Surgery

Regardless of the type of thyroid cancer you have, it is likely you will need an operation.

Surgical removal of the diseased thyroid and examination of the removed tissue is standard medical practice.

In some cases, your thyroid may be scanned before surgery using computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET), to build up a 3-D image, which can help guide the surgeon during the operation. 

Generally, the surgeon will remove all of your thyroid (this is called a full or total thyroidectomy) to ensure that the cancer is completely removed. Sometimes, only part of the thyroid is removed (this is called a lobectomy or hemithyroidectomy) or the decision to remove all of the thyroid is only made during surgery. 

Often, thyroid cancer is cured by surgery alone, especially if the cancer is small. If the cancer is larger, if it has spread to lymph nodes or if your doctor feels that you are at high risk for recurrent cancer, radioactive iodine may be used to destroy any remaining thyroid cancer cells after the thyroid gland is removed.

Without a thyroid gland, the body loses the ability to produce thyroid hormones, so you have to take them after surgery in tablet form (thyroid hormone replacement therapy). 

Taking thyroid hormone replacement

Following a total thyroidectomy, you will become hypothyroid, which will then require treatment with thyroid hormone.

Your doctor will monitor your thyroid hormone levels through regular blood tests as thyroid replacement tablets may have side effects. Too much thyroid hormone (hyperthyroidism) might cause weight loss, chest pain, rapid heart rate, irregular heartbeat, cramps, and diarrhoea. You might feel hot and sweaty. Bone loss or osteoporosis is also possible. Too little thyroid hormone (hypothyroidism) may cause tiredness, weight gain, and dry skin and hair. You may also feel cold.

The dose of thyroid hormone you need is different for every patient, and it can change as you get older. You should talk with your doctor about what signs to look for that may mean it is time to adjust your dose of hormone supplementation.