Thyroid cancer is the cancer in the thyroid gland, an endocrine organ which produces hormones that control the speed of metabolism. Read more about thyroid cancer here. Surgical removal of thyroid cancers is the first option recommended for any thyroid cancer, since thyroid nodules are present for all types of thyroid cancer and they have to be removed.
How surgery works for thyroid cancer?
Surgical procedures aim at removing the thyroid tumours and lymph nodes. The procedure is carried out by making small incisions at the front of the neck to reach the thyroid and remove the cancer. This treatment requires a lot of preparation and after care, because of which they become a major part of the procedure. General procedure of surgical treatments for treating thyroid cancer is as follows:
Before surgery: The patients will have to take diagnostic tests before the surgery. This will help the doctor to recommend the exact type of surgery that is required for the patient.
During the surgery: Depending on the type of surgery, the procedure is carried out. For thyroid cancer, removal of thyroid tumours and affected lymph nodes is the aim. The patient will be taken into the operation theatre and is made to lie down on a table. Based on the type of the treatment and tolerance levels, local or full body anesthesia is given.
After treatment: Post surgery, the patient is shifted to room where he/she is monitored for one to days before discharging. The patients are also instructed about the care that they have to take after going home.
Types of surgery for thyroid cancer:
Depending on the diagnostic results of the patient, the doctor will decide the best surgical procedure for patients. Read more about diagnosis of thyroid cancer here. Following are the surgical procedure used for treating thyroid cancer:
Lobectomy:
Lobectomy is a surgical procedure used to treat differentiated thyroid cancers like papillary or follicular thyroid cancers. It is only used for small and non-metastasized cancers. This treatment is one of the most recommended surgery to patients because it leaves behind a portion of the thyroid gland reducing the dosage of thyroid hormone pills. One disadvantage is that the thyroid that is left will show up in cancer recurrence diagnosis post the treatment, which makes it difficult to identify malignant cells.
The surgical procedure of lobectomy begins the doctor making incisions on the front of the neck, through which the thyroid gland is reached. Then, one or both of the cancerous lobes are removed along the isthmus. For patients whose FNA biopsy doesn’t give accurate results, lobectomy is used to diagnose thyroid cancer.
Thyroidectomy:
This is one of the most common surgical procedures for treating thyroid tumours. The procedure of the surgery is common with that of lobectomy, which begins with making incisions at the front portion of the neck and then removes the tumours. The main difference between thyroidectomy and lobectomy is that, this treatment does not leaves any portion of the thyroid. This helps in diagnosing recurrent cancers post the surgery.
There are two types of thyroidectomy: total and near-total thyroidectomy.
- Total thyroidectomy: This treatment involves the complete removal of the thyroid and tissue. Total thyroidectomy is not suggested for patients in whom the tumours affect the entire thyroid gland or it causes swelling.
- Near-total thyroidectomy: This treatment is also referred as subtotal thyroidectomy. It’s is the most commonly recommended surgery for thyroid cancer. For near-total treatment almost all of the gland is removed, whereas for subtotal treatment, the surgeon removes the gland up to the maximum extent.
Lymph node removal:
This treatment is used when the cancer has spread the lymph nodes and the nearby lymph nodes are removed if the cancer has spread to the lymph nodes or has shown signs of spreading. In most of the cases, these are removed along with the thyroid tissue, during the surgery for thyroid cancer. The lymph node removal is the most important treatment for medullary and anaplastic thyroid cancer and is a part of the treatment of papillary and follicular cancers. Post the treatment, radioactive iodine is often recommended for the patients to treat the residual cancer. The procedure for the removal of the lymph nodes at the center of the neck, is known as central compartment neck dissection. While the removal of more number of lymph nodes from different organs is called modified radical neck dissection.
Complications of surgery in thyroid cancer:
Complications of any surgery are a common issue that patients encounter. But, their intensity varies depending on the area that has been treated, patient’s overall health, type and stage of cancer and the type of treatment being used. Following are the side effects that one can experience after being treated by surgeries for thyroid cancer:
- Temporary or permanent hoarseness: This occurs as a result of damage to the larynx that is present in throat. Since it is responsible for the voice, there can be changes in the pace and tone of the patient’s voice.
- Damage to the paratyphoid gland: This gland is responsible for the regulation of calcium levels in the body. Damage to it can lead to abnormalities in the calcium level, leading to numbness and tingling sensations along with muscle spasms.
- Hematoma: This phenomenon is when there is excessive bleeding after the surgery, or the formation of blood clots in the neck.
Wound infection: In some cases, the wounds which are left to heal will get infected, if proper care is not taken. - Neck stiffness
- Tiredness
On experiencing any of the above symptoms, the patients have to consult a doctor immediately. However, not all patients experience the same side effects and this depends on a lot of factors. Having a proper follow up plan will help the patients cope up better with the complications. Read more about concerns after treatment for thyroid cancer here.
Outlook of surgery for thyroid cancer:
Surgery is required for almost all types and stages of thyroid cancer. Most of the surgeries are successful in removing the tumours and lymph nodes, but there will be a need of other treatments that follow the surgery in cases of metastasized or recurring cancer.
After care for surgery for thyroid cancer:
Post surgical procedures, the patients will have to be very careful to avoid recurrence of cancer and to cope up with its side effects. Following a few tips which help the patients take proper care of themselves:
- Not too much of physical activity for two to four weeks after surgery Patients are not advised to do much of physical activity
- They have to have a proper diet that are smooth on the throat
- It is a compulsion that patients follow the diet prescribed by a nutritionist
- The patients have to consume a lot of fluids and stay hydrated
- Have periodic regular blood tests and scanning
- Depending on diagnostic results, some patients might require blood or hormones infusions
- Immediate diagnosis is required on experiencing any signs or symptoms of recurrent cancer
- Maintain personal health records
- Plan to cope up with side effects
- Patients are also recommended to join a thyroid cancer follow up plan monitored by a specialized health care
