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Follow up

Find out about follow up appointments and tests after treatment for thyroid cancer.

Why you have follow up appointments

You have follow up appointments every few months to check how you are and see whether you have any problems or worries. The appointments also give you the chance to raise any concerns you have about your progress.

What happens

After your treatment has finished, your doctor will want you to have regular check ups. These include: 

  • being examined by your cancer specialist
  • blood tests
  • x-rays
  • scans

You won't have all these tests at every visit. But you usually have blood tests and your doctor is likely to examine you at each appointment. They will also ask how you are feeling and whether you have had any symptoms.

Blood tests

You might have several different types of blood tests. For example, a test to check:

  • hormone levels if you are taking thyroid hormones
  • calcium levels in your blood if your parathyroid glands were removed or damaged during surgery

Tumour markers
You might have tests for tumour markers. These measure the levels of substances in the blood that might go up if the cancer comes back. For example, you might have a test for thyroglobulin if you had treatment for follicular thyroid cancer. Or you have a blood test for calcitonin levels if you had medullary thyroid cancer.

Tumour marker levels can go up before you have any symptoms. So it can be an early warning. Your doctor will arrange other tests, such as a scan, if the levels are abnormal. The levels can go up for other reasons, so it does not always mean that your cancer has come back.  

Blood tests are sent to specialist labs and may take up to 4 weeks to come back. So you won't get the results for about a month after the test.

Scans

Radioactive iodine scan
You might have a scan about 9 to 12 months following radioactive iodine treatment. This is to check that the treatment killed all the thyroid cancer cells.

Before this scan, your doctor might ask you to start a low iodine diet and to stop taking your thyroxine hormone tablets for about 3 to 4 weeks. Or alternatively, a few days before the test you might have an injection of a hormone called recombinant human thyroid stimulating hormone. Both of these steps help the cancer cells take up the radioactive iodine.

Ultrasound
You might also have an ultrasound scan of your neck to check your lymph glands.

Some hospitals use a particular thyroid hormone and an ultrasound of the neck to check for cancer cells. You have the thyroid hormone, Thyrogen, as an injection once a day for 2 days.

You have more tests if the scans find any abnormal areas that could be thyroid cancer. Or if your thyroglobuline level is raised. You might need more treatment.

You might also have a scan if your doctor is worried that the cancer may have come back.

How often you have appointments

At first, your check ups are every 4 to 6 months. Gradually they become less frequent. This might be then only once a year. You’ll have check ups for at least 10 years, and often for life.

You might be seen more often at first if you have anaplastic thyroid cancer. For example, every 2 months.

Contact your doctor or specialist nurse if you have any concerns. You should also contact them if you notice any new symptoms between appointments. You don’t have to wait until your next visit.

An anxious time
Many people find their check ups quite worrying. A hospital appointment can bring back any anxiety you had about your cancer.

It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling after cancer treatment.

Life after cancer - Amy's story

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