What Treatment Could I Have for My Thyroid Cancer?
At Siteman, we offer many specialized treatments for thyroid cancer, including surgery and radiation therapy. Your doctor will decide to use them alone or combine them to get the best results for you. Your cancer is unique, so your treatment should be too.
After we have a precise diagnosis and have evaluated your case, your doctor will create a treatment plan designed specifically for you. This plan may combine standard treatments with new therapies that are only available through clinical trials. That’s why getting an accurate diagnosis matters so much.
Is Surgery Ever Used for Thyroid Cancer?
If you have thyroid cancer or non-cancerous thyroid lumps, you may need surgery as part of your treatment.
The surgery can include:
- Removing parts of your thyroid
- Taking a biopsy
- Removing nearby lymph nodes
We decide on the surgical approach based on your individual case. Some patients may be eligible for a scarless thyroidectomy. Our surgeons are some of the only physicians who offer this trans-oral surgical approach in the U.S.
Our head and neck surgeons have advanced training and are experts at protecting your vocal cords and vocal nerves when they remove part or all of your thyroid gland. Before your surgery, a team of experts will meet with you to discuss your surgical plan. They’ll explain whether you’re eligible for new techniques like scarless thyroidectomy, what side effects you might experience, and how we’ll care for you after surgery.
Types of Thyroid Surgery
- Lobectomy: We remove only the side of the thyroid where we found the cancer. We may also remove lymph nodes nearby and test them for cancer.
- Near-total thyroidectomy: We remove most of your thyroid but leave a small part.
- Scarless thyroidectomy: We remove part or all of your thyroid or parathyroid through your mouth (transoral) instead of through your neck. The surgeon makes three small cuts in the lower part of your mouth and uses special instruments to perform the surgery. Since the scars are inside your mouth where others can’t see them, we call this “scarless” surgery.
- Total thyroidectomy: We remove your entire thyroid.
- Lymph node dissection: We remove lymph nodes in your neck that contain cancer.
Whatever kind of surgery you have, you will need follow-up care afterwards for monitoring. The thyroid creates important hormones in the body, so you will need to replace them with a supplement.
Synthetic hormone pills work to help your body function like it did before cancer. An added benefit of these supplements is cancer prevention. The right level of thyroid hormones can stop cancer cells from returning and growing.
When Do Patients with Thyroid Cancer Receive Radiation Therapy?
Radiation therapy plays an important role in treating thyroid cancer. It is often used with surgery to cure patients of the disease. Siteman experts, called radiation oncologists, evaluate patients’ diagnoses to decide what kind of radiation therapy could be best for their kind of thyroid cancer, their cancer stage (1-4), and their symptoms.
One of the earliest cancer treatments used radioactive iodine to deliver small amounts of radiation directly into the gland. There have been many breakthroughs since, but it remains an effective way to combat cancer that has not spread outside of the thyroid gland.
Radioactive Iodine Therapy
Surgery is just one part of most treatment plans. After we remove part or all of your thyroid gland, many patients work with an expert called a radiation oncologist. This doctor uses radioactive iodine to kill any remaining cancer cells.
Radioactive iodine therapy with I-131 can be a pill or a liquid you swallow. The thyroid naturally absorbs iodine, so the radioactive iodine collects in any thyroid tissue left in your body after surgery and kills cancer cells. This is an effective treatment for most kinds of thyroid cancer, but not medullary thyroid cancer.
Intensity Modulated Radiation Therapy (IMRT)
IMRT is an advanced type of external beam radiation therapy. IMRT lets our radiation specialists shape the radiation to match the exact three-dimensional form of your tumor. This makes IMRT ideal for treating irregularly shaped tumors.
With IMRT, our specialists can also adjust the amount of radiation in each beam aimed at the tumor. They can turn the radiation on and off during treatments. This precise control means there is less radiation in your body and less radiation exposure to healthy tissue. Siteman often uses IMRT for head and neck cancers, including thyroid cancer. This can reduce the negative side effects of treatment.
Theranostics
Theranostics combines diagnosis and therapy. It uses special medicines called radiopharmaceuticals to create images and deliver targeted radiation therapy to cancer cells. This targeted approach to cancer care combines:
- High-resolution imaging from PET or SPECT scans with
- Highly specialized, radioactive medicines that target cancer cells
Each radiopharmaceutical works differently in patients, but all aim to maintain your quality of life during treatment. Theranostics can reduce or even reverse negative side effects like pain, low energy, and hormone imbalances. We usually provide these therapies on an outpatient basis under a physician’s supervision, so you can go home after your treatment.
Targeted Therapy
Targeted therapy is a treatment we use at Siteman to slow cancer growth. Not every patient can have surgery. And others have cancer that has spread to other parts of the body and metastasized. For these patients, we use tyrosine kinase inhibitors to slow cancer growth.
Tyrosine kinase inhibitors are an FDA-approved drug that blocks the enzymes that thyroid cancer cells need to keep growing. This drug stops tyrosine kinase and starves the cancer cells, so it can’t cause more damage in the body.
Hormone Therapy
Oral hormones can stop cancer cells from growing. When we treat thyroid cancer, we can use hormones to stop your body from making other hormones that might help cancer cells grow. We also use hormone supplements to replace what your thyroid gland made after we remove your thyroid gland.
Radiofrequency Ablation
Radiofrequency ablation is a non-surgical treatment that uses radiofrequency waves to overwhelm and kill cells inside a thyroid nodule. Radiofrequency ablation (RFA) is used for patients who have non-cancerous nodules or have an early-stage cancer. Because RFA can be done while you are awake, it can be a good option for patients who can’t undergo surgery.
For an RFA procedure, a WashU Medicine head and neck surgeon uses local anesthesia to numb the area. Then they insert a probe that looks like a large needle into the mass of cells. Intense waves make direct contact with tumor cells. As these cells die, your body naturally removes them. The whole process shrinks the nodules over time. Our physicians monitor all patients who have had RFA very closely. They watch and wait to see if the cells return.
Will Clinical Trials Be Part of My Treatment Plan?
As a research medical center, Siteman Cancer Center can offer you access to many clinical trials. Trials are a kind of research that tests new therapies as researchers develop them. Many WashU Medicine physician-researchers lead these trials. They can focus on finding breakthroughs in medical, surgical, and radiation treatments. We encourage all patients to explore their options with clinical trials. If your doctor hasn’t mentioned them yet, ask how clinical trials might help treat your cancer.
Your Second Opinion at Siteman
Siteman wants to be your first choice for cancer care, but that might not always be possible. If you have received a cancer diagnosis, started care somewhere else, or are a physician seeking specialized care for your patient, ask us about a second opinion. You can start the process. To make it easy, our care coordinators guide scheduling for yourself or your patient.
