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Treatment decisions

Read about the different types of treatment for thyroid cancer and how your doctor decides which treatment you need.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

Treatment overview

The main treatments for thyroid cancer.

Surgery is the treatment most often used for thyroid cancer. You may have part of your thyroid removed (called a lobectomy or partial thyroidectomy). Or you may have an operation to remove all of your thyroid gland (a total thyroidectomy). These are both major operations, carried out under general anaesthetic.

Radioactive iodine is a very effective type of treatment for thyroid cancer. Thyroid cells absorb iodine (131 or I-131) and radiation in the iodine kills the cancer cells. The iodine is only absorbed by the cancer cells in the bloodstream, so radiation only effects these. For papillary or follicular thyroid cancer, you may have this:
  • after surgery
  • for cancer that's spread or come back

You may have thyroid hormone therapy:

  • to treat the cancer
  • after surgery to replace the thyroid hormones your thyroid gland would normally make

If you have papillary or follicular thyroid cancer, your treatment may include the thyroid hormones:

  • thyroxine (T4)
  • tri iodothyronine (T3)

Taking thyroid hormones stops your body from making thyroid stimulating hormone (TSH) which may encourage the cancer to grow. This can help reduce the risk of the cancer coming back, or slow it down if it’s already spread.

Radiotherapy uses high energy waves similar to x-rays to kill cancer cells. Medullary and anaplastic thyroid cancers don’t pick up iodine well, so external beam radiotherapy is usually used.

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of cancer cells. It’s sometimes used to treat advanced thyroid cancers or cancer that has come back.

This is still an experimental treatment, but there have been reports that it’s kept thyroid cancer under control for long periods for some people. It can be used to treat all types of thyroid cancer.

Biological therapies are treatments that act on processes in cells or change the way that cells signal to each other. They can stimulate the body to attack or control the growth of cancer cells. There are many different types of biological therapy.

You might have biological therapy to treat advanced medullary thyroid cancer that is causing symptoms and cannot be operated on. You would have one of the following drugs:

  • vandetanib (Caprelsa)
  • cabozantinib (Cometriq)

You might have sorafenib (Nexavar) for advanced papillary thyroid cancer or follicular thyroid cancer, when radioactive iodine treatment is no longer working.

You may have these drugs and other biological drugs as part of a clinical trial. Other biological therapies being looked at include:

  • axitinib (Inlyta)
  • sunitinib (Sutent)
  • pazopanib (Votrient)
  • motesanib diphosphate

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Last reviewed: 
13 Nov 2014
  • Cancer and its management (6th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2010

  • Cancer principles and practice of oncology (9th edition)
    De Vita VT, Lawrence TS and Rosenberg SA
    Lippincott, Wiliams and Wilkins, 2011

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