Surgery for thyroid cancer
Surgery is the most common treatment for thyroid cancer. Before the operation, a surgeon and sometimes a specialist nurse will talk to you about what to expect. Ask them any questions and discuss any concerns you have. It is now more common to have just one lobe of the thyroid removed for smaller papillary cancers.
You will be given a general anaesthetic, and the surgeon will make a cut (usually around 3–5 cm) across your neck. How much tissue and how many lymph nodes are removed will depend on how far the cancer may have spread (see diagrams below).
Learn more about:
Types of thyroid surgery
Partial thyroidectomyIn a partial thyroidectomy (also called a hemithyroidectomy), only the affected lobe or section of the thyroid is removed. This is the most common surgery if the cancer is small and the other lobe looks normal on ultrasound. It may be used to diagnose thyroid cancer if a fine needle biopsy doesn’t give a clear diagnosis. This is called a surgical biopsy. If cancer is found after a partial thyroidectomy, you may need further surgery to remove all or most of your thyroid.
Total thyroidectomyMost people with thyroid cancer need to have a total thyroidectomy. This involves removing the whole thyroid (both lobes and the isthmus). Sometimes a small amount of thyroid may be left in a near-total thyroidectomy.
Lymph node removalWith either type of thyroid surgery, nearby lymph nodes may also be removed to help work out staging or if the initial scans show that the cancer has spread to them. This is called a neck dissection. Even if the cancer doesn’t appear to have spread, the nodes behind the thyroid are occasionally removed to reduce the risk of the cancer returning. In very rare cases, the surgeon also removes other tissue near the thyroid that has been affected by the cancer.
For more on this, see our general section on Surgery.
Podcast: Making Treatment Decisions
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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