Surgery is the first and main treatment for almost all thyroid cancers. Your doctor will use tissue removed during surgery to determine the cancer’s type and stage, which helps determine whether you need additional treatment. When you have surgery for thyroid cancer, your surgeon may use of of the following methods:
Total thyroidectomy. This is removal of the whole thyroid gland.
Near-total thyroidectomy. This surgery removes nearly all of the gland.
Subtotal thyroidectomy. Most of the thyroid gland is removed in this procedure.
Lobectomy. This may be used for some small cancers, in which only the lobe of the thyroid containing the tumor is removed. This approach may prevent the need to take a thyroid supplement afterward, however having some thyroid left can interfere with tests that look for recurrent cancer after treatment. Surgeons today most often do total or near-total thyroidectomies.
Your surgeon also may remove the lymph nodes near the cancer if they have known cancer cells or look suspicious. This procedure is called either a central compartment neck dissection or a modified radical neck dissection depending on the extent of lymph node removal.
After surgery, you may need treatment with radioactive iodine. This can kill any remaining cancer cells.
Surgery can cause discomfort and pain at and around the surgical incision. You may be uncomfortable during the first few days after surgery, but pain can be controlled with medication. Discuss pain relief options with your doctor or nurse.
For a while after surgery, you may feel tired or weak. The length of time it takes to recover from an operation varies. Surgery for thyroid cancer may also cause you to be hoarse or to lose your voice. This may not go away if permanent nerve damage occurs during the operation. Other possible side effects include infection, bleeding, and low blood calcium. Low blood calcium may occur because the parathyroid glands that control calcium levels in the blood may be removed unintentionally when the thyroid is removed.
If most or all of thyroid has been removed or destroyed during treatment, you will likely need to take a thyroid hormone pill each day to replace the lost hormones.