There are three parts to thyroid cancer treatment -- surgery, radioactive iodine, and medication. The hospitals best equipped to treat thyroid cancer are the large academic centers.

The surgeons and endocrinologists at these centers see many patients with thyroid cancer and are experts in operating on and treating this cancer. They are also up-to-date on the latest developments for treatment of cancer.

• Surgery should be performed to remove as much of the tumor as possible. The size of the tumor will dictate how much of the thyroid gland is removed. Frequently, the entire thyroid gland is removed.
• After the surgery, most (but not all) patients are treated with radioactive iodine, which targets any leftover thyroid tissue and destroys it. This also helps in imaging to look for additional cancer.
• If surgery is not an option, external radiation therapy can be useful.
• If the cancer has spread to other parts of the body, it can be treated with surgery to alleviate compression on bones or nerves by large tumors.
• After surgery, the patient will need to take replacement thyroid hormone for life. This medication is called levothyroxine sodium.

Routine follow-up after treatment involves blood tests every 3 to 6 months, and a radioactive iodine (I-131) scan at 9 to 12 months and then yearly.

Ten-year prognosis for papillary cancer of the thyroid is good. About 95% of adults with this cancer survive 10 years. The prognosis is better for patients younger than 40 and for those with smaller tumors.

Soft-tissue invasion by the cancer, large tumors, being older than 40, and the presence of distant metastases (cancer that has spread to distant parts of the body) are worse prognostic signs.

• After the thyroid gland has been removed, replacement of thyroid hormone with a drug called levothyroxine is required. One must take this for life. Other complications include accidental removal of the parathyroid glands (a gland involved in regulating calcium levels), and damage to a nerve that controls the vocal cords.
• Rarely, spreading of cancer to lymph nodes or through blood vessels to other sites (metastasis) occurs.

Call for an appointment with your health care provider if symptoms of this disorder occur.

Call for an appointment with your health care provider if you have had a thyroidectomy and new symptoms develop, including muscle twitching, cramps, or changes in your voice.