Follow up for thyroid cancer

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

• Being examined by your cancer specialist
• Blood tests
• X-rays
• Scans

You will not have all these tests at every visit. But your doctor is likely to examine you at each appointment and take blood tests. Your doctor will also ask how you are feeling and whether you have had any symptoms or are worried about anything.

You usually only have scans if you or your doctor have any worry that the cancer may have come back. But if you have had radioactive iodine treatment you may be asked to have a scan with radioactive iodine about 4 to 6 months after your treatment. This is to make sure that the treatment killed all the thyroid cancer cells. About 3 to 4 weeks before this scan, you may be told that you have to stop taking your thyroid tablets and start a low iodine diet. Or a few days before the test you may have an injection of a hormone called recombinant human thyroid stimulation hormone. This helps the cancer cells take up the radioactive iodine. There is more about thyroid scanning in the section on diagnosing thyroid cancer.

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

Some hospitals use a particular thyroid hormone (recombinant human TSH – Thyrogen) and an ultrasound of the neck instead of an iodine-131 scan to check for cancer cells. If you have the Thyrogen it is given as an injection 2 days in a row and you have a blood test 3 days later. 

If the scans find any abnormal areas that could be thyroid cancer or if your thyroglobulin level is raised you may have more tests. You may also need more treatment.

You may have several different types of blood tests. If you are taking thyroid hormones, your hormone levels will be tested to make sure they are right for you. If your parathyroid glands were removed or damaged during surgery, the calcium levels in your blood will also be checked.

If you have had follicular thyroid cancer or papillary thyroid cancer, you can have a test for thyroglobulin. If you have had medullary thyroid cancer, you can have a blood test for calcitonin levels. The levels of these substances may go up if the cancer comes back. The levels often go up before you have any symptoms so they are a sort of early warning system. Both these tests have to be 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 you've had the test.

At first, your check ups will be every 4 to 6 months. If all is well, they will gradually become less frequent, until they are only once a year. You will have check ups for at least 10 years, and often for life. If you have anaplastic thyroid cancer, you are likely to be seen more often at first after your treatment. Perhaps every two months.

If you are worried or notice any new symptoms between appointments, let your doctor or nurse know as soon as possible. You don’t have to wait until the next appointment.

Many people find their check ups quite worrying. If you are feeling well and getting on with life, a hospital appointment can bring all the worry about your cancer back to you. You may find it helpful to tell someone close to you how you are feeling. If you are able to share your worries, they may not seem quite so bad. It is quite common nowadays for people to have counselling after cancer treatment. You can find out about counselling in the counselling section.