Treatments for Thyroid Cancer

Surgery is the primary treatment for many types of thyroid cancer. Depending on the size and characteristics of the tumor, it may involve removing a single lobe of the thyroid—a procedure called a lobectomy—or the entire gland—a procedure called a total thyroidectomy. If lymph nodes in the neck are affected or strongly suspected of being affected, a lymph node dissection may be performed during the same surgical procedure.

Pathological analysis of the surgical specimen confirms the type of tumor, determines its extent, and helps determine follow-up treatments and monitoring.

Thyroid Surgery

This booklet describes the diagnostic tests, the main surgical procedures, the course of the operation, and postoperative care.

La chirurgie thyroïdienne

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Radioactive iodine, or iodine-131, is a targeted form of internal radiation therapy used to treat certain differentiated cancers originating from follicular cells. It may be recommended following a total thyroidectomy to destroy residual thyroid tissue, treat any persistent cancer cells, and, in certain situations, help assess the extent of the disease.

This treatment is not routine. Its indication depends, in particular, on the type of cancer and the risk of recurrence. It is discussed during a multidisciplinary team meeting, and the treatment is administered in a nuclear medicine department.

Radioactive Iodine Therapy

This booklet explains how to prepare for treatment, your hospital stay in the nuclear medicine department, the treatment process, and the radiation safety guidelines to follow after discharge.

Traitement de la thyroïde par l’iode radioactif

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After a total thyroidectomy, daily treatment with synthetic thyroid hormone replaces the hormones that the thyroid no longer produces. Depending on the type of cancer and the risk of recurrence, the dose may also be adjusted to maintain TSH at a level determined by the medical team.

Some locally advanced, recurrent, or metastatic differentiated thyroid cancers no longer respond to radioactive iodine. This is referred to as iodine-refractory cancer. Not all lesions require immediate treatment: the decision takes into account their location, progression, symptoms, and the patient’s overall condition.

Depending on the situation, several approaches may be considered:

• local treatment, such as surgery, external beam radiation therapy, or an interventional radiology technique;
• targeted therapy, selected based on the type of cancer and, in some cases, the molecular alterations found in the tumor;
• more rarely, chemotherapy;
• inclusion in a clinical trial when the patient is eligible.

Iodine-Refractory Thyroid Cancers

This document discusses follicular thyroid cancers that no longer respond to radioactive iodine, their monitoring, and the main treatment options.

Livret Cancers de la thyroïde réfractaires à l’iode

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