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ENDOCRINE CANCER

Diagnosis & Treatment

Thyroid Cancer

Find a thyroid cancer specialist

How is Thyroid Cancer Diagnosed?

Diagnosis

Thyroid cancer can be diagnosed after a person comes to the doctor with symptoms, or during a routine checkup or test. Some types of thyroid cancer are linked to genes passed down in families. NewYork-Presbyterian provides genetic counseling and testing for patients and their families for uncommon tumors such as medullary thyroid carcinoma. If you learn your family has a genetic mutation that increases your risk of thyroid cancer, we may monitor you or recommend prophylactic surgical removal of the thyroid to prevent cancer.

If your doctor suspects you may have thyroid cancer for any reason, they will conduct one or more tests to establish a positive diagnosis. Testing may include:

  • Physical exam - Your doctor will examine your neck area for any lumps
  • Imaging tests - Your physician may order one or more imaging tests, including an ultrasound imaging test and an imaging test using a radioactive tracer. If thyroid cancer is detected, they may order an MRI or CT scan to determine if the cancer has spread beyond the thyroid.
  • Blood tests - A blood test can help determine how your thyroid is functioning by measuring levels of thyroid-stimulating hormone (TSH) in the blood
  • Biopsies - Your doctor may order an ultrasound-guided fine-needle aspiration biopsy to remove and analyze cells from thyroid nodules. You can often have a needle biopsy on the same day as your initial evaluation. Our experts will perform an ultrasound scan of your thyroid, decide whether the findings require a biopsy, and perform the biopsy if needed.

How is Thyroid Cancer Treated?

Treatments

Depending on the type and stage of your thyroid cancer, lifestyle, and preferences, your doctor will recommend a treatment plan. This thyroid cancer treatment plan can consist of one or more of the following treatment options.

Thyroid cancer surgery

Most thyroid cancers are curable. These cancers are typically treated with surgery to remove part or all of the gland. The extent of surgery largely depends on the growth of your tumor. Our surgeons are experienced in performing these procedures using minimally invasive approaches, including transoral or robotic surgery. You may have:

  • Lobectomy - Removal of the lobe in which thyroid cancer is found
  • Near-total thyroidectomy - Removal of all but a very small part of the thyroid
  • Total thyroidectomy - Removal of the whole thyroid
  • Lymphadenectomy - Removal of nearby lymph nodes to see if they contain cancer cells

If you need thyroid surgery, you might be concerned about having a visible scar on your neck afterward. Our surgeons can use a surgical robot to access the thyroid from under the arm in some patients, reducing the visibility of the incision. We offer this technology to patients who want to avoid a neck scar and to those whose skin does not heal well after surgery.

There is a risk of nerve injury with thyroid surgery that can affect the quality of your voice and certain other risks. Our expert surgeons have minimized these risks to some of the lowest in the country.

Thyroid hormone replacement therapy

The thyroid normally produces thyroid hormone, which the body needs to help maintain normal metabolism. After your thyroid is surgically removed, your doctor will prescribe thyroxine (thyroid hormone) to replace your thyroid function. You’ll also undergo blood tests to monitor your thyroid hormone levels, specifically thyroid stimulating hormone (or TSH), to ensure you take a dose that works best for you.

When treating papillary or follicular thyroid cancers, typically, the goal is to keep the TSH in the low normal range since high levels of TSH can fuel the growth of any thyroid cancer cells remaining in your body.

Radioactive iodine for thyroid cancer

Radioactive iodine is sometimes recommended for more aggressive thyroid cancers. It is given as a single dose of radiation taken in a small capsule to try to kill any thyroid cancer cells that may remain in your body after surgery, thus reducing the chance of cancer returning.

We typically prescribe this treatment if you have papillary or follicular thyroid cancer (and some Hurthle cell carcinomas) that spread to lymph nodes or other parts of your body. Radioactive iodine is preferentially taken up by thyroid cells and some thyroid cancer cells, so toxicity associated with radioactive iodine treatment is generally minimal.

Targeted therapies for thyroid cancer

People with thyroid lymphoma, anaplastic thyroid cancer, and medullary thyroid cancer may have chemotherapy to shrink the tumor (such as the drug, paclitaxel. We give these therapies in our modern and comfortable infusion suites, which are staffed by experienced oncology nurses who are there to monitor and support you.

There are also several targeted therapies approved to treat persistent thyroid cancers. Examples include: cabozantinib and vandetanib for inoperable or advanced medullary thyroid cancer, and lenvatinib and sorafenib for advanced thyroid cancers that do not respond well to radioactive iodine. Because these targeted medications can be taken by mouth, you can take them at home. Your doctor will tell you if any of these treatments are an option for you.

Highly focused radiation therapy

If your thyroid cancer has spread or cannot be effectively treated with radioactive iodine or other therapies, you may have traditional external radiation therapy. NewYork-Presbyterian's state-of-the-art radiation treatment centers offer highly focused radiation therapy to treat thyroid cancer that aims at tumors while sparing as much nearby healthy tissue as possible, lessening the risk of side effects.

Clinical Trials

NewYork-Presbyterian participates in clinical studies evaluating novel treatments to advance the care of people with thyroid cancer, especially those whose disease does not respond well to standard therapies. Your doctor will let you know whether you’re eligible to participate in a clinical trial.

FAQs

FAQs

There is no definitive answer to how long your thyroid cancer can remain undiagnosed and unnoticed. Many thyroid cancers do not cause symptoms in the early stages of the disease. If you know you're at high risk of developing thyroid cancer, schedule regular physicals and screenings to improve your chances of catching any tumors early.

Almost 44,000 new thyroid cancer cases are diagnosed annually in the United States. Thyroid cancer is the seventh most common cancer in women.

Most thyroid cancers remain localized, but about 30% of patients will have metastatic cancer. Thyroid cancer cells can spread to the lymph nodes and distant organs and tissues such as the lungs and bones.

Most thyroid cancers are curable. The five-year survival rate for papillary and follicular cancer is almost 100% if the cancer is localized when treated. If papillary cancer has spread to distant organs, the survival rate falls to about 75%. Anaplastic thyroid cancers has a significantly worse prognosis. The five-year survival rate for localized anaplastic cancer is 34%, and falls to 7% if the disease metastasizes to distant organs.

Get Care

Trust NewYork-Presbyterian for Thyroid Cancer Treatment

NewYork-Presbyterian is committed to advancing our understanding of the cause of thyroid cancers and the best treatment options. Depending on the type and stage of your tumor, your team may include endocrinologists, endocrine surgeons, head and neck surgeons, and medical and radiation oncologists—all of whom have extensive experience working with thyroid cancer and other endocrine cancer patients.

NewYork-Presbyterian holds multidisciplinary clinics and tumor boards where specialists from different treatment modalities come together to customize your treatment needs. Team members collaborate to create a care plan wholly unique to you and ensure that you feel empowered and informed every step of the way.