Thyroid cancer

A small cut is usually made in the centre of your neck to get directly at your gland. If any tissue is left behind after surgery, you might need radioiodine therapy later.

Your surgeon might need to remove some of the tissues in the area around the thyroid gland if you have anaplastic thyroid cancer or if the cancer has begun to spread outside the thyroid gland.

The thyroid gland has 2 halves called lobes. Sometimes it is possible to remove just the affected lobe. This is called a lobectomy or partial thyroidectomy. 

Your surgeon might remove some or all of the lymph nodes close to your thyroid gland during your thyroid cancer surgery. These can be examined under a microscope to see if cancer has spread to them or not. Removing the lymph nodes is called a lymphadenectomy or a neck dissection. As many nodes as possible are removed to prevent the cancer from coming back.

Sometimes there may be slight damage to the nerves to the voicebox (larynx). This can make your voice sound hoarse and weak. In most cases it a temporary problem, but it can be permanent for a very small number of people.

If there is damage to your parathyroid glands during surgery, the calcium levels in your blood may drop. Signs of low calcium levels include tingling in your hands, feet or around your mouth. Or you may have unusual muscle movements, such as jerking or muscle cramps. You will have regular blood tests to check the calcium levels in your blood. If needed, your doctor will prescribe calcium, and possibly vitamin D, until your levels are normal again. 

You may experience some neck stiffness for a few days or weeks after your surgery. Your doctor will prescribe painkillers to help with this. 

It is natural to be worried about scars after surgery. You will have a small scar across the front of your neck just above your collar bone. The scar will look red or dark at first but will fade with time. It is usually very neat and fades to a pale silver, depending on your complexion.

The usual thyroid hormone replacement is thyroxine, which is also called T4. You will be given this replacement for the rest of your life.

Without these hormones, you would develop signs and symptoms of an underactive thyroid. This is called hypothyroidism. Signs of it include weight gain, tiredness, dry skin and hair, and physical and mental slowness.

Most people only need to take the drug once a day, but at the same time every day. It may take some months to find the correct dosage for you. As a result, you will have blood tests to check your hormone levels regularly. 

For many patients, an important part of treatment is keeping thyroid-stimulating hormone (TSH) levels low. TSH is made by the pituitary gland in your brain and it can encourage the growth of thyroid cancer cells. 

By keeping TSH levels low, it prevents thyroid cancer developing. By giving higher than normal doses of thyroid hormone, TSH levels can be kept very low. This is also known as TSH suppression. You may be given thyroid hormone if only part of your thyroid gland
is removed. 

TSH will be kept low for at least 1 year after radioactive iodine therapy or until you complete the surveillance testing.