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Surgery |
Surgery is usually the first treatment needed for papillary, follicular
and medullary thyroid cancers. It is unlikely to be recommended
for lymphoma and anaplastic types of thyroid cancer.
If thyroid cancer has been diagnosed before surgery it is usual for
the whole thyroid gland to be removed during the operation (total
thyroidectomy). If there has been difficulty diagnosing the reason
for a thyroid lump or if cancer was not suspected before surgery
then removal of only one lobe of the thyroid may be done
(hemithyroidectomy or lobectomy).
If only one lobe has been removed and then cancer is discovered in
it, it is usual for the other thyroid lobe to be removed at a second
operation. In some cases however (young patients with small
follicular or papillary tumours) it might be suggested not to remove
the second lobe.
Sometimes the lymph glands/nodes are also removed. The number
of glands removed will depend on the size and type of the cancer,
what the surgeon can see and feel at the time of the operation and
the results of any scans performed before the
operation.
Many patients are able to go home 3-5 days after their operation.
Because of where the thyroid gland lies in the neck it is possible for the following to occur after a thyroid operation:
Hoarse Voice This can occur when the nerve that supplies the vocal cords is ‘bruised’ or damaged during the operation. The voice changes in this case are usually temporary.
Sometimes the nerve has to be cut in order to get the thyroid gland and the cancer out, this is rare however and your surgeon will talk to you about any expected risks before the operation.
Low calcium levelsThis can happen when the parathyroid
glands (there are 4 of them) that sit close to the thyroid
gland are removed or get ‘bruised’ during the operation.
These glands control the calcium levels in the blood.
If they are not working normally the calcium level will be low.
The calcium level will be checked by a blood test after your
operation and if the levels are low you will be given extra
calcium either as a tablet or through a drip.
Your surgeon will talk to you about this in more detail.
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Thyroxine |
When the thyroid gland is removed, thyroid hormone medication is needed to replace the thyroid hormones that the body can no longer make. Thyroxine tablets need to be taken once a day and are best taken first thing in the morning.
It might take a little while to get the right dose for each patient. But once the dose is sorted you should feel your normal self as the tablets are replacing the hormones that your thyroid gland would have produced. The dose will be monitored by finding out how you feel and by checking blood tests (TFTs).
(If you are going to need radioactive iodine treatment you may be
put on Tri-iodothyronine tablets to start with. This is given as a
tablet 3 times a day).
You will need to carry on with thyroid hormone medication for the
rest of your life.
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