You need regular checkups after treatment for thyroid cancer. Even when there are no longer any signs of cancer, the disease sometimes returns because cancer cells remained somewhere in the body after treatment.
Your doctor monitors your recovery and checks for return of the cancer with blood tests and imaging tests. If thyroid cancer returns, it is most commonly found in the neck, lungs, or bones.
Also, checkups help detect health problems that can result from cancer treatment. People treated with radioactive iodine therapy or external radiation therapy have an increased chance of developing other cancers later on. If you have any health problems between checkups, you should contact your doctor.
People treated for papillary or follicular thyroid cancer have blood test to check the levels of TSH and thyroglobulin. Thyroid hormone is normally stored in the thyroid as throglobulin. If the whole thyroid has been removed, there should be very little or no thyroglobulin in the blood. A high level of thyroglobulin may mean that thyroid cancer has returned. Your doctor helps you get ready for a thyroglobulin test in one of two ways:
You stop taking your thyroid hormone pills for a short time: About six weeks before the throglobulin test, your doctor may change the type of thyroid hormone pill you take. About two weeks before the test, you stop taking any type of thyroid hormone pill. This can cause uncomfortable side effects. You may gain weight and feel very tired. It may be helpful to talk with your doctor or nurse about ways to cope with such problems. After the thyroglobulin test, you can take your usual thyroid hormone pill again.
You get a shot of TSH: Your doctor may give you a shot of TSH. If any cancer cells remain in the body after treatment, TSH cases them to release thyroglobulin. The lab checks the level of thyroglobulin in the blood. People who get this shot don’t have to stop taking their thyroid hormone pill.
People treated for medullary thyroid cancer have blood test to check the level of calcitonin and other substances.
In addition to blood test, checkups may include one or more of the following imaging tests:
Ultrasound: An ultrasound exam of the neck may show whether cancer has returned there.
Whole body scan: To get ready for the whole body scan, you either stop taking your thyroid hormone pill for several weeks or you get a shot of TSH (as described above for the thyroglobulin test). Most people need to avoid eating shellfish and iodized salt for a week or two before the scan. Your doctor gives you a very small dose of radioactive substance. The radioactive substance is taken up by cancer cells (if any cancer cells are present). Cancer cells show up on the scan.
PET scan: Your doctor uses a PET scan to find cancer that has returned. You receive an injection of a small amount of radioactive sugar. A machine makes computerized pictures of the sugar being used by cells in the body. Cancer cells use sugar faster than normal cells, and areas with cancer look brighter on the pictures.
CT scan: A CT scan may show whether cancer has returned.
MRI: MRI may show whether cancer has returned.
You may want to ask your doctor these questions after you have finished treatment:
- How often will I need checkups?
- Which follow-up tests do you suggest for me?
- Do I need to avoid iodized salt and other sources of iodine before any of these tests?
- Between checkups, what health problems or symptoms should I tell you about?
SOURCES OF SUPPORT
Learning that you have a serious disease such as thyroid cancer is not easy. You may worry about caring for your family, keeping your job, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common.
It may help to share your feelings with family, friends, a member of your health care team, or another person with cancer, Here’s where you can go for support:
Doctors, nurses, and other members of your health care team can answer questions about treatment, working, or other activities.
Social workers, counselors, or members of the clergy can be helpful if you want to talk about your feelings or concerns. Often, social workers can suggest resources for financial aid, transportation, home care, or emotional support.
Support groups can also help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, of treatment. Groups may offer support in person, over the telephone, or on the Internet. You may want to talk with a member of your health care team about finding a support group.
Information specialists at 1-800-4-CANCER and at LiveHelp (http:www.cancer.gov/help) can help you locate programs, services, and publications. They can send you a list of organizations that offer services to people with cancer.
THE PROMISE OF CANCER RESEARCH
Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). Clinical trials are designed to answer important questions and to find out whether new approaches are safe and effective. Research already has led to advances in the diagnosis and treatment of thyroid cancer. Researchers continue to search for new and better ways to treat thyroid cancer.
People who join clinical trials may be among the first to benefit if a new approach is effective. And even if the people in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about thyroid cancer and how to control it. Although clinical trials may pose some risks, researchers do all they can to protect their patients.
A dictionary with thousands of terms is on the NCI Web site at http://www.cancer.gov/dictionary.
Anaplastic thyroid cancer (A-nuh-PLAS-tik THY-ROYD KAN-ser): A rare, aggressive type of thyroid cancer in which the malignant (cancer) cells look very different from normal thyroid cells.
Benign (beh-NINE): Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body.
Biopsy (BY-op-see): The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. When only a sample of tissue is removed, the procedure is called an incisional biopsy. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy, core biopsy, or fine-needle aspiration.
C cell: A type of cell in the thyroid. C cells make calcitonin, a hormone that helps control the calcium level in the blood.
Calcitonin (KAL-sih-TOH-nin): A hormone formed by the C cells of the thyroid gland. It helps maintain a healthy level of calcium in the blood. When the calcium level is too high, calcitonin lowers it.
Calcium (KAL-see-um): A mineral found in teeth, bones, and other body tissues.
Cancer (KAN-ser): A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems.
Chemotherapy (KEE-moh-THAYR-uh-pee): Treatment with drugs that kill cancer cells.
Clinical trial: A type of research studies that test how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of disease. Also called a clinical study.
CT scan: Computed tomography scan (kum-PYOO-ted-tuh-MAH-guh-fee-skan). A series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan.
Endocrinologist (en-duh-krih-NAH-loh-jist): A doctor who specializes in diagnosing and treating hormone disorders.
External radiation therapy (RAY-dee-AY-shun): Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external-beam radiation.
Familial medullary thyroid cancer (fuh-MIH-lee-ul-MED-yoo-LAYR-ee): An inherited form of medullary thyroid cancer (cancer that forms in the cells of the thyroid that make the hormone calcitonin).
Familial polyposis (fuh-MIH-lee-ul PAH-lee-POH-sis): An inherited condition in which numerous polyps (growths that protrude from mucous membranes) form on the inside walls of the colon and rectum. It increases the risk of colorectal cancer. Also called familial adenomatous polyposis and FAP.
Fertility (fer-TIL-i-tee): The ability to produce children.
Fine-needle aspiration (as-per-AY-shun): The removal of tissue or fluid with a needle for examination under a microscope. Also called a needle biopsy.
Follicular thyroid cancer (fuh-LIH-kyoo-ler THY-rod KAN-ser): Cancer that develops from cells in the growing, highly treatable types of thyroid cancer.
Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.
Gland: An organ that makes one or more substance, such as hormones, digestive juices, sweat, tears, saliva, or milk.
Goiter (GOY-ter): An enlarged thyroid. It may be caused by too little iodine in the diet or by other conditions. Most goiters are not cancer.
Hormone: A chemical made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in a laboratory.
Hyperthyroidism (HY-per-THY-ROY-dih-zum): Too much thyroid hormone. Symptoms include weight loss, chest pain, cramps, diarrhea, and nervousness. Also called overactive thyroid.
Hypothyroidism (HY-poh-THY-ROY-dih-zum): Too little thyroid hormone. Symptoms include weight gain, constipation, dry skin, and sensitivity to the cold, Also called underactive thyroid.
Incision (in-SIH-zhun): A cut made in the body to perform surgery.
Iodine (I-oh-dine): An element that is necessary for the body to make thyroid hormone. It is found in shellfish and iodized salt.
Isthmus (iz-muhs): A narrow part inside the body that connect two larger structures.
Larynx (LAYR-inks): The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called the voice box.
Lobectomy (loh-BEK-toh-mee): Surgery to remove a whole lobe (section) of an organ (such as a lung, lover, brain, or thyroid gland).
Local therapy (THAYR-uh-pee): Treatment that affects cells in the tumor and the area close to it.
Lymph node (limf): A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called a lymph gland.
Lymph vessel (limf): A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also call lymphatic vessel.
Malignant (muh-LIG-nunt): Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.
Medical oncologist (MEH-dih-kul on-KAH-loh-jist): A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often is the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.
Medullary thyroid cancer (MED-yoo-LAYR-ee THY-royd KAN-ser): Cancer that develops in C cells of the thyroid. The C cells make a hormone (calcitonin) that helps maintain a healthy level of calcium in the blood.
Metastasis (meh-TAS-tuh-sis): The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).
Metastatic (meh-tuh-STA-tik): Having to do with metastasis, which is the spread of cancer from one part of the body to another.
MRI: Magnetic resonance imaging (mag-NEH-tik-REH-suh-nunts IH-muh-jing). A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. Also called nuclear magnetic resonance imaging (NMRI).
Multiple endocrine neoplasia syndrome (MUL-tih-pul EN-doh-krin NEE-oh-PLAY-zhuh SIN-drome): MEN. An inherited condition that may result in the development of cancers of the endocrine system (hormone-releasing tissues, such as the thyroid and pancreas). There are several types of multiple endocrine neoplasia syndrome, and patients with each type may develop different types of cancer. The altered genes that cause each type can be detected with a blood test. Also called MEN syndrome.
Nodule (NOD-yool): A growth or lump that may be cancerous or noncancerous.
Oncology nurse (on-KAH-loh-jee): A nurse who specializes in treating and caring for people who have cancer.
Papillary thyroid cancer (PA-pih-LAYR-ee THY-royd KAN-ser): Cancer that forms in follicular cells in the thyroid and grows in small finger-like shapes. It grows slowly, is more common in women than in men, and often occurs before age 45. It is the most common type of thyroid cancer.
Parthyroid gland (PAYR-uh-THY-royd): One of four pea-sized glands found on the surface of the thyroid. The parathyroid hormone made by these glands increases the calcium level in the blood.
Pathologist (puh-THAH-loh-jist): A doctor who identifies diseases by studying cells and tissues under a microscope.
PET scan: Positron emission tomography scan (PAH-zih-tron ee-MIH-shun toh-MAH-gruh-fee skan). A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.
Radiation (RAY-dee-AY-shun): Energy released in the form of particles or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, and medical x-rays.
Radiation Oncologist (RAY-dee-AY-shun on-KAH-loh-jist): A doctor who specializes in using radiation to treat cancer.
Radiation therapy (RAY-dee-AY-shun THAYR-uh-pee): The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy and irradiation.
Radioactive fallout (RAY-dee-oh-AK-tiv): Airborne radioactive particles that fall to the ground during and after an atomic bombing, nuclear weapons test, or nuclear plant accident.
Radioactive iodine (RAY-dee-oh-AK-tiv I-oh-dine): A radioactive form of iodine, often used for imaging tests or to treat overactive thyroid, thyroid cancer, and certain other cancers. For imaging test, the patient swallows a small dose of radioactive iodine that collects in thyroid cells and certain kinds of tumors and can be detected by a scanner. To treat thyroid cancer, the patient swallows a large dose of radioactive iodine, which kills thyroid cells.
Registered dietitian (dy-eh-TIH-shun): A health professional with special training in the use of diet and nutrition to keep the body healthy. A registered dietitian may help the medical team improve the nutritional health of a patient.
Surgeon: A doctor who removes or repairs a part of the body by operating on the patient.
Surgery (SER-juh-ree): A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
Surgical biopsy (SER-jih-kul BY-op-see): The removal of tissues by a surgeon for examination by a pathologist. The pathologist may study the tissue under a microscope.
Systemic therapy (sis-THE-mik THAYR-uh-pee): Treatment using substances that travel through the bloodstream, reaching and affecting cells all over the body.
Thyroglobulin (THIGH-roe-GLOB-yoo-lin): The form that thyroid hormone takes when stored in the cells of the thyroid. If the thyroid has been removed, thyroglobulin should not show up on a blood test. Doctors measure the thyroglobulin level in blood to detect thyroid cancer cells that remain in the body after treatment.
Doctors measure the thyrolobulin level in blood to detect thyroid cancer cells that remain in the body after treatment.
Thyroid (THY-royd): A gland located beneath the voice box (larynx) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism.
Thyroid follicular cell (THY-royd fuh-LIK-yoo-ler): A type of cell in the thyroid. Thyroid follicular cells make thyroid hormone.
Thyroid hormone (THY-royd HOR-mone): A hormone that affects heart rate, blood pressure, body temperature, and weight. Thyroid hormone is made by the thyroid gland and can also be made in the laboratory.
Thyroid hormone treatment (THY-royd HOR-mone): Treatment with thyroid hormone, which is a hormone that affects heart rate, blood pressure, body temperature, and weight.
Thyroid-stimulating hormone (THY-royd STIM-yoo-LAY-ting HOR-mone): TSH. A hormone produced by the pituitary gland. TSH stimulates the release of thyroid hormone from thyroglobulin. It also stimulates the growth of thyroid follicular cells. An abnormal TSH level may mean that the thyroid hormonal regulation system is out of control. Usually as a result of a benign condition (hyperthyroidism or hypothyroidism).
Thyroidectomy (THY-roy-DEK-toh-mee): Surgery to remove part or all of the thyroid.
Thyroidologist (THY-roy-DOL-oh-jist): A medical doctor who specializes in thyroid diseases.
Tumor (TOO-mer): An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign ( not cancerous), or malignant (cancerous). Also called neoplasm.
Ultrasound (UL-truh-SOWND): A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.
X-ray: A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.
NATIONAL CANCER INSTITUTE INFORMATION RESOURCES
You may want more information for yourself, your family, and your doctor. The following NCI services are available to help you.
NCI’s Cancer Information Service (CIS) provides accurate, up-to-date information about cancer to patients and their families, health professionals, and the general public. Information specialist translate the latest scientific information into plain language and respond in English or Spanish. Calls to the CIS are confidential and free.
Telephone: 1-800-4-CANCER (1-800-422-6237)
NCI’s Web site provides information from numerous NCI sources. It offers current information about cancer prevention, screening, diagnosis, treatment, genetics, supportive care, and ongoing clinical trials. It has information about NCI’s research programs, funding opportunities, and cancer statistics.
If you’re unable to find what you need on the Web site, contact NCI staff.
Use the online contact form at http://www.cancer.gob/contact or send an email to firstname.lastname@example.org
Also, information specialists provide live, online assistance through LiveHelp at http://www.cancer.gov/help
NATIONAL CANCER INSTITUTE PUBLICATIONS
NCI provides information about cancer, including the publications mentioned in this booklet. Many are available in both English and Spanish.
You may order these materials by telephone, on the Internet, or by mail. You may also read them online and print your own copy.
By telephone: People in the United States and its territories may order these and other NCI publications by calling the NCI’s Cancer Information Service at 1-800-4-CANCER
On the Internet: Many NCI publications may be viewed, downloaded, and ordered from http://www.cancer.gov/publications on the Internet. People in the United States and its territories may use this Web site to order printed copies. This Web site also explains how people outside the United States can mail or fax their requests for NCI booklets.
By mail: NCI publications may be ordered by writing to the address below:
Publications Ordering Service
National Cancer Institute
6116 Executive Boulevard, MSC 8322
Bethesda, MD 20892-8322
Radiation Therapy and You (also available in Spanish: La radioterapia y usted)
Radiation Therapy for Cancer: Questions and Answers
Chemotherapy and You (also available in Spanish: La quimioterapia y usted)
How To Find a Doctor or Treatment Facility If You Have Cancer (also available in Spanish: Cómo encontrar a un doctor o un establecimiento de tratamiento si usted tiene cáncer)
Living With Cancer
- Eating Hints for Cancer Patients (also available in Spanish: Consejos de alimentación para pacientes con cancer)
- Pain Control (also available in Spanish: Control del dolor)
- Facing Forward Series: Life After Cancer Treatment (also in Spanish: Siga adelante: la vida después del tratamiento del cáncer)
- Facing Forward Series: Ways You Can Make a Difference in Cancer
- Taking Time: Support for People with Cancer
- Coping with Advanced Cancer
- When Cancer Returns
Taking Part in Cancer Treatment Research Studies
Thinking About Complementary & Alternative Medicine: A guide for people with cancer
Complementary and Alternative Medicine in Cancer Treatment: Questions and Answers (also available in Spanish: La medicina complementaria y alternative en el tratemiento del cáncer: preguntas y respuestas)
Radioactive Iodine Fallout
- Get the Facts About Exposure to I-131 Radiation
- Making Choices: Screening for Thyroid Disease
- I-131 and Radioactive Fallout: Questions and Answers
- When Someone You Love Is Being Treated for Cancer: Support for Caregivers
- When Someone You Love Has Advanced Cancer: Support for Caregivers
- Facing Forward: When Someone You Love Has Completed Cancer Treatment
>> Back to top