Thyroid Cancer Treatment Options

The thyroid is a small gland in the front part of the neck that secretes hormones and is a part of the body’s endocrine system. Thyroid hormones regulate many important functions in the body. When cells in thyroid tissue grow out of control, it is called thyroid cancer.

Around 12,000 men and 33,000 women are diagnosed with thyroid cancer each year in the United States. The disease claims over 2,000 lives every year. However, most cancers of the thyroid gland can be cured, especially if the cancer cells have not spread to other parts of the body.

Please continue reading to learn more about the various options to treat thyroid cancer.

What are the risk factors for thyroid cancer?

According to the American Cancer Society, age and gender are risk factors for thyroid cancer. This type of cancer is up to 3 times more common in women than men and tends to occur in women in their 40s and 50s and men in their 60s and 70s. Other risks include genetic mutations, a family history of thyroid cancer, radiation therapy to the head or neck, being overweight or obese, and having too much or too little iodine in the diet.

What are the different types of thyroid carcinoma?

Papillary thyroid cancer

Most common type of thyroid cancer
Frequently affects people between the ages of 30 and 50
These thyroid tumors are usually small in size
Response to treatment tends to be good even if cancer cells have spread to the neck lymph nodes
Aggressive papillary thyroid cancers can spread to other structures in the neck and other parts of the body

Follicular thyroid cancer

Rare type of thyroid cancer
Commonly affects people over the age of 50
Cancer cells do not usually spread to the lymph nodes in the neck
Some aggressive follicular thyroid cancers can spread to other parts of the body. For example, stage IV thyroid cancer may spread to the lungs and bones

Hurthle cell thyroid cancer

Rare and aggressive type of thyroid cancer
The thyroid cancer cells can invade other structures in the neck and spread to other organs in the body

Poorly differentiated thyroid cancer

Rare type of thyroid cancer, which is more aggressive than differentiated thyroid cancers
Frequently unresponsive to standard thyroid cancer treatments

Anaplastic thyroid cancer

Rare thyroid cancer, which is fast-growing
Usually occurs in people over 60 years of age
Tends to cause severe symptoms such as neck swelling and difficulty breathing and swallowing
Can be difficult to cure, but treatments can slow its growth

Medullary thyroid cancer

Rare type of thyroid cancer that involves C cells in the thyroid gland which make calcitonin hormone
Can be detected at an early stage by elevated calcitonin levels in the blood
Some medullary thyroid cancers are inherited from a parent to a child and caused by a gene called RET
Changes in the RET gene are associated with familial medullary thyroid cancer and multiple endocrine neoplasia type 2 (MEN type 2). These conditions increase the risk of thyroid cancer and certain other types of cancers

Other rare types of thyroid cancer

Thyroid lymphoma and thyroid sarcoma are very rare types of thyroid cancer that start in the immune cells and connective tissue cells, respectively.

How do doctors diagnose thyroid cancer?

Tests such as a laryngoscopy, blood hormone levels, blood tests, and imaging studies like ultrasound and CAT scan are used to diagnose thyroid cancer.

Thyroid cancers are classified according to the types of cancer cells found on biopsy when a sample of thyroid tissue is examined under a microscope. The specific cancer diagnosis helps to determine the treatment and prognosis (chances of recovery or recurrent cancer).

Notably, thyroid nodules are common and do not usually indicate cancer. A biopsy can help to determine whether a thyroid nodule is cancerous or benign.

Can thyroid cancer be treated successfully?

Yes, thyroid cancer can be treated successfully. Most thyroid cancers are curable, especially if the cancer is detected early before it has spread to other parts of the body.

If thyroid cancer cannot be cured, treatments can help to destroy as many thyroid cancer cells as possible and prevent the thyroid tumor from growing in size, spreading to other parts of the body, and coming back.

For late-stage thyroid cancers that are not curable, treatments can be used to relieve symptoms such as pain or difficulty breathing or swallowing.

What is the most effective treatment for thyroid cancer?

The most effective treatment for thyroid cancer depends on the type and stage of the cancer, i.e., the thyroid cells affected and whether the cancer has spread to lymph nodes in the neck or other organs in the body (this is called metastatic thyroid cancer).

Surgery is the most common treatment for thyroid cancer. A surgeon can treat cancer by removing one lobe of the thyroid gland where cancer cells are found. This is called a thyroid lobectomy. Usually, nearby lymph nodes in the neck are also removed at the time of thyroid surgery to check whether the cancer has spread.

A near-total thyroidectomy involves the removal of all of the thyroid gland except a small part. The entire thyroid gland is removed during a total thyroidectomy.

Sometimes, surgeons have to perform a tracheostomy, which is an opening in the trachea (windpipe) to help with breathing. This is needed if the thyroid cancer is compressing the trachea and narrowing it, making it difficult to breathe.

What is the alternative to surgery for thyroid cancer?

In addition to surgery, there are several other treatments for a thyroid cancer diagnosis. The treatment plan depends on the type and stage of the cancer and the patient’s general health status. Often, more than one type of treatment is needed.

Radiation therapy

External radiation therapy is a cancer treatment that uses high doses of radiation to destroy cancer cells or stop them from growing. Radiotherapy may be offered after thyroid surgery to kill cancer cells that remain. There are different types of radiation therapy, such as external beam radiation therapy and stereotactic body radiotherapy.

Radioactive iodine therapy

This thyroid cancer treatment is taken by mouth. Only thyroid cells absorb iodine, including cells in a thyroid tumor. The radioactive iodine destroys the thyroid cells without harming other tissues in the body. Radioactive iodine treatment is used for papillary and follicular thyroid cancers.

Chemotherapy

This involves the use of drugs to kill thyroid cancer cells. The drugs may be given by mouth or injected into a vein or muscle. Chemotherapy is typically used for medullary and anaplastic thyroid cancers. It may include drugs such as dacarbazine, cyclophosphamide, vincristine, doxorubicin, fluorouracil, streptozocin, carboplatin, paclitaxel, and docetaxel.

Thyroid hormone therapy

This thyroid cancer treatment blocks the action of thyroid hormones to stop cancer cells from growing. For example, drugs are given to prevent the formation of thyroid stimulating hormone (TSH), which helps thyroid cancer cells grow. Patients who take thyroid hormone therapy have low thyroid hormone levels. They need to take thyroid hormone replacement pills to prevent thyroid disease because their body stops making thyroid hormones.

Targeted therapy drugs

These are treatments that specifically target cancer cells in thyroid tumors. They may include tyrosine kinase inhibitors such lenvatinib, sorafenib, vandetanib, selpercatinib, entrectinib, cabozantinib, larotrectinib, and pralsetinib. In addition, protein kinase inhibitors such as dabrafenib and trametinib are used in certain thyroid cancer patients who have a mutation (defect) in a gene called BRAF.

Immunotherapy

This thyroid cancer treatment consists of boosting the body’s immune system and its ability to fight cancer.

Clinical trials

People with thyroid cancer may be able to sign up for clinical trials that are studying the safety and efficacy of new treatments for thyroid cancer. The National Cancer Institute website is a good resource to find an ongoing clinical trial.

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