There are three types of thyroid surgery to treat thyroid cancer. Thyroid lobectomy removes a part (or lobe) of your thyroid gland. Near-total thyroidectomy removes all but a very small part of your thyroid. Total thyroidectomy removes your whole thyroid gland. If the cancer has spread to your lymph nodes, those will also be removed. The decision about which type of surgery to have is based on your age, the type of thyroid cancer you have, how much the cancer has spread, and your general health.
- Total thyroidectomy removes the entire thyroid gland. This is the most common type of surgery, because most people have cancer in both parts (lobes) of the thyroid gland. This type of surgery provides the highest rates of cure and also makes radioactive iodine treatment and TSH suppression therapy work better.
- Near-total thyroidectomy removes all but a very small part of the thyroid gland. This is done in special cases with smaller tumors or if an experienced surgeon is not available.
- Thyroid lobectomy removes only one part (lobe) of the thyroid gland. This surgery is an option if your cancer is small and is only in one lobe of your thyroid gland. Lobectomy is less complicated than a thyroidectomy and less likely to lead to hypothyroidism. But people who have this type of surgery have a greater chance of their cancer coming back than people who have a thyroidectomy. Sometimes a lobectomy is done when cancer is suspected but not confirmed. If cancer is found in this case, a procedure called a completion thyroidectomy may be necessary.
During surgery, lymph nodes in the neck may also be removed and tested for cancer cells. If thyroid cancer has spread to the lymph nodes, radioactive iodine will be used to destroy the remaining cancer cells.
What To Think About
Most thyroid cancers grow and spread so slowly that you can delay surgery for a short time if necessary. If you choose to postpone surgery, your thyroid cancer should be watched closely by an endocrinologist.
Surgery to remove only the part of the thyroid gland that contains cancer (lobectomy) is less complicated than total thyroidectomy and less likely to lead to hypothyroidism. But thyroid cancer comes back (recurs) after lobectomy more often than it does after total thyroidectomy.
If you and your doctor decide that you need surgery, it is important to have the procedure done by a highly skilled surgeon at a hospital that has a good success rate. There are fewer problems from surgery when a person has a skilled and experienced surgeon.2
Clinical trials continue to evaluate new treatments for thyroid cancer. Talk with your doctor about clinical trials in your area. Information about ongoing clinical trials is also available from the National Cancer Institute. For more information, see the Other Places to Get Help section of this topic.
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