Surgery for thyroid cancer

Most types of thyroid cancer are easy to detect early, and can be fully cured by removing (part of) the thyroid and, if necessary, the lymph nodes on the affected side of the neck.

If your thyroid needs to be removed in its entirety (thyroidectomy), you will need to take medication for life. This medicine is usually sufficient to establish a good quality of life. You will require radioactive iodine treatment between 4 and 6 weeks following your surgery to destroy any cancer cells that may have remained.

Surgery for thyroid cancer - what to expect?

We will use an ultrasound to create images of your neck which will help us detect potential metastases in the lymph nodes. If it turns out that your cancer has spread, we will remove all lymph nodes on the side of the neck that contains the metastases in order to prevent the tumor from spreading to the lungs.

If we cannot tell whether your tumor is malignant, we will only remove the section of the thyroid on which the tumor has developed.

Effectiveness

Most patients with thyroid cancer recover after adequate treatment. The survival rates after 15 years are 95%. Some patients have an increased risk of recurrence , mainly due to the size of their tumor.

Thyroid cancer treatment and the screenings that follow aim to detect tumor recurrence at an early stage in order to treat it immediately.

Preoperative screening

Before your surgery, you will be invited to meet with your anesthesiologist at the outpatient clinic for a consultation and a brief examination to assess your overall shape and any potential particularities we will need to keep in mind. The consultation assistant will measure your heart rate and blood pressure and will inquire about your height and weight. If needed, we can take those measurements during the appointment.

This preoperative screening will take approximately 20 minutes and will form the base of your anesthesia. Your anesthesiologist will listen to your lungs and heart and inspect your mouth and throat in preparation of the breathing tube that will be placed during surgery. Your anesthesiologist will also ask you:

whether you have been under anesthesia before
whether you have any other conditions
whether you have taken cancer medicine before
whether you have had radiation treatment before
whether you have any allergies
whether you smoke
whether you drink alcohol
what kind of medication you take

Please inform your anesthesiologist of the type of medication and dose you take, and how often you take it. Your physician may want to run more tests before your surgery, such as: electrocardiogram (ECG), lung x-rays, a lung function test, or a blood test.

General or local anesthesia

Before your surgery you will be given general anesthesia, local anesthesia, or a combination of the two. General anesthesia means that you will be completely unconscious during surgery, whereas local anesthesia means that a part of your body will be numb and motionless.

General anesthesia

General anesthesia completely sedates your body. You will be given a cocktail of sleeping medicine, pain killers, and sometimes a muscle relaxant through IV. You will be unconscious within 30 seconds. You will be ventilated during the entire process.

If you are having major surgery, we will place a respiration tube in your throat. For smaller surgeries, a small cap in the back of the throat will suffice. We will closely monitor your heart rate, blood pressure, breathing, and temperature through our monitoring devices.

Local anesthesia

If you are given local anesthesia, you will be conscious during your surgery. Local anesthetics are usually administered through an epidural in the spine, and will temporarily numb all body parts underneath. We may place a tube to give you IV pain medication during and after surgery.

Your anesthesiologist will keep a close eye on your blood pressure, heart rate, breathing, and temperature in order to adapt the anesthesia if needed.

Most people undergoing major surgery will be given a mixture of general and local anesthetics.

Side-effects and complications

A small number of people experience hemorrhaging after surgery, which will be treated immediately with surgery. The treatment may affect your vocal cord nerve or parathyroid nerve. These complications are rare and can be adequately treated.

You will need thyroid hormone replacement therapy after a total thyroidectomy. It may take some time before your body has adjusted to this medication. Most thyroid cancer patients take several weeks or months to fully recover from their treatment.

After surgery

You will need a temporary drain in the neck for proper wound drainage. Most patients will only need to spend one night at the hospital after a partial thyroidectomy. Patients undergoing a total thyroidectomy will need to spend one day at our Intensive Care unit for observation, after which you will be moved to a regular ward for 3 to 4 days of recovery.

Radioactive Iodine treatment after surgery

You will receive radioactive iodine treatment after 4 to 6 weeks following your surgery, to destroy any cancer cells that may have remained. This will decrease the risk of recurrence. Cancer cells in the thyroid will absorb the radioactive iodine, which allows the radiation to kill the cancer cells without harming the healthy tissue. To further increase the effects of the treatment, we stimulate the remaining cancer cells to absorb as much radioactive iodine as possible by increasing the level of TSH proteins in the blood. After your radioactive iodine treatment, you will need to stay at the hospital for a few days to avoid exposing others to the radioactivity. You will not be allowed to receive visitors during your stay.

Surgery for thyroid cancer

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