Treatment

Treatment for thyroid cancer depends on the type of thyroid cancer you have and how far it has spread.

The main treatments are:

• a thyroidectomy surgery to remove part or all of the thyroid
• radioactive iodine treatment you swallow a radioactive substance that travels through your blood and kills the cancer cells
• external radiotherapy a machine is used to direct beams of radiation at the cancer cells to kill them
• chemotherapy and targeted therapies medications used to kill cancer cells

You'll also needcontinuing care after treatment to check for and prevent any further problems.

Your treatment plan

You'll be cared for throughout your treatment by a team of healthcare professionals. Yourteam will recommend what they feel is the best treatment for you.

This will largely depend on the Thyroid cancer you have. For example:

• papillary carcinoma and follicular carcinoma canusually be treated with surgery followed by radioactive iodine treatment
• medullary thyroid carcinoma is usually treated with surgery to remove the thyroid, often followed by radiotherapy
• anaplastic thyroid carcinoma can'tusually be treated with surgery, butradiotherapy and chemotherapy can helpcontrol the symptoms

You may want to write down a list ofquestions to askyour team before you go to hospital to discuss your treatment options.

Surgery

Surgery is the first treatment for most types of thyroid cancer. It may involve removing:

• part of the thyroid
• the whole thyroid
• nearby lymph glands

The operation is carried outunder a general anaesthetic ,where you're asleep. Most people are well enough to leave hospitalafter a few days.

You'll need to rest at home fora few weeks and avoid any activities that could put a strain on your neck, such as heavy lifting. You'll have a small scar on your neck,but thisshould become less noticeable over time.

It's a good idea to talk to your surgeon about the exact operation they recommend and find out what it involves.

Radioactive iodine treatment

A course of radioactive iodine treatment is often recommended after surgery.This willhelp destroy any remaining cancer cells in your body andreduce the risk ofthe cancer returning.

Preparing for treatment

An iodine-richdiet may reduce the effectiveness of radioactive iodine treatment, so you'll be advised to follow a low-iodine diet for a week or two before treatment begins.

It's recommended that you:

• avoid all seafood
• limit the amount of dairy products you eat
• don't take cough medicines thesecan contain iodine
• eat plenty of fresh meat, fresh fruit and vegetables ,pasta and rice

Tell your care team if you think youcould be pregnant, as the treatment isn't safe during pregnancy.

Women should avoid getting pregnant for at least six months afterwards, and men should avoid fathering a child for at least four months.

If you're breastfeeding, you'll ideally need to stop for at least eight weeks before treatment starts.

You should avoid breastfeeding your current child after treatment, but youcan safely breastfeed any babies you may have in the future.

The procedure

Radioactive iodine treatment involves swallowing radioactive iodine in either liquid or capsule form. Theiodine travels through your blood and kills any cancerous cells.

You'll need to stay in hospital fora few days afterwards because the iodine will make your body slightly radioactive. As a precaution, you'll need to stay in a single room and won't be able to have visitors at first.

You'll be able to have visitors andgo home once the radiation levels in your body have come down. Your care team will advise you whether you need to take any precautions after going home.

Side effects

Side effects of radioactive iodine treatment are uncommon, but can include:

• neckpain or swelling
• feeling sick
• a dry mouth
• an unpleasant taste in the mouth

Thetreatment doesn't affect fertility in women.Fertility can be reduced in men after treatment, but it should improve over time.

External radiotherapy

External radiotherapy may be usedto reduce the risk of thyroid cancer coming back after surgery if radioactive iodine treatment isn't suitable or is ineffective.

Itcan also be used to control symptoms of advanced or anaplastic thyroid carcinomas if they can't be fully removed with surgery.

External radiotherapyusually involvestreatment once a day from Monday to Friday, with a break at weekends, for four to six weeks.

Side effects of radiotherapy can include:

• feeling and being sick
• tiredness
• pain when swallowing
• a dry mouth

These side effects should pass within a few weeks of treatment finishing.

Chemotherapy and targeted therapies

Chemotherapy is rarely used for thyroid cancer nowadays, but it's sometimes used to treat anaplastic thyroid carcinomas that have spread to other parts of thebody.

Itinvolves taking powerful medicines that kill cancerous cells. It doesn't cure thyroid cancer, butmay help control the symptoms.

More recently, newer medicinesknown as targeted therapies have been used more widely to treat several types of thyroid cancer.

These specifically target cancer cells, rather than harming healthy cells at the same time as chemotherapy does.

Targeted therapies still aren't offered routinely on the NHS, but may be available through the Cancer Drugs Fund in special circumstances.

Alternatively, your care team may suggest taking part in a clinical trial studying targeted therapies for thyroid cancer.

After treatment

After your treatment has finished you may need to continue taking medication to reduce the risk of further problems.

You'll also be advised to have regular check-ups to look for signs of the cancer coming back.

Medication and supplements

If some or all of your thyroid gland is removed, it will no longer produce thyroid hormones.

This means you'll need to take replacement hormone tablets for the rest of your life to prevent symptoms of an underactive thyroid , such as fatigue, weight gain and dry skin.

Occasionally, the parathyroid glands can be affected during surgery. These glands are located close to the thyroid gland and help regulate the levels of calcium in your blood.

If your parathyroid glands are affected, your calcium levels may temporarily decrease. If this happens, you might need to take calcium supplements until the glands start to function normally again.

Follow-up tests

Thyroid cancer can come back after treatment, so you'll be asked to attend regular check-ups to look for signs of this.

You may need tests every few months to begin with, but they'll be needed less frequently over time.

Tests you may have include:

• ablood test to detect substances released by cancerous thyroid cells
• an ultrasound scan to check for signs of cancer in your neck
• a radioisotope scan a type of scan that highlights cancerous thyroid cells

Treatment will usually need to be repeated ifyour cancer does come back.