyroid cancer treatment options available to you, aside from surgery.

Diagnosis of Thyroid Cancer

The first step in thyroid cancer treatment is diagnosis. To diagnose thyroid cancer, your doctor will likely order one or more of the following tests:

• Blood test: A blood test can help to check for high levels of thyroid hormones or thyroglobulin.

• Ultrasound: An ultrasound uses sound waves to create a picture of the inside of your body. This can help your doctor see if there are any abnormal growths on your thyroid gland.
• Fine needle biopsy: In this procedure, a thin needle is inserted into the thyroid gland to remove cells for testing.
• Thyroid scan: A radioactive iodine tracer is injected into your bloodstream and then concentrates in your thyroid tissue. An image is then taken of your neck to look for any areas of abnormal thyroid tissue.
• Thyroidectomy: Thyroidectomy is surgical removal of half or full of your thyroid gland. Few reasons for your doctor to suggest thyroidectomy can be:
  

  a) Goiter, i.e. large disfiguring gland putting pressure on your breathing tube/ going towards chest

  b) Thyroid cancer

  c) Diagnosing a suspicious/ indeterminate nodule (diagnostic lobectomy)

  d) Before radio-iodine therapy for advanced thyroid cancer

Stages of Thyroid Cancer

After diagnosis, your doctor will determine the stage of cancer. This helps to determine how far along the cancer is and how best to treat it.

There are four stages of thyroid cancer:

• Stage I: The cancer is confined to the thyroid gland and has not spread to other parts of the body.

• Stage II: Cancer has spread to nearby tissues or lymph nodes but not to other parts of the body.
• Stage III: Cancer has spread to nearby tissues or lymph nodes and to other parts of the body.
• Stage IV: Cancer has spread to distant parts of the body:
  • IVa: where the disease at thyroid is large in size and involves nodes
  • IVb: where the disease has spread in other parts of body aside of neck, i.e. lungs, bones etc.

Thyroid cancer (differentiated) staging is based on age (< 55 and > 55 years). In people < 55 years, stages are only I and II; where as in people > 55 years, stages I, II, III & IV are seen.

Types of Thyroid Cancer

The type of thyroid cancer you have will also play a role in deciding which treatment is best for you. There are four main types of thyroid cancer:

• Papillary thyroid cancer: This is the most common type of thyroid cancer, accounting for about 80% of all cases. It is more likely to occur in women and young adults.

• Follicular thyroid cancer: This type of thyroid cancer accounts for about 15% of all cases. It is more likely to occur in women and middle-aged adults.
• Medullary thyroid cancer: This type of thyroid cancer accounts for about three to five percent of all cases. It is more likely to occur in men and middle-aged adults.
• Anaplastic thyroid cancer: This is the least common type of thyroid cancer, accounting for about two percent of all cases. It is more likely to occur in older adults.

Treatment for thyroid cancer often depends on the stage and type of cancer you have. The most common treatment options are surgery, radioactive iodine therapy, and hormone therapy.

What Happens During Surgery?

The most common type of surgery for thyroid cancer is a total thyroidectomy. This is a procedure to remove the entire thyroid gland. A partial thyroidectomy, which removes only part of the gland, may be an option in some cases.

During surgery, your doctor will make an incision in your neck and carefully remove the thyroid gland. The surrounding lymph nodes may also be removed.
In some cases, it may not be possible to remove all of cancer during surgery. In this case, you may need additional treatment with radioactive iodine therapy or hormone therapy.

After surgery, you will likely need to take medication to replace the hormones that are no longer being produced by your thyroid gland.

Thyroid Hormone Therapy

Thyroid hormone therapy is to supplement the thyroid hormone production of your body partially or completely by external sources, i.e. tablets.

Your doctor may prescribe thyroid hormone therapy in the following cases:

• if you have low hormone production by your own thyroid gland, or
• after complete or partial removal of the gland by surgery

The most common type of thyroid hormone therapy is called levothyroxine. This medication is taken daily and replaces the thyroid hormone that your body is no longer able to produce.

Thyroid hormone therapy can have side effects, such as weight gain, fatigue, and muscle aches. These side effects are usually mild and go away over time.

If you are unable to take levothyroxine for any reason, you may be able to take another medication called liothyronine. This medication is taken three times per week and also replaces the thyroid hormone that your body is no longer able to produce.

Thyroid hormone therapy is often used in combination with other treatments, such as surgery or radioactive iodine therapy.

Thyroid Cancer Treatment Radioactive Iodine Therapy

Radioactive iodine therapy is a treatment that uses radiation to kill cancer cells. The radioactive iodine is taken in the form of a pill or liquid and is absorbed by the thyroid gland.

The thyroid gland then concentrates the radioactive iodine and kills the cancer cells. This treatment can also damage nearby healthy tissues, so it is important to talk with your doctor about the risks and benefits of this treatment.

Radioactive iodine therapy is usually only used for papillary thyroid cancer and follicular thyroid cancer. It is often used after surgery to remove any remaining cancer cells.

This treatment can have side effects, such as nausea, vomiting, diarrhea, and fatigue. These side effects are usually mild and go away over time.

Conclusion

Thyroid cancer is a relatively rare type of cancer, but it is important to be aware of the symptoms and risk factors. If you are diagnosed with thyroid cancer, there are many treatment options available. The best treatment plan for you will depend on the stage and type of cancer you have.

If you have any questions about thyroid cancer or its treatment, be sure to ask your doctor. They can help you understand your diagnosis and create a treatment plan that is right for you.

Apollo Cancer Centres Approach to Cancer Treatment

Apollo Cancer Centres have ushered in international standards in cancer care wherein the focus is on early diagnosis of the ailment and adoption of structured approach for the treatment. Along with advanced diagnostics, this also involves application of molecular pathology, and organ specific tumor board approach to arrive at a consensus among clinicians on what can be the best course of treatment for the patient under the available modalities at Apollo Cancer Centres viz. Surgical Oncology, Medical Oncology, Radiation Oncology & Nuclear Medicine. The Tumor Board consists of a panel of clinicians with significant experience in Medical, Surgical and Radiation oncology, who are supported by Onco-Radiologist & Histo-Pathologist to win over cancer.

At Apollo Cancer Centres, we aim to bring together the best minds in Oncology to discuss and deliberate the emerging trends in cancer management and their impact on clinical practice. Each of our patient care teams combine the skills and experience of several healthcare professionals, who specializes in diagnosing and treating a particular type of cancer associated with an organ. This has led to the development of ‘Clinical Management Teams’ (CMT). Our team members meet regularly to discuss diagnostics and treatment related support for patients, meaning that each patient benefits from a wide range of expertise. Having clinicians of many different disciplines involved in your care, ensures that you will receive the best possible treatment for your specific needs.

Do connect with the experts at Apollo Cancer Centre for thyroid cancer diagnosis and treatment.
Request an appointment at Apollo Cancer Centres online or by calling 1800-203-1066.