Getting diagnosed with any malignancy can be scary. But if you are diagnosed with a thyroid malignancy, you may have the highest chances of getting cured. Thyroid cancers may be of different types: papillary carcinoma, follicular carcinoma or medulllary carcinoma. Rarer varieties and mixed forms also do exist.
The doctor would first remove the entire thyroid gland (it is called total thyroidectomy). At times the diagnosis is confirmed only after a part of the gland is removed, in this case the doctor would decide if you require a “completion thyroidectomy”. The pathology may show a well demarcated tumour or otherwise with or without involvement of the lymph nodes. Once all these are known, your doctor would classify your “risk status”.
He will take a radioactive iodine whole body scan after 4 to 6 weeks to see if there is any residual tissue left in the neck or spread to any regions. Depending on your risk status, your doc will decide if you require Radioactive Iodine therapy, again a very benign mode of treatment. It doesn’t pain you nor make you feel like a patient. He will also check your blood for thyroglobulin, a marker of thyroid tissue in the blood.
Radioactive iodine therapy destroys any thyroid tissues which are left behind in your body (normal or abnormal). Following this, your doctor will start you on thyroxine to make sure that your TSH is kept on targets to prevent reactivation of the disease process.
Every 6 months, your doctor may ask you to come back for a review at which time the thyroxine is stopped and you may be subjected to a thyroglobulin blood test and a radioactive iodine whole body scan to decide your disease state. This method is gradually getting replaced with ultrasound scanning. This process may be followed for sometime till your doctor is sure that the disease is cured. At times you may be subjected to other imaging modalities like PET scans or CT scans.
Yes, it sounds a bit cumbersome. But you have very high likelihood of getting cured.
Dr. Mathew John