Life after treatment for thyroid cancer
For most people, the cancer experience doesn’t end on the last day of treatment. Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.
Some people say that they feel pressure to return to “normal life”. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.
Cancer Council 13 11 20 can help you connect with other people who have had thyroid cancer, and provide you with information about the emotional and practical aspects of living well after cancer.
For more on this, see Living well after cancer.
Learn more about:
- Follow-up appointments
- Anxiety about follow-up appointments
- Dealing with feelings of sadness
- Looking after yourself
- If thyroid cancer returns
After treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects and check the cancer hasn’t come back or spread. During these check-ups, you may have a physical examination, blood tests, x-rays or scans. You will also be able to discuss how you’re feeling and mention any concerns you may have.
Blood tests to measure thyroglobulin (Tg)
If you have been treated for papillary, follicular or oncocytic thyroid cancer, you will have blood tests to check the levels of Tg. This protein is made by normal thyroid tissue and it may also be made by certain thyroid cancer cells. After a total thyroidectomy, you should have little or no Tg in your body, but levels will rise if the cancer comes back.
In the past, people often had to raise the TSH levels in their blood before having a Tg blood test. This improved the accuracy of the results. However, newer Tg tests are more sensitive, and most people won’t need to do this now. If a certain level of Tg is found in your blood, your doctor may suggest having scans. A small number of people have Tg antibodies. These antibodies don’t do any harm, but they make it hard to accurately measure Tg. They tend to be less detectable after RAI treatment.
Other blood tests
For medullary thyroid cancer, blood levels of calcitonin and carcinoembryonic antigen (CEA, a protein made by some cancer cells) will be measured periodically.
Blood tests are also done regularly to check if you are on the right dose of thyroid hormone replacement. Once this dose is stable, thyroid function blood tests are usually only needed every 6–12 months, or when there has been a change in thyroxine dose.
An ultrasound is used to see if any cancer is left or has come back in the area where the thyroid was removed. It also checks for cancer in the lymph nodes around the neck.
If your doctor needs more information, or if cancer cells are found elsewhere in your body, you may have a CT or PET scan. Radioisotope scans are no longer commonly used.
When a follow-up appointment or test is approaching, many people find that they think more about the cancer and may feel anxious.
Talk to your treatment team or call Cancer Council 13 11 20 if you are finding it hard to manage this anxiety.
Check-ups will become less frequent if you have no further problems. Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.
If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.
Talk to your GP, as counselling or medication – even for a short time – may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may also run a counselling program in your area.
Cancer can cause physical and emotional strain, so it’s important to look after your wellbeing. Cancer Council has free booklets and programs to help you during and after treatment.
Call 13 11 20 to find out more, or see Managing cancer side effects, Exercise after a cancer diagnosis, Complementary therapies, Emotions and cancer, Nutrition and cancer, Sexuality, intimacy and cancer, Fertility and cancer, LGBTQI+ people and cancer and Living well after cancer.
Alternative therapies are therapies used instead of conventional medical treatments. These are unlikely to be scientifically tested, may prevent successful treatment of the cancer and can be harmful. Cancer Council does not recommend the use of alternative therapies as a cancer treatment.
If thyroid cancer returns
For most people, thyroid cancer does not come back (recur) after the initial treatment. However, some people do have a recurrence. This is why it’s important to have regular check-ups.
If thyroid cancer does come back, it will often be in the lymph nodes. You may be offered further surgery, or a repeat of RAI treatment.
If the cancer has spread into other parts of the body, the first treatment will usually be RAI. Additional treatments such as targeted therapy, immunotherapy, external beam radiation therapy or chemotherapy may also be used. You may also be able to get new drugs through clinical trials.
A/Prof Diana Learoyd, Endocrinologist, GenesisCare North Shore, Faculty of Medicine and Health, University of Sydney, NSW; Emeritus Professor Leigh Delbridge AM, The University of Sydney, Thyroid Surgeon, The Mater and North Shore Private Hospitals, NSW; Prof Ruta Gupta, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and The University of Sydney, NSW; Susan Leonard, Cancer Nurse Coordinator Thyroid and Brachytherapy, Cancer Care Services, Royal Brisbane and Women’s Hospital, QLD; Dr Dean Lisewski, Endocrine and General Surgeon, Fiona Stanley Hospital and St John of God Hospital, Murdoch, WA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Jonathan Park, Consumer; A/Prof David Pattison, Deputy Director and Senior Staff Specialist, Department of Nuclear Medicine and Specialised PET Services, Royal Brisbane and Women’s Hospital and School of Medicine, University of Queensland, QLD; Prof Bruce Robinson, Endocrinologist, Co-Head, Cancer Genetics, Kolling Institute of Medical Research, The University of Sydney and Royal North Shore Hospital, NSW; Marissa Ryan, Team Leader (Cancer) Pharmacist, Princess Alexandra Hospital, Brisbane, QLD.
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