This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on June 7, 2022.
Thyroid cancer experts develop a comprehensive treatment plan based on each patient's overall health, thyroid cancer type and personal preferences.
Each patient's oncology care team will go over the treatment options available. Some of the most common treatments for thyroid cancer are detailed below.
Chemotherapy is sometimes used to sensitize anaplastic thyroid cancers to external beam radiation therapy (EBRT).
The potential side effects of chemotherapy may include nausea, vomiting, hair loss and mouth sores. The care team will use multiple measures to help reduce or moderate chemotherapy-related symptoms. Prior to receiving chemotherapy for thyroid cancer, the patient may receive pre-medications to help make symptoms more tolerable.
Patients with thyroid cancer who have had most or all of their thyroid gland removed by surgery need to take daily hormone supplements in order to maintain their bodies’ normal metabolism.
Maintaining normal or above-normal levels of thyroid hormone in the blood may help reduce the amount of thyroid stimulating hormone (TSH) made by the pituitary gland. TSH is a regulatory hormone that stimulates the growth of the thyroid gland, and may also stimulate thyroid cancer cells. Normally, the pituitary gland makes more TSH when levels of thyroid hormone are low, so increasing these levels can send a signal to reduce production of thyroid stimulating hormone, and potentially help to keep some thyroid cancers from recurring.
If the patient needs to take thyroid hormone therapy, the care team works with him or her to find the right dosage and help manage potential side effects.
Radiation therapy options for thyroid cancer include those listed below.
External beam radiation therapy directs a beam of radiation from outside the body at cancerous tissues inside the body to destroy cancerous cells and shrink tumors. Specific advantages of EBRT for thyroid cancer may include those listed below.
It's an outpatient procedure. This technique does not carry the standard risks or complications associated with major surgery for thyroid cancer, which may include surgical bleeding, post-operative pain or the risk of stroke, heart attack or blood clot.
EBRT is painless.
It poses no risk of radioactivity to the patient or others he or she contacts. So, as the patient undergoes EBRT, he or she may continue normal activities with family and friends.
Intensity modulated radiation therapy (IMRT), also referred to as brachytherapy, uses advanced software to plan a precise dose of radiation, based on tumor size, shape and location. A computer-controlled device called a linear accelerator delivers radiation in sculpted doses that match the 3D geometrical shape of the tumor, including concave and complex shapes. If the patient has previously had radiation therapy for thyroid cancer and is experiencing recurrent tumors in the treated area, IMRT may be an option.
Compared to standard radiotherapy, IMRT allows radiation oncologists to use higher radiation doses than traditional therapies would allow in these areas. At the same time, IMRT helps to spare more of the surrounding healthy tissue from harmful doses of radiation.
Radioactive iodine therapy for thyroid cancer may be used alone or in combination with other treatments, such as surgery. Treatment with radioactive iodine is used most frequently for thyroid cancers that have spread to the lymph nodes and other parts of the body.
Because almost all iodine in the bloodstream gets taken up by the thyroid gland, radioactive iodine (I-131) may be used to destroy the thyroid gland and thyroid cancer cells in lymph nodes or other parts of the body. For this procedure, the radioactive iodine is taken into the body either in liquid or capsule form.
Radioactive iodine therapy is only recommended for differentiated cancer, such as papillary or follicular thyroid cancers. It is not used to treat medullary thyroid carcinoma or anaplastic thyroid cancers, because these types of cancer cells do not take up iodine.
Radioactive iodine for thyroid cancer will cause the body to give off radiation for a period of time, and this requires special precautions to prevent others from being exposed. If the care team thinks treatment with I-131 may be an option, they will discuss the possible risks and benefits the patient, as well as necessary precautions, to help the patient make an informed decision.
TomoTherapy combines a form of IMRT with the accuracy of computed tomography (CT) scanning technology, in one machine. With this technology, the care team delivers more precise radiation to match complex tumor shapes while avoiding sensitive structures. Using built-in CT scanning to confirm the shape and position of the tumor before each treatment, TomoTherapy may reduce radiation exposure to healthy tissues and organs.
TomoTherapy may offer the following advantage for thyroid cancer patients:
A few different types of surgeries may be used to treat thyroid cancer.
For small, well-differentiated tumors that have not spread beyond the thyroid gland, a lobectomy may sometimes be performed. In this type of thyroid cancer surgery, the lobe containing the cancer is removed, leaving the other healthy lobe behind. This may reduce the need to take thyroid hormone treatment after surgery, since a functioning part of the thyroid remains.
In this procedure, most or all of the thyroid gland is removed by surgery (total, near-total or subtotal thyroidectomy). This type of surgery for thyroid cancer is used for most patients. However, because very little or no functioning thyroid tissue is left behind, patients need to take daily thyroid hormone replacement pills afterwards.
When the surgeon suspects that the thyroid cancer cells have spread to nearby lymph nodes, he or she will remove the enlarged or suspicious nodes in order to remove as much of the cancer as possible. Lymph node removal is usually performed at the same time as the surgery on the primary tumor.
Targeted therapy drugs are designed to seek out a specific characteristic in cancer cells, such as a gene mutation or a protein, and attach themselves to those cells. Once attached, these drugs may kill the cells or may help other therapies, such as chemotherapy, work better.
Among the drugs used in targeted therapy are so-called kinase inhibitors, which target specific enzymes called protein kinases that help regulate cell growth. Other targeted drugs, called angiogenesis inhibitors, are designed to prevent tumors from establishing new blood supplies.
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