Surgery for Thyroid Cancer: Risks, Recovery, and Expectations

The thyroid is located at the base of the neck. This butterfly-shaped gland produces hormones for controlling your body's metabolism, weight, heart rate, and blood pressure.

Therefore, if cancer develops in the thyroids, it can affect various bodily systems and functions. Radioactive iodine therapy, radiotherapy, and chemotherapy accompany thyroid surgery as the primary treatments for thyroid cancer.

What does the thyroid do?

The thyroid, or thyroid gland, is something that most people know very little about. Butterfly-shaped and sitting at the front of your neck, the thyroid is responsible for the functions of several body areas and systems. Without the thyroid regulating certain hormones, your body would not function correctly.

The thyroid uses hormones to regulate functions, such as:

Learn how your thyroid affects your mental health.

What is thyroid cancer?

Cancer occurs when cells grow out of control. Thyroid cancer is the uncontrolled growth of the cells in your thyroid.

Symptoms include:

• Swelling or a lump at the front of your neck;
• Difficulties with breathing or swallowing;
• Pain in the front of the neck;
• Cough not related to another illness and that does not go away;
• Voice changes;
• Hypothyroidism — not making enough thyroid hormones;
• Hyperthyroidism — making too many thyroid hormones.

Diagnostic testing for thyroid cancer:

• Blood test, especially for thyroid hormones;
• Physical exam;
• Imaging – ultrasound, CT-scan, MRI, Radioiodine Scan, PET-scan;
• Biopsy of any suspicious nodules or lumps.

There are four types of thyroid cancer, based on how aggressive they are: follicular, medullary, anaplastic, and papillary.

Treatments for thyroid cancer

Treatment of thyroid cancer depends on the type and stage. Your oncologist will meet with you to make a plan specific to you.

Type of treatments include:

Surgeries for thyroid cancer

Surgeries for treating thyroid cancer depend on how big the cancer is and where it is. Often, surgery is the primary therapy used for the treatment of thyroid cancer. However, if the cancer is contained in a small area, a lumpectomy can be performed to remove the tumor.

A lobectomy, or hemithyroidectomy, is the removal of one of the lobes, or wings, of the thyroid. Occasionally, lymph nodes are removed as well if they are found to contain cancer cells.

Total removal or near-total removal of the thyroid is called a thyroidectomy. The most common surgery used for thyroid cancer, your surgeon does their best to remove as much of your thyroid as possible.

Risks of thyroid surgery

As with any surgery or procedure, there are risks involved. Some of those risks are the same, no matter what surgery you are having, while others are specific to a particular surgery. Thyroid surgery does carry some risks, but as medical procedures and techniques advance, risks decrease.

• Bleeding. All surgery carries a risk of bleeding. The thyroid has a large blood supply, so a lot more bleeding can be expected with both a partial and total thyroidectomy. After surgery, you should watch for bruising, swelling, neck pain, new noisy breathing, or shortness of breath.
• Laryngeal nerve damage. The laryngeal nerves are connected to your voice box. Monitor for the following symptoms and let your surgeon know if any of them develop — hoarseness, difficulty speaking, or difficulty swallowing. Sometimes the nerve is just injured, and your symptoms will clear up in four to six weeks — but it can take up to a year to fully heal. The damage is most likely permanent if it has not healed within a year.
• Hyperparathyroidism. There are two parathyroid glands located near the thyroid. They release hormones to control the amount of calcium in your blood. Calcium is important in several of your body functions, most notably the beating of your heart and the regulation of nerves. Hyperparathyroidism is treated with a variety of medications and diet changes. Let your surgeon know if you develop any numbness or tingling in your fingers or mouth.

Recovery from thyroid surgery

Recovery time after a thyroid surgery depends on the individual and surgical procedure. However, most people go home within a day. Surgeons generally advise that their patients take two weeks off work to recover from surgery fully.

You can also expect:

• Pain that goes away with time;
• Swelling that goes away with time;
• Restrictions on lifting and any activities that can strain your neck;
• Scarring.

Do not hesitate to call your surgeon if you have any questions or concerns.

What to expect after thyroid surgery

After you recover from your surgery, there will be long-term effects of having all or part of your thyroid removed. If only part of your thyroid was removed, you will need to check thyroid hormone levels regularly to see if you need a thyroid hormone replacement therapy, such as levothyroxine. If your whole thyroid is removed, you will be started on replacement therapy right away.

Symptoms that your thyroid levels are low include:

• Feeling colder than normal;
• Increased tiredness;
• Dryer skin;
• Feelings of depression;
• Forgetfulness.

If you develop any of these symptoms, contact your doctor and let them know.

Thyroid surgery is almost always the first treatment for those diagnosed with thyroid cancer. It involves the removal of part or all of the thyroid to remove as much cancer as possible. There are risks and benefits to this surgery, as well as lifestyle changes that will happen after the surgery. Make sure you understand the risks and benefits before undergoing surgery.