Know Your Options
Click on each colored circle to view more information on each option.
Not all treatment approaches are recommended for all situations. Below are a few examples:
Why Would You Wait?
Perhaps you want/need more information before you decide to get treatment or the timing is not optimal at the moment for surgery followed by Radioiodine therapy. It is YOUR decision. You need to know though that “Watchful Wait” refers to NO treatment and monitoring to see how thyroid cancer progresses. It is sometimes called “Active Surveillance” or “Observation only”. Experts do not agree on the intervals between check ups and which doctor should be responsible for long-term follow-up.
Informed ConsentGetting Surgery
Surgery is usually the first step in thyroid cancer treatment. Total Thyroidectomy removes all or most of your thyroid gland (both lobes). Lobectomy removes part of your thyroid gland. Thyroid cancer cells are microscopic (very small) and may not be completely removed with surgery.
Lump (Nodule) Discovered
Example:
“At my Annual Physical, my doctor found lump(s) in my neck. I had a Neck Ultrasound confirming nodule(s) 1 cm (10 mm). Fine needle biopsies (FNA) were performed and results are low suspicion (5-10% risk of cancer)/indeterminate (Doctor not sure if its cancer).”
Cancer Suspected
Example:
“I found lump(s) in my neck. My doctor referred me to an endocrinologist who performed a neck ultrasound. The mass(es) is(are) 2-4 cm (20 to 40 mm). Differentiated Thyroid Cancer suspected.”
Lobectomy Performed
Example:
“I was diagnosed with Differentiated Thyroid cancer. I had a lobectomy (surgeon removed just a portion of my thyroid gland).”
Thyroidectomy Performed
Example:
“I was diagnosed with Differentiated Thyroid cancer. I had a total thyroidectomy. (Surgeon removed my entire thyroid gland)”
Watchful Wait
No treatment. Monitoring disease progression during regular visits. Tests may be performed for example blood tests, ultrasound of the neck, fine needle biopsies.
Lump Discovered + Watchful Wait
Physicians may propose to their patients with indeterminate or cancerous small nodules (less than 10 mm/1 cm), to hold off treatment and come for regular follow-up visits. It is important to discuss all aspects including your ability to adhere to this follow-up schedule, costs associated and coverage by insurance.
Cancer Suspected + Watchful Wait
Some physicians propose to their patients with known cancerous nodules of 20 mm (2 cm) to 40 mm (4 cm) to hold off treatment and come for regular follow-up visits to follow the disease status (progression or stable). It is important to discuss all aspects including your ability to adhere to this follow-up schedule, costs associated and coverage by insurance.
Surgery
Removal of cancerous tissue. Lobectomy means only one lobe of the thyroid is removed. Total thyroidectomy means the removal of the entire thyroid gland.
Lump Discovered + Surgery
This is not a common scenario. It is the patient’s choice to have surgery or not once the diagnosis is made that the lesion(s) is cancerous, however small it may be.
Lump Discovered + Surgery
Surgery is effective by standard of care for thyroid cancer treatment. Depending on the situation, the surgeon may propose lobectomy or total thyroidectomy.
Radioactive Iodine (RAI)
Radioactive iodine is administered by mouth in either liquid or capsule form. I-131 treats thyroid cancer and minimizes the potential for any remaining or “escaped” thyroid cells from becoming more aggressive and unresponsive to later treatment.
Cancer Suspected + RAI
Standard of care following surgery. Studies have shown that patients who undergo radio-iodine therapy after surgery have 10 year survival of 96%.
Lobectomy + RAI
Not recommended in case of lobectomy because the radioactive iodine would kill the remaining thyroid cells in the thyroid gland lobe left in place.
Thyroidectomy + RAI
Standard of care following total thyroidectomy. Studies have shown that patients who undergo radio-iodine therapy after surgery have 10 year survival of 96%.