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Occasionally, symptoms such as hoarseness, neck pain, and enlarged lymph nodes do occur in people with thyroid cancer.. Although as much as 75 % of the population will have thyroid nodules, the vast majority are benign. That's right, most of us have nodule in our thyroid glands! Young people usually don't have thyroid nodules, but as we get older, more and more of us will develop a nodule. By the time we are 80, 90% of us will have at least one nodule. Far less than 1% of all thyroid nodules are malignant. A nodule which is cold on scan (shown in photo outlined in red and yellow) is more likely to be malignant, nevertheless, the majority of these are benign as well.

Most thyroid cancers are very curable. In fact, the most common types of thyroid cancer (papillary and follicular) are the most curable. In younger patients, both papillary and follicular cancers can be expected to have better than 97% cure rate if treated appropriately. Both papillary and follicular cancers are typically treated with complete removal of the lobe of the thyroid which harbors the cancer, PLUS, removal of most or all of the other side. The bottom line, most thyroid cancers are papillary thyroid cancer, and this is one of the most curable cancers of ALL cancers that humans get. As we often tell our patients, if you must choose a type of cancer to have, papillary cancer would be your choice. Treat it correctly and the cure rate is extremely high!

Overview of typical Thyroid cancer treatment

1. Usually diagnosed by sticking a needle into a thyroid nodule or removal of a worrisome thyroid nodule by a surgeon.
2. The removed thyroid nodule is looked at under a microscope by a pathologist who will then decide if the nodule is benign (95 - 99% of all nodules that are biopsied) or malignant (way less than 1% of all nodules, and about 1 - 5 % of nodules that are biopsied).
3. The pathologist decides which type of thyroid cancer it is: papillary, follicular, mixed papilofollicuar, medullary, or anaplastic.
4. The entire thyroid is removed by a competent surgeon (sometimes this is done during the same operation where the biopsy takes place). He/she will assess the lymph nodes in the neck to see if they need to be removed also. In the case of anaplastic thyroid cancer, a decision will be made regarding the possibility of a tracheostomy.
5. About 4-6 weeks after the thyroid has been removed, the patient will undergo radioactive iodine treatment. This is very simple and consists of taking a single pill. The pill will contain the radioactive iodine in the dose that has been calculated for that individual. The patient goes home, avoids contact with other people for a couple of days (so they are not exposed to the radioactive materials), and that's it.
6. A week or two after the radioactive iodine treatment the patient is started on a thyroid hormone pill. You can't live without thyroid hormone and since you don't have a thyroid anymore, the patient will take one pill per day for the rest of their life. This is very simple and a very common medication (example of drug names are: Synthroid, Levoxyl, Armour Thyroid, etc).
7. Every 6 - 12 months the patient returns to his endocrinologist for blood tests to determine if the dose of daily thyroid hormone is correct and to make sure that the thyroid tumor is not coming back. The frequency of these follow up tests and which tests to get will vary greatly from patient to patient. Endocrinologists are typically quite good at this and will typically be the type of doctor that follows this patient long-term.

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