How is thyroid cancer treated? How many treatments are there?

Surgical treatment

Surgery is the first choice for the treatment of thyroid cancer. Once diagnosed, as long as conditions permit, the source and metastatic lesions should be completely removed to prevent metastasis and recurrence, so as to achieve the goal of cure. This is the basic principle of surgical treatment of thyroid cancer. However, due to the different stages of cancer, the scope of surgery should also be different. The operation must be thorough (no cancer cells should remain or spread) and safe (no life-threatening or unnecessary disability). The surgical method should be determined based on the pathological classification and clinical stage of thyroid cancer, as well as the patient's age and gender.

Radionuclide therapy

Thyroid tissue and differentiated thyroid cancer cells have the ability to absorb 131I. The biological effect of ionizing radiation of beta rays generated by 131I can destroy the residual thyroid tissue and cancer cells, thereby achieving the purpose of treatment. For patients with differentiated thyroid cancer, if there is residual thyroid tissue after surgery, the 131I absorption rate is greater than 1%, and if there is residual thyroid tissue in the thyroid bed during thyroid tissue imaging, 131I treatment should be performed. 131I treatment includes the removal of residual thyroid tissue after thyroid cancer surgery and the treatment of thyroid cancer metastatic lesions. Removal of residual thyroid tissue can reduce the possibility of recurrence and metastasis.

Endocrine therapy

Patients who have undergone subtotal or total thyroidectomy should take thyroxine tablets or levothyroxine for life to prevent hypothyroidism and inhibit TSH. Differentiated thyroid cancer cells all have TSH receptors, and TSH can affect the growth of thyroid cancer through its receptors. The general dosage is controlled to keep TSH at a low level but not cause hyperthyroidism. Plasma T4 and TSH are measured regularly to adjust the dosage.

External beam radiation therapy

Mainly used for undifferentiated thyroid carcinoma

Chemotherapy

Chemotherapy is not very effective for thyroid cancer. It is mainly used as an adjuvant treatment for poorly differentiated or undifferentiated cancer after surgery, and as a palliative treatment for advanced cases that are inoperable or have distant metastases and local recurrences that rapidly worsen after surgery.

Adriamycin is the most effective, with a response rate of 30% to 45%. It can prolong life and even allow long-term survival when the cancer lesions do not shrink.

In comparison, undifferentiated carcinoma is more sensitive to chemotherapy and is often treated with combination chemotherapy and specialized drugs.

In addition, chemotherapy kills cancer cells and also kills normal cells in the human body. Moreover, the drug dosage is not easy to control and is prone to toxic side effects. Chemotherapy also has toxic side effects (dizziness, nausea, vomiting, loss of appetite, fever, hair loss, leukopenia, etc.), which reduces the body's immunity and the patient's ability to fight cancer.