There are four main types of cancer in the thyroid gland. These are, in order of frequency, papillary, follicular, medullary, and anaplastic carcinomas. Papillary and follicular thyroid cancers are completely curable if treated on time. Medullary thyroid cancer has a more dangerous course than the first two types. Anaplastic thyroid cancer progresses very rapidly and is very rare.

The first treatment option in thyroid cancer is surgery. In this operation, the entire thyroid gland should be removed and no thyroid tissue should be left behind. During surgery, lymph nodes around the thyroid gland should also be removed and sent for histopathological examination.

In case of detecting the presence of a diseased lymph node in the neck before or during the operation in thyroid cancer, neck dissection should be performed to remove the lymph node groups in the neck.

In the event that no diseased lymph node is detected in the neck, it is sufficient to remove the lymph nodes around the thyroid.

Since this type of cancer shows a very rapid course in patients with anaplastic thyroid cancer, most patients lose the chance of surgery when the disease is detected. Radiotherapy and chemotherapy are given to these patients. Radiotherapy and chemotherapy are applied to the operated patients after the surgery.

In thyroid cancers, additional treatment techniques that vary according to the type of cancer are applied after surgery.

In papillary and follicular thyroid cancers, high-dose radioactive iodine treatment is administered 6 weeks after the operation, in case there may be cancer cells left behind after the surgery.

Radioactive iodine treatment is also used after surgery in patients who have been operated for medullary thyroid cancer.

In cases where the thyroid cancer cannot be completely removed, in addition to these, longitudinal radiation therapy can be applied in medullary or anaplastic thyroid cancers.

Post-treatment follow-up in thyroid cancers

Following surgery and radioactive iodine treatment, the patient is prescribed thyroid hormone (thyroxine) tablets. Thyroid hormone tablets not only regulate the hormone metabolism, but also suppress the secretion of thyrotropin by suppressing the pituitary gland. In this way, the serum TSH level in patients with thyroid cancer is kept below normal and new cancer cells that may develop are tried to be suppressed.

Measurement of serum thyroglobulin level is the best method used in thyroid cancer follow-up. Neck ultrasound and chest X-ray can be illuminating whether the cancer recurs or not.

Iodine-131 MIBG scintigraphy is the only method to be preferred in the follow-up of medullary cancer. In anaplastic cancer, whole body bone scintigraphy is performed for follow-up purposes.