Thyroid Cancer Diagnosis & Treatment

When a thyroid nodule is found to be cancerous, Virginia Mason Franciscan Health offers comprehensive care provided by a multidisciplinary team that includes endocrinologists (doctors specializing in diseases related to hormones), surgeons, radiologists and if needed, oncologists (cancer specialists). Together, they develop a targeted and focused plan of treatment specifically tailored to your needs.

Your doctor may use several tests to diagnose thyroid cancer:

• Medical history and physical exam: Your doctor will talk with you about your risk factors and examine your neck to feel for thyroid nodules.
• Blood tests help determine if your thyroid gland is functioning normally.
• Imaging tests, such as ultrasound, CT, MRI, and nuclear imaging tests, help your care team see your thyroid better and determine whether a thyroid nodule is likely to be cancerous.
• A fine-needle aspiration biopsy uses a long, thin needle, often guided by ultrasound imaging, to obtain a sample for testing.
• Genetic testing can identify genetic changes that can be associated with other endocrine cancers.

Most patients with thyroid carcinoma will need to have the entire thyroid gland removed. It’s important that your surgery be performed by a surgical team with a lot of experience doing these kinds of procedures.

Your doctor may recommend radioactive iodine therapy if the cancer exceeds a certain size or has spread to adjacent tissue or to distant sites in the body (metastasized). This treatment is uniquely suited for thyroid cancer because thyroid cells are the primary cells in the body that utilize iodine. Thus, using radioactive iodine, which is toxic to cells that take it up, the treatment targets only thyroid cells. This therapy allows for destruction of remaining normal and abnormal thyroid tissue, including metastatic disease, and also improves the ability to perform surveillance for recurrence.

If your thyroid gland is removed, you’ll need to take thyroid hormone replacement in pill form each day to replace the hormone that’s no longer being produced in your body.

The primary goal in replacing thyroid hormone for most people with thyroid cancer is to make the thyroid-stimulating hormone (TSH) levels in the blood lower than the normal range, since TSH from the pituitary gland is known to stimulate tumor growth. “TSH suppression” is accomplished by giving higher than average amounts of thyroid hormone pills. Medical studies have found that cancer is more likely to come back in individuals who do not take this therapy. It’s important that you let all your doctors know you have thyroid cancer when they check your TSH levels, because “normal” values in a person with thyroid cancer may be inappropriate.

If you’ve been diagnosed with thyroid cancer, learn more about second opinions and how they may help you find all your available treatment options.

Virginia Mason Franciscan Health is a leader in cancer research. Learn more about research and clinical trial options. 

Cancer treatment includes more than just treating physical symptoms. Learn more about our comprehensive wellness and support services. 

To learn more about thyroid cancer or to make an appointment, find a specialist near you.