Surgery is the recommended treatment for most types of thyroid cancer. However, there are times when surgery may not be effective, or can be safely postponed.

The thyroid is a small gland in the lower middle part of your neck. It resembles a pair of wings that wraps around your windpipe.

It’s common for nodules or lumps to grow on the thyroid gland. Most are not a sign of cancer. If you have a thyroid nodule, your doctor will run tests to determine whether it’s cancerous.

Surgery is a common treatment for thyroid cancer. But there may be instances when surgery isn’t necessary. This article will help explain when surgery is needed for thyroid cancer and when other treatments may be more effective.

Surgery is the first line of treatment for nearly all types of thyroid cancer. With that said, there are certain instances when surgery may not be required.

For example, if you have a very slow-growing type of thyroid cancer known as micro-papillary cancer, your doctor might suggest monitoring your condition with regular ultrasounds before treating the cancer. You might need surgery eventually, though.

Another instance when surgery may not be helpful is if you have a very rare type of thyroid cancer called anaplastic cancer.

By the time it’s diagnosed, anaplastic cancer has usually spread throughout the body. As a result, surgery isn’t likely to remove all the cancer. In this case, treatments such as chemotherapy or radiation may be the preferred course of action.

Your doctor can provide you with an overview of the safety and effectiveness of each available treatment. It’s important to voice any concerns you might have with your healthcare team before undergoing treatment.

Nearly 80% of thyroid cancers are papillary cancers, according to the American Cancer Society. Papillary cancers tend to grow very gradually and don’t usually spread beyond the nearby lymph nodes.

Because papillary cancers are localized to a single area, surgery is often the most effective way to treat them. This procedure involves removing the cancer as well as some or all of the thyroid gland. If the lymph nodes are affected, they can be removed as well.

Unlike chemotherapy or radiation, thyroid cancer surgery only affects the part of your body where the cancer is located. It’s a relatively short procedure with a fairly quick recovery time. In fact, you should be able to return to your usual activities within 1–2 weeks.

Side effects of thyroid surgery

After surgery for thyroid cancer, you might have some post-operation soreness where the surgeon made the incision in your neck. The incision will eventually form a tiny scar that should fade over time.

Although rare, other potential side effects of thyroid removal surgery can include:

  • infections
  • blood loss
  • blood clots
  • damage to the windpipe or vocal cords

Before undergoing surgery for thyroid cancer, be sure to ask your healthcare team what to expect and what your recovery timeframe will likely be.

Thyroid cancer is most often treated with surgery. There are several types of surgical procedures for thyroid cancer, including:

  • Lobectomy: If the cancer is confined to one lobe of the thyroid gland, the surgeon will only remove that lobe.
  • Near-total thyroidectomy: The surgeon removes almost all of the thyroid gland, including all of the cancer.
  • Total thyroidectomy: The surgeon removes all of the thyroid gland.

During the procedure, your surgeon will also check the lymph nodes in your neck for signs of cancer. If necessary, they can be taken out at the same time.

Following a near-total or total thyroidectomy, you’ll need to take thyroid hormone replacement medication called levothyroxine on a daily basis. This long-term treatment mimics the way a healthy thyroid gland functions and may help reduce your risk of cancer coming back.

Other types of treatment

Other treatments for thyroid cancer may be prescribed alongside surgery, but it depends on the type and stage of your cancer. Some possible therapies include:

  • Radioactive iodine (RAI): This treatment delivers radioactive iodine directly to thyroid cells, including cancer cells. It’s often used after surgery to destroy leftover thyroid gland tissue.
  • External beam radiation therapy (EBRT): EBRT uses a machine to send radiation to areas of your body affected by cancer. It’s used to treat rare, more aggressive types of thyroid cancer, including medullary thyroid carcinoma and anaplastic thyroid cancer.
  • Targeted drug therapy: Kinase inhibitors target proteins called kinases, which play a role in cell growth. They may be used to treat thyroid cancer when surgery or other treatments aren’t effective.
  • Chemotherapy (chemo): Chemotherapy involves taking drugs that help destroy or slow down the growth of cancer cells. Chemo is only used to treat thyroid cancers that have spread throughout the body.

Surgery is the recommended treatment for most types of thyroid cancer. During a thyroidectomy, a surgeon will remove some or all of the thyroid gland, including any tumors.

Surgery isn’t always necessary, though. It depends on the type of thyroid cancer and what stage it is.

For cancers that are small and slow-growing, surgery can sometimes be safely postponed. And for more advanced, aggressive thyroid cancers, surgery might not be effective.