General management plan for thyroid cancer
What is the general management plan for patients diagnosed with thyroid cancer?
Usually, patients who are diagnosed with thyroid cancer initially undergo surgery to remove the thyroid gland. Occasionally, one lobe is removed first, and then, if cancer is detected, the other lobe is removed. Most of the time, when cancer has already been definitively diagnosed in advance with biopsy, as much of the thyroid gland is removed as possible. The patient then goes to the nuclear medicine department for a scan and therapy. The pretherapy scan usually shows some uptake in the thyroid bed because it is difficult to remove all of the gland surgically, especially when it is adjacent to critical structures in the neck. Therapy is subsequently performed using 131 I after the patient has undergone thyroid hormone withdrawal or after receiving Thyrogen stimulation. The purpose of this therapeutic dose is to ablate any remaining normal thyroid tissue (some of which is usually left by the surgeon because of its proximity to critical structures in the neck) and to eliminate any remaining thyroid cancer cells. Patients are followed up at regular intervals with neck and whole body iodine scans as well as with serum measures of thyroglobulin. Patients can be retreated with 131 I if there is residual or recurrent tumor