Thyroid cancer refers to the formation of cancer cells in your thyroid, the butterfly-shaped gland located at the front base of your neck. The National Cancer Institute (NCI) estimates 43,800 new cases of thyroid cancer in 2022.

If you receive a thyroid cancer diagnosis, your doctor will outline their recommended treatment options based on your age and cancer stage. Thyroid surgery (thyroidectomy) is the preferred method of treatment because it removes part or all of the thyroid gland.

Read on to learn more about thyroid cancer surgery, including the types, what the procedure involves, and what you can expect after surgery.

Illustration showing location of thyroid cancerShare on Pinterest
The size and location of a tumor on the thyroid gland determine the type of surgery needed. Illustration by Sophie Smith

Surgery is the primary form of treatment for thyroid cancer. However, not all cases are treated with a total thyroidectomy. Below are the types of thyroid cancer surgery your doctor may consider and why.

Thyroidectomy (total or partial)

A thyroidectomy refers to the removal of the thyroid gland. It’s considered the most common type of surgery used to treat thyroid cancer. A doctor can choose from three different types of thyroidectomy:

  • Total thyroidectomy: A total thyroidectomy means that the entire thyroid gland is removed.
  • Near-total thyroidectomy: A near-total thyroidectomy means almost the entire thyroid gland is removed.
  • Partial thyroidectomy: A partial thyroidectomy means only the affected portion or half of the thyroid gland is removed during surgery.

Lobectomy

A lobectomy involves the removal of the cancer lobe, as well as a small piece of gland called the isthmus.

This type of surgery is only preferred if an initial thyroid biopsy was inconclusive or in cases of papillary or follicular types of thyroid cancer that are extremely small and haven’t spread.

Lymph node removal

As the name suggests, this type of surgery involves the removal of nearby lymph nodes in which the thyroid cancer may have spread.

Rather than being done as a stand-alone procedure, lymph node removal is typically performed at the same time as a thyroidectomy.

Before your surgery, your doctor will advise you to stop taking certain herbs, supplements, and medications that may cause bleeding, including aspirin. You will be asked to fast after midnight on the morning of your surgery.

Thyroid cancer surgery is done at a hospital. You will arrive early in the morning to check in, and a nurse will take your vitals. General anesthesia is also used to help put you to sleep.

During the procedure, a surgeon makes a small incision across the base of your neck, usually about 3 inches long.

In all, the surgery takes about 2 to 3 hours. You will then be placed in a recovery room where your vitals are monitored while you wake up from anesthesia.

In some cases, people who undergo thyroid surgery can go home the same day.

Your surgeon will send you home with prescription pain medications following your operation. Depending on the type of stitches used, they will either be absorbed by your body or your doctor will remove them at your follow-up appointment.

If you have a near-total or total thyroidectomy, your doctor will prescribe thyroid hormone replacement medication, such as levothyroxine (Synthroid). This helps make up for the absence of thyroid hormones and must be taken daily.

You may have a small scar at the site of the incision. However, this may become less noticeable in the long term.

While you may be able to return to work within several days after surgery, you may need to wait 4 weeks to lift heavy objects.

It’s normal to experience some bleeding and discharge at the incision site.

While not common, potential complications of surgery for thyroid cancer include:

  • infection
  • excessive bleeding
  • formation of a blood clot in your neck (hematoma)
  • hoarse voice, which can happen due to windpipe irritation from the breathing tube used
  • vocal cord damage, which may cause temporary or permanent loss of voice
  • parathyroid gland damage, which may lead to symptoms of low blood calcium, such as numbness, tingling, and muscle spasms

The overall outlook for people who undergo thyroid cancer surgery is generally positive, especially when the cancer is caught in the early stages.

According to data from the NCI, the 5-year relative survival rate between 2012 and 2018 for thyroid cancer was 98.4%. Thyroid cancer comprises 0.4% of all cancer-related deaths.

The overall outlook also depends on age, with the risk of related death highest between the ages of 75 and 84.

Other factors that may affect your prognosis include:

  • whether the surgery removed all of the cancer
  • the type of thyroid cancer, with medullary types being the most serious
  • the stage of the cancer
  • your overall health

After surgery, you can expect to see your doctor regularly for thyroid checkups. You will also undergo blood testing to check your thyroid hormone levels, especially if you’re taking thyroid hormone replacement medication.

What are the symptoms of thyroid cancer?

Early stages of thyroid cancer may not cause any symptoms. However, as the tumor grows larger, you may feel a lump or swelling in your neck.

Other possible symptoms of thyroid cancer include:

  • hoarseness
  • trouble breathing
  • difficulty with swallowing

Where does thyroid cancer typically spread?

Thyroid cancer may spread to nearby tissues or through lymph nodes or your blood to more distant sites. Thyroid cancer can metastasize to the following areas:

  • Direct metastases (nearby tissues): esophagus and larynx
  • Distant metastases: lungs, liver, bones

What are the risk factors for thyroid cancer?

It’s estimated that 1.2% of adults will develop thyroid cancer during their lifetime. This type of cancer is more common in females and adults ages 25 to 65.

Other risk factors include a family history of thyroid disease or cancer and a personal history of an enlarged thyroid (goiter).

Is thyroid cancer curable with surgery, or can it come back?

While cancer recurrence is possible, surgery is considered the most effective option for treating thyroid cancer.

According to a 2021 review of 117 studies, total thyroidectomy was found to have the longest rates of recurrence-free survival in patients with papillary thyroid microcarcinoma, a type of thyroid cancer with small tumors.

What is the survival rate for thyroid cancer?

While individual circumstances may vary, thyroid cancer has a high survival rate overall, with an estimated 5-year survival rate of over 98%. Talk with your doctor about your case and what factors might affect your risk of cancer recurrence.

Surgery is the preferred treatment method for thyroid cancer, and it almost always consists of a partial or total thyroidectomy. Depending on whether the cancer has spread to your lymph nodes, some of your lymph nodes may also be removed during surgery.

When detected early, thyroid cancer has a high survival rate. Still, your doctor will want to follow up with you periodically to test for cancer recurrence.

If you’re taking thyroid hormone replacements, you will also need regular blood testing to make sure your thyroid levels are within a normal range.