Our Summary

This article discusses traditional surgical treatments for thyroid cancer, touching on established and widely accepted principles and practices. It also delves into recent debates and changes to traditional thyroid surgery, such as when surgery should be performed, how to manage certain nerves and glands during surgery, how much of the thyroid should be removed, and the significance of tracking surgical results and improving the quality of care.

FAQs

  1. What are the recent debates and changes to traditional thyroid surgery?
  2. What factors are considered when deciding how much of the thyroid should be removed during surgery?
  3. How is the management of certain nerves and glands during surgery essential in thyroidectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to make sure to follow all pre-operative instructions provided by the surgical team. This may include fasting before the procedure, stopping certain medications, and arranging for transportation to and from the hospital. Following these instructions can help ensure a successful surgery and smooth recovery.

Suitable For

Patients who are typically recommended for thyroidectomy include those with:

  1. Thyroid cancer: Patients with thyroid cancer may undergo thyroidectomy as part of their treatment plan. The extent of the surgery will depend on the type and stage of the cancer.

  2. Large or symptomatic goiters: A goiter is an enlarged thyroid gland that can cause symptoms such as difficulty swallowing or breathing. In cases where the goiter is large or causing symptoms, thyroidectomy may be recommended.

  3. Hyperthyroidism: In some cases of hyperthyroidism, where medications or other treatments have not been effective, thyroidectomy may be recommended to remove part or all of the thyroid gland.

  4. Suspicious thyroid nodules: If a thyroid nodule is found to be suspicious for cancer or is causing symptoms, thyroidectomy may be recommended to remove the nodule and surrounding tissue.

  5. Recurrent thyroid nodules: Patients with recurrent thyroid nodules that continue to grow or cause symptoms despite previous treatments may be recommended for thyroidectomy.

  6. Genetic conditions: Patients with certain genetic conditions that increase the risk of thyroid cancer, such as multiple endocrine neoplasia type 2 (MEN2) or familial medullary thyroid cancer, may be recommended for thyroidectomy as a preventive measure.

It is important for patients to discuss their individual case with their healthcare provider to determine if thyroidectomy is the best treatment option for them.

Timeline

Before Thyroidectomy:

  1. Diagnosis: The patient may experience symptoms such as difficulty swallowing, hoarseness, or a visible lump in the neck, leading to a visit to the doctor for evaluation.
  2. Testing: The doctor may order blood tests, ultrasound, fine-needle aspiration biopsy, or other imaging tests to confirm the presence of thyroid cancer and determine the extent of the disease.
  3. Pre-operative preparation: The patient may undergo further tests, such as a thyroid scan, to assess the function of the thyroid gland and determine the appropriate course of treatment.

After Thyroidectomy:

  1. Recovery: The patient will typically stay in the hospital for a day or two after the surgery to be monitored for any complications and receive pain management.
  2. Hormone replacement therapy: Since the thyroid gland is responsible for producing hormones that regulate metabolism, the patient will need to take synthetic thyroid hormone medication for the rest of their life to maintain proper hormone levels.
  3. Follow-up care: The patient will have regular follow-up appointments with their doctor to monitor their hormone levels, check for signs of recurrence, and address any potential complications from the surgery.
  4. Lifestyle adjustments: The patient may need to make dietary changes, such as avoiding certain foods that can interfere with thyroid hormone absorption, and may need to adjust their medication dosage as needed.

What to Ask Your Doctor

  1. Why is a thyroidectomy recommended for my condition?
  2. What are the risks and potential complications associated with thyroidectomy?
  3. How experienced are you in performing thyroidectomy surgeries?
  4. What type of thyroidectomy procedure will be performed (total, partial, etc.) and why?
  5. Will I need to take thyroid hormone replacement medication after the surgery?
  6. How long will the recovery process be and what kind of follow-up care will be necessary?
  7. What can I expect in terms of potential changes to my voice or swallowing after the surgery?
  8. Are there alternative treatment options to consider before undergoing thyroidectomy?
  9. What are the chances of the cancer returning after thyroidectomy?
  10. How will my thyroid function be monitored post-surgery and what signs should I watch out for that may indicate complications?

Reference

Authors: Roman BR, Randolph GW, Kamani D. Journal: Endocrinol Metab Clin North Am. 2019 Mar;48(1):125-141. doi: 10.1016/j.ecl.2018.11.003. PMID: 30717897