Thyroid, thyroid

How is Thyroid Cancer Treated?

The number of thyroid cancers detected each year is increasing. This cancer, which mainly affects women, has a very good prognosis with a cure rate over 90%. The chances of cure are higher when the cancer is diagnosed at an early stage. In this article, discover the different steps of thyroid cancer treatment.

Thyroid Cancer Treatment

When a patient is diagnosed with thyroid cancer, a specialized team is mobilized to oversee the care pathway, which includes several steps.

Thyroid Cancer Treatment

Thyroid cancer treatment is mainly surgical. Surgery is considered the best way to avoid an extension of the tumor. It also facilitates additional treatments and subsequent follow-up.

An operation is usually scheduled to remove the thyroid gland. This surgical procedure is called thyroidectomy. If the tumor has a diameter larger than 1 centimeter, the removal will be complete. If the tumor is smaller, partial removal may be possible.

The operation is performed under general anesthesia. It generally requires a hospital stay of 48 to 72 hours.
 
Surgeons often rely on innovative technologies such as the FLUOBEAM® LX solution for thyroid surgery. The use of this autofluorescence imaging technique can minimize the risk of post-operative complications by preserving the parathyroid glands during thyroid removal.

If surgery is almost always required, in certain cases such as very localized thyroid cancers (microcancers) with a small tumor and no negative criteria, monitoring without surgery may be considered.

Second Treatment Step: Thyroxine (T4)

After thyroid removal, patients must take a medicine called thyroxine. This treatment is required if the thyroid was completely removed and can be indicated in case of partial removal. Since the body is no longer naturally supplied with thyroid hormones, it must be given synthetic thyroid hormones.

Thyroxine comes in the form of a tablet, which must be taken daily upon discharge from the hospital. The prescribed dose depends on the patient's age and weight. It may take some trial and error to find the right dose.

Regular monitoring of TSH (thyroid stimulating hormone) levels is required to confirm that the hormonal balance is adequate. If it is the case, the physician may only ask for an annual check-up.

Third Treatment Step: Iodine-131

When there is a risk of recurrence, the last step in the treatment of thyroid cancer is the administration of iodine-131. Radioactive iodine is both a means of observation and treatment. The radiation that is emitted destroys any remaining thyroid tissue and cancerous cells..

Taking iodine-131 requires specific preparation and special precautions as it is a radioactive substance. The patient is usually hospitalized alone, in a room designed for this purpose and equipped to collect radioactive urine.

In some cases, other types of treatment may be recommended:

  • Poorly differentiated and anaplastic thyroid cancers tend to be quite aggressive, with an unfavorable evolution. For these cancers, surgery is often associated with chemotherapy and radiotherapy.
  • Innovative treatments called targeted therapies may be prescribed to patients with metastasis when the cancer is refractory to iodine-131 treatment or in case of medullary cancer.

Surveillance and Recurrence Risk

After thyroid cancer treatment, regular medical monitoring is required.

Treatment Success Confirmation

A scintigraphic examination is performed 2 to 5 days after the post-operative administration of iodine-131 to confirm the absence of cancerous cells. Long-term treatment success is assessed 9 to 12 months after the initial treatment. Several tests are performed, including a cervical ultrasound and a thyroglobulin test. An abnormality can be a sign of recurrence. If no abnormality is detected, the risk of subsequent recurrence is very low.

Recurrence

Cervical recurrences occur in approximately 15% of patients. The chances of recurrence are greater when the tumor is large or when there is lymph node involvement. The reappearance of cancer cells usually occurs in the neck area (cervical recurrence) or in other parts of the body (distant metastases). The majority of recurrences can be treated or cured. Iodine-131 is the preferred treatment in the event of a relapse. For certain difficult-to-treat metastases, such as bone metastases, radiotherapy or targeted therapies may be recommended.

The treatment of thyroid cancer is primarily surgical, with a total or partial removal of the thyroid gland to eliminate the tumor and minimize the risk of recurrence. Hormone replacement therapy is required to compensate for the absence of thyroid and ensure a good quality of life. Other specific treatments may be prescribed depending on the type of cance