How Thyroid Cancer Treatment Can Cure Patients

Treatment for thyroid cancer is decided upon using multiple factors—the type of thyroid cancer present, the stage of the cancer (how large it is and if it has spread outside of the thyroid), and any other health conditions the person has.

The most common types of thyroid cancer can often be cured (such as papillary thyroid cancer) as they tend to grow more slowly than the rarer forms of thyroid cancer, such as anaplastic thyroid cancer.

Common treatment options include surgery, radioactive iodine therapy, and external radiation therapy. Targeted therapy may be used in advanced thyroid cancer. This article will review the treatments for thyroid cancer based on stage and what to expect from these treatments. 

Thyroid Cancer

Does Thyroid Cancer Treatment Prolong Life Expectancy?

A diagnosis of thyroid cancer is likely to make your question your life expectancy with this disease. Although each person should discuss this with their own oncology team, the prognosis of most thyroid cancers is quite good with treatment.

For example, differentiated thyroid cancers (which includes over 90% of thyroid cancers), such as papillary thyroid cancer and follicular thyroid cancer, have an overall survival rate of 98.3% at five years. This means that 98.3% of people with that cancer are still alive five years following their diagnosis.

The statistics are even better when these are diagnosed while still localized, with greater than 99.5% five-year survival. With thyroid cancer, 64% of people are diagnosed when it is localized, 30% when it has spread to regional lymph nodes, and 3% when it has spread to distant areas.

Anaplastic thyroid cancer makes up 1% to 2% of cases. Unfortunately, it has a lower five-year survival rate of 39% when diagnosed while localized, 11% if regional, and 4% with a distant spread.

When developing a treatment plan for thyroid cancer, multiple healthcare providers can be a part of the decision-making process. This can include a surgeon, radiation oncologist, medical oncologist, and endocrinologist. Together, they will develop the best treatment plan based on the type and stage of the cancer. 

Thyroid Cancer Treatment Based on Stage 

The cancer stage, or how advanced the cancer is, is determined by categorizing the size of the tumor, the presence of cancer in nearby lymph nodes, and if the cancer has spread to distant areas of the body. Different types of thyroid cancer have different stages.

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What Patients Should Know About Thyroidectomy

Differentiated Thyroid Cancer

Differentiated thyroid cancer—which includes the papillary and follicular types—is the most commonly diagnosed. For stages 1 to 3, treatment will include surgery.

Surgery can include a lobectomy, in which only part of the thyroid is removed, or a total thyroidectomy, during which the entire thyroid is removed. Thyroid hormone replacement therapy will be needed to replace the hormone that is no longer being made if a total thyroidectomy is done.

Following surgery, radioactive iodine treatment may be needed to kill any remaining thyroid cancer cells in the body. A large dose of radioactive iodine is given in pill or liquid form. It is then taken up by any thyroid cells left behind, killing them.

External beam radiation may also be needed in some cases. This type of therapy uses a machine to deliver high-energy radiation beams to kill the remaining thyroid cancer cells.

In some instances, if the cancer is smaller than the size of a pea and hasn’t spread into any nearby lymph nodes, an active surveillance (watchful waiting) approach to therapy may be taken.

With active surveillance, no treatment (including surgery) will be given as the cancer is slow-growing. Treatment won’t begin until the cancer starts to grow. The tumor will be followed regularly with imaging tests, such as ultrasound, to see how it is growing.

For advanced (stage 4) differentiated thyroid cancer, many previously described treatments will be used, including surgery, radioactive iodine treatment, and external radiation. However, additional treatments may be needed as well.

Targeted therapy with a tyrosine kinase inhibitor may be used to target the pathways the cancer is using to grow. Examples of this type of medication include Nexavar (sorafenib) and Lenvima (lenvatinib).

Clinical trials may be recommended. These are done to help determine if new treatments or combinations of treatments are effective against the cancer.

Medullary Thyroid Cancer

For early stages of medullary thyroid cancer, surgery and radiation may be used. Radioactive iodine treatment is not used to treat medullary thyroid cancer. If the cancer is more advanced, different medications may be added to treat the cancer.

Additional testing of the cancer may be done to see if the cancer contains certain types of mutations that may allow other medications to be used. If the tumor mutational burden (TMB) is high, immunotherapy with Keytruda (pembrolizumab) may be used.

If an RET mutation is found, Retevmo (selpercatinib) or Gavreto (pralsetinib) can be used. Other targeted therapy may be used if these mutations are not found.

Anaplastic Thyroid Cancer

Anaplastic thyroid cancer is the most aggressive form of thyroid cancer, and as such is only given a stage 4 diagnosis. Treatment is not usually given with the intent to cure the cancer but to help manage symptoms and prolong life.

Treatments can include surgery as well as external beam radiation. Other treatments can include chemotherapy and targeted therapy if certain mutations exist in the cancer.

Clinical Trials

Clinical trials are an option for anyone with any cancer diagnosis. People often associate clinical trials with being a "guinea pig," but that isn't necessarily the case. Clinical trials can use medications that have been shown to work and compare them against the standard of care treatment to see which outcomes are better.

Ask your healthcare team about clinical trials that may be appropriate for you.

Regardless of the type of cancer or the treatments given, costs are associated with these treatments. How much your particular treatment can cost will depend upon the exact type of treatment you receive and if you have insurance. Talk with your cancer care team if you need specifics and if you need any help in paying for your medical bills. 

Thyroid Cancer Treatment: Post-Op

Surgery for thyroid cancer can include a lobectomy, in which only part of the thyroid is removed, or a total thyroidectomy in which the entire gland is removed. For most people, surgery is done with the intent of curing the person of thyroid cancer.

Following surgery, you may experience hoarseness in your voice, as the area of surgery is located near the vocal cords. There is a small risk that the hoarseness can be permanent if the nerve supplying the vocal cords is damaged during surgery. 

Following surgery, ongoing thyroid hormone replacement may be needed, especially if the entire thyroid is removed. As there is limited or no thyroid tissue left after surgery, artificial replacement of the thyroid hormone needs to be given to continue to support the metabolic functions of the hormone. Labs will be monitored periodically to ensure the levels are where they need to be.

Other labs that need to be followed include monitoring for hypoparathyroidism. The parathyroid glands are located near the thyroid and are responsible for maintaining appropriate calcium levels in the body. These can be damaged by surgery, and regular monitoring of calcium and vitamin D levels is important to look for hypoparathyroidism.

Thyroid Cancer Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor discussion guide

Where Do Patients Get Thyroid Cancer Treatment?

Each person’s journey with thyroid cancer may look different, and who’s involved in their care may be different as well. Healthcare providers that are part of the care team for thyroid cancer include:

  • Primary care provider
  • Surgeon
  • Endocrinologist (specialist in conditions affecting glands producing hormones)
  • Radiation oncologist (specialist in treating cancer with radiation therapy)
  • Medical oncologist (specialist in treating cancer with medications, including chemotherapy)

Some of these providers may work together as part of a larger, comprehensive cancer center. Other people may receive care from each of these providers individually.

However you receive your treatment for thyroid cancer, be sure you’re with healthcare providers you are comfortable with and who have experience in treating your type of cancer. You should also be comfortable asking them the questions that you have about your treatment and prognosis. 

Recurrent Thyroid Cancer After Treatment 

When treatment for thyroid cancer is complete, you’ll likely be monitored regularly for recurrent disease. This can include blood tests and imaging, such as ultrasound. If testing shows that the cancer has recurred, additional treatment may be offered.

Some treatments may be similar to what was done previously, including surgery, radioactive iodine, or external beam radiation, especially if the cancer has only recurred in the area of the neck.

If cancer has recurred in other areas of the body, additional testing of the cancer cells will likely be done to see if the cancer cells harbor any actionable mutations, such as RET or NTREK. These mutations may allow targeted therapy to be given. In some instances, immunotherapy with Keytruda can be used.

Self-Care During Thyroid Cancer Treatment 

During thyroid cancer treatment, self-care is very important. What each person needs will be based on their individual treatment plan.

Being informed and feeling comfortable in making treatment decisions should be of focus. You should be able to ask questions and have discussions that allow you to make decisions with all of the information you need. Ask what side effects of treatment to expect and measures you can take if they do.

Support groups may be helpful, and finding one that has others with your type of cancer and stage may be the most beneficial. Your oncology team may have suggestions on where to find the best support group for you.

Taking care of yourself physically during treatment is important. Eating a well-balanced diet and getting some form of exercise can help you feel your best.

Summary 

The most common types of thyroid cancer are often curable with treatment. The most commonly used treatment is surgery. If needed, radioactive iodine treatment and external beam radiation may be used.

If thyroid cancer has spread to other areas of the body, it may be treated with additional therapies such as chemotherapy, targeted therapy, or immunotherapy. 

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Comprehensive Cancer Network. NCCN guidelines for patients: thyroid cancer.

  3. American Cancer Society. Thyroid cancer survival rates, by type and stage.

  4. National Cancer Institute. Cancer stat facts: thyroid cancer.

  5. National Cancer Institute. Anaplastic thyroid cancer.

  6. National Cancer Institute. Thyroid cancer treatment.

  7. Ulisse S, Baldini E, Lauro A, et al. Papillary thyroid cancer prognosis: an evolving fieldCancers. 2021;13(21):5567. doi:10.3390/cancers13215567

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By Julie Scott, MSN, ANP-BC, AOCNP
Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community.