Thyroid cancer is an affection of the thyroid gland. It is known that this curable cancer may be treated only with surgical removal of at least a part of the thyroid gland. This surgical intervention needs to be followed by RAI. A lifelong T4 treatment is recommended to hold back serum TSH. With less chances of curing we might mention histological thyroid cancer such as undifferentiated thyroid cancer, medullary thyroid cancer and follicular thyroid cancer. Invasive tumor and old age also represent along with tumors larger than 5 cm poor prognostic factors in thyroid cancer.



It is not a general opinion that says subtotal or complete thyroidectomy in absolutely necessary in treating thyroid cancer. More than that most of the specialists believe that partial thyroidectomy or lumpectomy is a poor operation.

These different opinions about treating patients with thyroid cancer are the results of many medical reports that say papillary thyroid cancer, for example, will be cured well in more than 80 % of the cases in spite of how they are treated.

Regardless to all different opinions we may say that total thyroidectomy has advantages too. Total thyroidectomy means the removal of all intrathyroid tumors and the ability to follow up with thyroglobulin.

After surgical treatment of any type of thyroid cancer a decision about ablating or not any remaining tissue must be taken.

Some categories of patients such as patients that have passed 40 years, patients with follicular cancer, patients with occult papillary cancer, patients under 20 with the same types of cancer and patients of any age with residual tumor or in metastatic phases are highly recommended for an ablative dose of l-131. Contrarily to the categories of patients mentioned earlier, patients with medullary and anaplastic cancers do not concentrate l-131 therefore there is no need for ablation.

Ablation treatment is recommended is indicated to be taken for at least four weeks after ending T3 and T4 treatments in order to increase l-131 intake. If this method fails the patient is advised for thyroid hormone therapy. This way of treatment should hold back serum TSH to reach undetectable levels. Another scan is not necessary if the ablation proves to be a success or if thyroglobulin level is normal and recurrent disease does not mean a risk. I-131 ablation is the choice for metastatic thyroid cancer too because chemotherapy proved to be inefficient.

One of the biggest concerns of the patients is the cosmetic appearance after an intervention. Treatment is not going to reduce significantly the size of the goiter and neither the surgical intervention. More than that, a surgical intervention never proved to be unaesthetic.