Thyroid Cancer

Specialists in our Thyroid Cancer Center employ a multidisciplinary, team-based approach to the evaluation and treatment of patients with thyroid cancer. Our medical oncologists, endocrinologists, surgeons, radiation oncologists, and support staff will collaborate with you to develop a personalized treatment plan for you based on your type of thyroid cancer. Each year, our team provides advanced surgical, medical, and radiation treatments during thousands of patient visits, resulting in excellent outcomes.

Surgery

Surgery is the primary form of treatment for early-stage thyroid cancer. Our surgeons perform a high volume of procedures for thyroid cancer and are known for influencing thyroid surgery practices throughout the world.

We use real-time imaging during thyroid surgery to avoid injury to nerves and other important structures. Select thyroid and parathyroid cancer cases may be surgically treated in the Advanced Multimodality Image Guided Operating (AMIGO) Suite at Brigham and Women's Hospital Surgical to enhance navigation of certain tumors.

Surgical procedures for thyroid cancer may include:

• Thyroidectomy: Total thyroidectomy is the removal of the whole thyroid gland. Near-total or subtotal thyroidectomy is the removal of nearly all or most of the thyroid gland. The vast majority of our patients return home the next day following thyroidectomy.
• Thyroid lobectomy: A thyroid lobectomy is the removal of one lobe of the thyroid and the isthmus. Patients undergoing this procedure usually leave the hospital the same day.
• Lymph node excision or lymphadenectomy is the removal of nearby lymph nodes. This procedure may also be called a central compartment neck dissection or a modified radical neck dissection, depending on the extent of lymph node removal. Lymphadenectomy may be performed during thyroidectomy or lobectomy.

Medical oncology

Medical therapies may be provided for thyroid cancer and as a result of thyroid cancer treatment, including:

• Targeted therapies and chemotherapy: If thyroid cancer returns, a number of highly effective therapies are available. Chemotherapy may be used to treat the cancer, enhance radiation response, and ease symptoms. Targeted therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules, or molecular targets, that are involved in the growth, progression, and spread of cancer. Our team has led studies of numerous targeted therapies that have been shown to be effective in treating thyroid cancers. Patients with advanced and aggressive forms of thyroid cancer may access one of our clinical trials.
• Thyroid hormone therapy: Following thyroidectomy and radioactive iodine therapy, you may be prescribed thyroid hormone therapy to replace the thyroid hormones that your body needs but is no longer able to produce.

Radiation therapy

Radiation therapy may be used in conjunction with surgery and medical therapy to optimize treatment results and ease symptoms. Our team treats a high volume of patients with thyroid cancer, and our radiation oncologists, radiation therapists, and physicists specialize in the treatment of thyroid cancer and other head and neck cancers.

• External beam radiation: Several external beam radiation techniques may be used to treat patients with thyroid cancer. Intensity modulated radiation therapy (IMRT) is an external beam radiation therapy that precisely delivers radiation to the cancer site while minimizing radiation exposure and damage to normal surrounding tissues. In IMRT, the radiation dose can be customized by varying the amount of radiation given to different parts of the treatment area.
• Radioactive iodine (I-131): Radioactive iodine therapy uses a form of iodine that distributes radiation to treat common types of thyroid cancer. The thyroid gland absorbs iodine in the blood. When a large dose of radioactive iodine is taken, the radiation can destroy thyroid cancer cells with little effect on the rest of the body. Radioactive iodine is sometimes combined with external beam radiation. Together with surgery, these treatments have brought the cure rate for papillary and follicular thyroid cancers to more than 90 percent.

Treatment options by stage

Stage I and Stage II Papillary and Follicular Thyroid Cancer

• Total or near-total thyroidectomy or lobectomy
• Surgical removal of affected lymph nodes
• Radioactive iodine therapy may be given following surgery
• Thyroid hormone therapy

Stage III Papillary and Follicular Thyroid Cancer

• Total thyroidectomy
• Surgical removal of affected lymph nodes
• Radioactive iodine therapy or external radiation therapy may be given after surgery
• Thyroid hormone therapy

Stage IV Papillary and Follicular Thyroid Cancer

• Radioactive iodine therapy
• External-beam radiation therapy
• Surgical removal of affected lymph nodes and metastases
• Thyroid hormone therapy
• Clinical trial

Medullary Thyroid Cancer

• Total thyroidectomy for Stages I, II, and III
• Removal of affected lymph nodes for all stages
• External beam radiation therapy for Stages II, III, and IV
• Targeted therapy for Stage IV (metastatic medullary thyroid cancer)
• Chemotherapy to relieve symptoms and improve the quality of life for patients with Stage IV

Anaplastic Thyroid Cancer (always Stage IV)

• Total thyroidectomy (if thyroid cancer has not spread to other organs)
• Tracheostomy to relieve symptoms and improve quality of life
• External beam radiation therapy
• Chemotherapy
• Clinical trial

Your hospital care

Post-surgical and other inpatient care are provided by the Dana-Farber Brigham Cancer Center team either at Brigham and Women's Hospital or at Dana-Farber's Inpatient Hospital located within Brigham and Women's Hospital.

All outpatient therapy is provided at the Yawkey Center for Cancer Care at Dana-Farber Cancer Institute, one of the most advanced outpatient cancer centers in the country.

Radiation Oncology has two separate units, one at Brigham and Women's Hospital and one at Dana-Farber Cancer Institute.

For Referring Physicians

Referring physicians are an integral part of our patients' care team. We are committed to collaborating with you to provide the best care for your patient.

If you would like to refer a patient with diagnosed or suspected thyroid cancer, we look forward to working with you. How to refer a patient.

Informative links

Clinical Trials for Head and Neck Cancer

Patient's dramatic response and resistance to cancer drug traced to unsuspected mutations