Treatment options

Treatment and care of people with cancer is usually provided by a team of health professionals, both medical and allied health, called a multidisciplinary team. 

Treatment for thyroid cancer depends on:  

• the stage of the disease 
• the location of the cancer 
• the severity of symptoms 
• your general health and wishes. 

A combination of treatments is often used. 

Surgery

Surgery is the main treatment for most thyroid cancers^[26]. Surgery may remove the affected part of the thyroid gland (lobectomy), or all of the thyroid gland (thyroidectomy). If the cancer has spread to the lymph nodes in the neck, these will be removed in the same surgery procedure^[27]. 

Radiation therapy

Radiation therapy can include taking a pill that contains radioactive substances (radioactive iodine therapy). These radioactive substances are absorbed by the thyroid cells and thyroid cancer cells^[28] and can damage the cells in the thyroid gland (including cancer cells) with little effect on the rest of the body. 

Radiation therapy can also be done from outside the body, using a machine to deliver high-energy rays to destroy cancer cells or slow their growth (external beam radiation therapy)^[29]. This is often used for cancers that don’t take up iodine, are resistant to radioactive iodine therapy, or have spread beyond the thyroid gland. 

Targeted therapy

Targeted therapy refers to treatment with medicines that are designed to specifically attack cancer cells with less harm to normal cells. Targeted therapy can be helpful when surgery and radioactive iodine therapy haven’t worked. 

These medicines target proteins that help cancer cells multiply, form new blood vessels and grow. Different medicines are used to treat the different types of thyroid cancer. Medicines used to treat papillary or follicular thyroid cancer include multikinase inhibitors such as lenvatinib and sorafenib. These are given in a tablet form.  

In some thyroid cancers, the cells have a change in the RET gene, which helps them grow andRET inhibitors such as selpercatinib can be accessed for these cancers.  

New types of tyrosine kinase inhibitors are being studied to treat advanced thyroid cancer. ^[30] 

Chemotherapy

Chemotherapy is not effective on its own to treat thyroid cancer. It may be used to treat advanced cancers that were not responding to radioactive iodine treatment or targeted therapy. It may be given as an injection into the veins, or as a tablet. Chemotherapy is usually given alone, but may also be used in combination with radiotherapy. 

Thyroid hormone therapy

Thyroid hormone therapy is used after the thyroid gland has been removed. It involves taking medicines to replace the hormones that the body can no longer produce after the surgery^[31]. This helps maintain the body’s normal function and may help lower the risk of the cancer coming back^[32]. 

Research is ongoing to find new ways to diagnose and treat different types of cancer. Some people may be offered the option of participation in a clinical trial to test new ways of treating thyroid cancer.