• surgery (taking out the cancer)
• radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
• hormone therapy (using hormones to stop cancer cells from growing)
• chemotherapy (using drugs to kill cancer cells)

Surgery is the most common treatment of cancer of the thyroid. A doctor may remove the cancer using one of the following operations:

• Lobectomy removes only the side of the thyroid where the cancer is found. Lymph nodes in the area may be taken out (biopsied) to see if they contain cancer.
• Near-total thyroidectomy removes all of the thyroid except for a small part.
• Total thyroidectomy removes the entire thyroid.
• Lymph node dissection removes lymph nodes in the neck that contain cancer.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation for cancer of the thyroid may come from a machine outside the body (external radiation therapy) or from drinking a liquid that contains radioactive iodine. Because the thyroid takes up iodine, the radioactive iodine collects in any thyroid tissue remaining in the body and kills the cancer cells.

Hormone therapy uses hormones to stop cancer cells from growing. In treating cancer of the thyroid, hormones can be used to stop the body from making other hormones that might make cancer cells grow. Hormones are usually given as pills.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the thyroid.

Treatment by stage

Treatment of cancer of the thyroid depends on the type and stage of the disease, and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for some patients with cancer of the thyroid. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

STAGE I PAPILLARY THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove one lobe of the thyroid (lobectomy), followed by hormone therapy. Radioactive iodine also may be given following surgery.
2. Surgery to remove the thyroid (total thyroidectomy).

STAGE I FOLLICULAR THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove the thyroid (total thyroidectomy).
2. Surgery to remove one lobe of the thyroid (lobectomy), followed by hormone therapy. Radioactive iodine also may be given following surgery.

STAGE II PAPILLARY THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove one lobe of the thyroid (lobectomy) and lymph nodes that contain cancer, followed by hormone therapy. Radioactive iodine also may be given following surgery.
2. Surgery to remove the thyroid (total thyroidectomy).

STAGE II FOLLICULAR THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove the thyroid (total thyroidectomy).
2. Surgery to remove one lobe of the thyroid (lobectomy) and lymph nodes that contain cancer, followed by hormone therapy. Radioactive iodine also may be given following surgery.

STAGE III PAPILLARY THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove the entire thyroid (total thyroidectomy) and lymph nodes where cancer has spread.
2. Total thyroidectomy followed by radiation therapy with radioactive iodine or external beam radiation therapy.

STAGE III FOLLICULAR THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove the entire thyroid (total thyroidectomy) and lymph nodes or other tissues around the thyroid where the cancer has spread.
2. Total thyroidectomy followed by radioactive iodine or external beam radiation therapy.

STAGE IV PAPILLARY THYROID CANCER

Treatment may be one of the following:

1. Radioactive iodine.
2. External beam radiation therapy.
3. Hormone therapy.
4. A clinical trial of chemotherapy.

STAGE IV FOLLICULAR THYROID CANCER

Treatment may be one of the following:

1. Radioactive iodine.
2. External beam radiation therapy.
3. Hormone therapy.
4. A clinical trial of chemotherapy.

MEDULLARY THYROID CANCER

Treatment will probably be surgery to remove the entire thyroid (total thyroidectomy) unless the cancer has spread to other parts of the body. If lymph nodes in the neck contain cancer, the lymph nodes in the neck will be removed (lymph node dissection). If the cancer has spread to other parts of the body, chemotherapy may be given.

ANAPLASTIC THYROID CANCER

Treatment may be one of the following:

1. Surgery to remove the thyroid and the tissues around it. Because this cancer often spreads very quickly to other tissues, a doctor may have to take out part of the tube through which a person breathes. The doctor will then make an airway in the throat so the patient can breathe. This is called a tracheostomy.
2. Total thyroidectomy to reduce symptoms if the disease remains in the area of the thyroid.
3. External beam radiation therapy.
4. Chemotherapy.
5. Clinical trials studying new methods of treatment of thyroid cancer.

RECURRENT THYROID CANCER

The choice of treatment depends on the type of thyroid cancer the patient has, the kind of treatment the patient had before, and where the cancer comes back. Treatment may be one of the following:

1. Surgery with or without radioactive iodine.
2. External beam radiation therapy to relieve symptoms caused by the cancer.
3. Chemotherapy.
4. Radioactive iodine.
5. Radiation therapy given during surgery.
6. Clinical trials.