Hearing you have a thyroid nodule can be scary, but it doesn’t always
mean you have cancer. In fact, only about 10% of thyroid nodules are malignant.
But if you’ve been diagnosed with thyroid cancer, you may be feeling anxious about
the next steps, which almost always include surgery.
Below, Mark Zafereo, M.D., shares what to consider
before undergoing thyroid cancer surgery.
Get an accurate diagnosis
It’s important that you’re comfortable with the evaluation of your
thyroid nodule before undergoing surgery. Since most nodules aren’t
cancerous, many patients don’t need surgery at all.
There are four types of thyroid cancer. About 95% of thyroid cancers
are either papillary thyroid cancer or follicular thyroid cancer.
Patients with these cancers typically have a good prognosis.
The remaining 5% are medullary thyroid cancer and anaplastic thyroid
cancer, which can be more aggressive and may require more extensive treatment.
There are different types of thyroid cancer surgery
The type of surgery your doctor recommends will be based on a risk
assessment that includes the tumor pathology, size and location.
The simplest thyroid tumor surgery is a lobectomy. This procedure
removes half the thyroid gland. When a thyroid tumor is more likely to
spread, a total thyroidectomy (removal of the entire thyroid gland)
may be performed.
If the cancer has spread beyond the thyroid gland to surrounding
lymph nodes, a more extensive surgery removing these lymph nodes may
In rare cases, thyroid cancers may spread to other important
structures of the neck, which may require more complex surgeries that
are best performed by an expert thyroid and neck surgeon.
Ask the right questions
When you meet with your surgeon, make sure you have a clear
understanding of your diagnosis, surgical plan and expected recovery.
Here are some questions to ask:
- How many thyroid cancer surgeries do you perform each year?
The most experienced thyroid cancer surgeons perform more than 100
thyroid/neck surgeries annually.
- What type of thyroid
cancer surgery do I need? How much experience do you have performing
this specific type of surgery? If the surgeon hasn’t performed many
surgeries like yours, seek a second opinion from someone who
- How many of your newly diagnosed patients have to
undergo a second thyroid/neck surgery within a year? This number
should be less than 1%.
- How closely do you work with an
endocrinologist, radiologist and pathologist? It’s important that
your doctors collaborate and are all confident in the diagnosis and
care plan. This minimizes surprises during and after surgery.
- Will the surgery affect my metabolism regulation? If part of
your thyroid gland is removed, it may still produce enough of the
hormone that regulates your metabolism. But if you have the whole
gland removed, you’ll need to take a daily thyroid hormone pill for
the rest of your life.
- What are the risks of this thyroid
- How much discomfort will I have after surgery?
Every patient’s recovery from thyroid cancer surgery is different
Every patient’s recovery is different. Most people take a week or
two off work to recover, but can talk and eat a few hours after
surgery. All patients will have a scar after surgery. With surgeries
limited to the thyroid, the scar is usually about 2 inches long and
will look like a natural crease in the neck over time. But ask your
doctor what to expect after your particular surgery.
Don’t rush into surgery
With thyroid cancer, you’re not in a race to remove the tumor as
soon as possible. Except for the most aggressive thyroid cancers (such
as anaplastic thyroid cancer), these cancers are typically
slow-growing. Even when the cancer has spread to the lymph nodes,
there’s generally not an urgent need for surgery. So, take time to
research your options, and find the right cancer center with the right
surgeon to perform the right surgery the first time.
Since there’s more urgency with anaplastic thyroid cancer, we
encourage these patients to seek proper care soon after diagnosis. At
MD Anderson, our specialized clinic
called Facilitating Anaplastic Specialized Treatments, or
FAST, enables us to quickly finalize treatment plans for
patients with suspected anaplastic thyroid cancer.
Specialized care has benefits
Receiving thyroid cancer care at a major cancer center like MD Anderson can make a significant difference
in your outcome. At MD Anderson, we have
care teams studying every aspect of thyroid cancer, which gives you
access to the most cutting-edge care and clinical trials. In fact, MD Anderson has the most clinical trials in
the world for medullary and anaplastic thyroid cancers. No matter what
type of thyroid cancer you have, a specialized team can help ensure
you have a well-thought-out care plan that reduces your chances of
recurrence and the need for another surgery.
Request an appointment at MD Anderson online or by