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Treatment of thyroid cancer

Thyroid cancer is treated using:

  • surgery
  • thyroid suppression with medication
  • radioactive iodine
  • external radiation treatment

In 75-80% of the patients, the treatment is intended to cure the disease. Adjuvant treatment with radioactive iodine is given to the majority of patients to remove remaining tumor tissue.

For locally advanced cancer, all identifiable tumor tissue should be removed, even if this involves recurrence nerves, larynx cartilage, the trachea, and the esophagus. Loss of function and morbidity as a result of surgery must be assessed individually and related to other treatment possibilities. Locally advanced thyroid cancer should be treated on a regional level.

For undifferentiated (anaplastic) carcinoma without distant metastases, a combination of external radiation and chemotherapy before surgery may be the best choice of treatment. Medullary thyroid carcinoma is treated by a total thyroidectomy with lymph node dissection.

Radioactive iodine is part of primary treatment for differentiated thyroid carcinoma. Iodine scintigraphy shows uptake near the midline in the thyroid region, which is assumed to be microscopic remains of thyroid tissue. In such cases, an ablation dose of radioactive iodine is given to destroy the remaining thyroid tissue. The basis for using s-thyroglobulin as a biochemical marker for recurrence is optimal when the thyroid tissue is not present.

There are clinical and experimental evidence that TSH suppression inhibits development of recurrence and metastasis of differentiated follicle cell-derived carcinomas (FTC and PTC).

For advanced illness, treatment is palliative radiation therapy and sometimes palliative surgery.

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