Thyroid Cancer

Treatment

Mayo Clinic offers the latest treatment options to patients. Treatment decisions are based on each patient's needs. Clinical trials, which are new therapeutic approaches being further evaluated in carefully controlled studies, may sometimes be appropriate for patients with thyroid cancer.

Surgery

Surgery is usually the only treatment necessary for benign thyroid gland tumors. Specialists at Mayo Clinic recommend near total or total thyroidectomies (thyroid gland removal) when malignant cells are present. These procedures ensure the best chance for survival and the lowest risk for recurring cancer. At Mayo Clinic, skilled surgical pathologists work with the surgeon during the operation. The pathologist examines layers of the patient's tissue under a microscope to determine the cell type (benign or malignant) and whether cancer has spread to lymph nodes. This operation usually requires only one to two days of hospitalization.

Radioactive Iodine Treatment

Radioiodine therapy (radioactive iodine) destroys thyroid tissue that may be left after thyroid surgery. This can limit the chance for cancer to recur. It can also be used to treat thyroid cancer that has spread beyond the thyroid gland. Patients take radioiodine therapy orally.

Thyroid Hormone Therapy

After a thyroidectomy, the patient takes a thyroid hormone replacement drug (levothyroxine) for the rest of his or her life. This therapy will help sustain normal hormone levels and suppress the pituitary gland's production of thyroid-stimulating hormone (TSH), which could otherwise aid the reproduction of any remaining cancer cells.

Radiation Therapy

Malignant thyroid tumors rarely require external beam radiation after surgery. (External beam radiation is directed at the cancer site from outside the body.) It may be considered for treatment of inoperable tumors, for tumors that have spread and are causing symptoms, and in cases when the risk of recurrence is high. Mayo Clinic offers state-of-the-art radiation therapy, including intensity modulated radiation therapy (IMRT). IMRT and other radiation technologies allow the radiation oncologist to treat the cancer effectively while limiting the amount of radiation to important normal tissues such as the lungs, esophagus, larynx and spinal cord.

Alcohol Ablation

Mayo physicians have recently pioneered an alcohol ablation treatment for recurring thyroid cancers. Currently the treatment is available only at Mayo Clinic. Physicians use the treatment mainly for patients with limited recurrence in the neck, either lymph nodes or thyroid bed. The advantage of this treatment over other therapies is that it does not require surgery and is effective for tumors that cannot be treated with radioactive iodine. One hundred patients have already been treated with alcohol ablation for thyroid cancer recurrence at Mayo Clinic in Minnesota.

Chemotherapy

Chemotherapy is typically only used for anaplastic thyroid tumors or for certain other cases that have metastasized (spread). In patients with widespread (metastatic) thyroid cancer, chemotherapy (including both commercially available agents and drugs in clinical trials) and/or octreotide (hormonal therapy) are sometimes utilized.