From primary care and endocrinology to surgical oncology and support services, find a team of specialists who work together so you have the best possible outcome
By Dr. Susana-Vargas-Pinto, Endocrine Surgery, Nuvance Health
The thyroid gland is small but mighty because it has a big impact on your health. It produces hormones that affect your metabolism. You might be surprised by the many specialists involved to successfully treat cancer when it grows in this two-inch gland.
Comprehensive, integrated multispecialty care is paramount to treating thyroid cancer. Thyroid cancer happens when cells grow out of control in the butterfly-shaped gland in the lower front of your neck.
Here is what to expect if you are diagnosed with thyroid cancer so you can feel reassured and well-cared for every step of the way.
What are symptoms of thyroid cancer?
Thyroid cancer usually does not cause symptoms when it is an early stage. If thyroid cancer does cause symptoms, you may experience:
- A lump in the neck that is growing
- Swelling in the neck
- Pain in the front of the neck that sometimes goes up to the ears
- Persistent hoarseness or voice changes
- A cough that does not go away and is not caused by something else like a respiratory illness
- Difficulty swallowing or breathing
How is thyroid cancer detected?
Oftentimes, primary care providers initiate thyroid tests if they feel an enlarged thyroid or nodules during an annual wellness visit. They will usually recommend the patient have an ultrasound of their neck and also see an endocrinologist.
It is also common for thyroid nodules to be incidental findings when someone has an ultrasound of their neck for another reason, such as an injury.
If the ultrasound reveals one or more suspicious nodules, the endocrinologist may recommend a biopsy, depending on the size and shape of the nodules and your symptoms.
Ultrasound-guided fine-needle aspiration biopsy of the thyroid gland
A biopsy is required to confirm thyroid cancer. An endocrinologist or interventional radiologist will perform an ultrasound-guided fine-needle aspiration biopsy. They will insert a thin needle into the nodule to take a sample of it. A pathologist will then study the tissue sample to determine if it is cancerous.
How is thyroid cancer treated?
Thyroid cancer surgery
If you have thyroid cancer, your endocrinologist will connect you with an endocrine surgeon or head and neck surgeon who specializes in thyroid surgery. The type of thyroid surgery will depend on the kind of cancer you have, such as papillary or follicular, and size and stage of the cancer.
Thyroid cancer treatments
Early-stage thyroid cancer that has not spread can usually be cured with surgery alone. However, make sure your surgeon is part of and consulting with a multispecialty cancer care team, including endocrinology, medical oncology and radiation oncology.
People with papillary or follicular thyroid cancer that has spread to the neck or other parts of the body usually will have radioactive iodine (RAI) after surgery. RAI eliminates any remaining thyroid tissue and cancer cells. Depending on the facility, an endocrinologist, nuclear medicine physician or radiation oncologist can administer the oral treatment.
You will need hormone therapy if your surgeon removed your entire thyroid to treat the cancer. Oral thyroid hormone therapy will help your body produce the hormones it needs to regulate your metabolism.
Radiation therapy may be recommended for thyroid cancer that has spread and cannot be treated with radioactive iodine. These types of cancers include anaplastic thyroid cancer and medullary thyroid cancer.
Chemotherapy is not effective for most thyroid cancers, but it usually is not needed anyway. Your care team may recommend it if you have anaplastic thyroid cancer that has spread and is not responding to other treatments.
Thyroid cancer nurse navigators, nutritionists and support services
Look for a cancer program that has nurse navigators, oncology dietitians, social workers and therapists.
At Nuvance Health, nurse navigators guide cancer patients every step of the way. Nurse navigators are your point people for questions. They coordinate all your care and appointments and offer reassurance and support.
Registered dietitians who are certified oncology nutritionists help cancer patients use food as medicine to prepare for treatments and have the best possible outcomes. They also help patients maintain a healthy diet and active lifestyle to reduce the risk of the cancer from coming back.
Social workers and therapists offer valuable emotional, mental and socioeconomic resources and support so you can focus on getting better.
Speech therapy after thyroid cancer surgery
Depending on the location and size of the cancer, some people experience changes in their voice and swallowing after surgery. Your surgeon will monitor these changes and may recommend you have speech therapy, although that is not very common. These changes usually resolve on their own over time.
What happens after completing thyroid cancer treatment?
After active treatment for thyroid cancer, most people will continue follow up visits with their endocrinologist. Follow up endocrinology visits and tests may be about every six months after your initial diagnosis and treatment, and then be less frequent if you continue to stay cancer free. Tests usually include neck ultrasounds and blood work to monitor your hormone levels and tumor markers.
Thyroid cancer that had spread to the neck lymph nodes may require more extensive surgery called a neck dissection. People who have a neck dissection may also continue follow up visits with their surgeon.
The bottom line: While primary care providers usually initiate thyroid tests, pay attention to possible thyroid cancer symptoms such as a growing lump in your neck. Your primary care provider, endocrinologist, endocrine or head and neck surgeon and cancer care team will get you on the path to recovery after a thyroid cancer diagnosis.
Dr. Susana Vargas-Pinto is a board certified and fellowship trained endocrine surgeon. She is the co-director of the Endocrine Neoplasia Program at Norwalk Hospital. She cares for adolescents and adults with health conditions that affect the thyroid, parathyroid and adrenal glands. She has a particular interest in managing thyroid cancer and hypercalcemia related to parathyroid gland tumors. Dr. Vargas-Pinto is originally from Puerto Rico and speaks Spanish. Book an appointment directly online with Dr. Vargas-Pinto.
Dr. Susana-Vargas-Pinto, Endocrine Surgery, Nuvance Health