Are you getting ready for thyroid cancer surgery? You probably have a few questions. We asked endocrine surgeon Rosemarie Metzger, MD, the most common questions people ask about thyroid surgery. Here are her responses:
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1. Is there more than one type of surgery for thyroid cancer?
The standard treatment for thyroid cancer is surgical removal of the entire thyroid (total thyroidectomy). “The major way that surgeries for thyroid cancer can differ is if we also have to remove the lymph nodes,” says Dr. Metzger.
“In some cases, we’ll remove the lymph nodes that are immediately behind or underneath the thyroid if we suspect the cancer has spread to those lymph nodes or if we discover they are cancerous during surgery. In a small subset of patients, we may also have to remove the lymph nodes on the side of the neck.”
2. Will I be in pain after thyroid cancer surgery?
Surprisingly, most people report minimal pain after thyroid cancer surgery.
“Thyroid surgery is very well tolerated by the vast majority of people,” Dr. Metzger says. “We inject local anesthetic during surgery to help minimize pain afterwards. Most do well on just Tylenol® or ibuprofen following surgery. The type of pain that people most frequently experience is rawness in the throat from the breathing tube. Most people do not have significant neck pain, although some report pain or stiffness in the back of the neck from the position they were in during surgery.”
3. How long will I have to stay in the hospital?
Most patients are discharged the morning after thyroid cancer surgery. It does not tend to take more than an overnight stay in the hospital to get patients back to home.
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4. When can I go back to work?
Although time off of work can differ depending on your overall health and the type of work you do, most people are able to go back to work within one to two weeks after thyroid cancer surgery. The average time is about a week.
“We ask people to avoid heavy lifting for at least a week after surgery, so people whose jobs require manual labor may need a little more time off than those who have a more sedentary job,” says Dr. Metzger.
5. What will my scar look like?
The average length of an incision for typical thyroid cancer surgery is approximately two inches.
“The length of the incision depends on the size of the thyroid,” Dr. Metzger says. “We’re very conscious of the fact that head and neck surgeries may result in visible scarring, so we do what we can cosmetically.”
“Most people have naturally occurring creases in their neck. I find these creases and mark them before surgery. Then I look to see which crease lines up best with the thyroid and that’s where I make my incision. As the scar heals, it fades and blends in with the skin crease.”
6. Will I need hormone replacement therapy?
After thyroid removal, you’ll need to take thyroid hormones for the rest of your life.
“The pill you take after thyroid removal is the exact same hormone that your thyroid normally makes,” says Dr. Metzger. “Most people don’t have any problems with the pills unless the dose is incorrect, in which case it can be adjusted.”
7. Will I need additional treatments after surgery?
Many patients will not need additional treatments after total thyroidectomy for thyroid cancer. Some may need radioactive iodine therapy. For this treatment, a patient swallows capsules or a liquid containing a small dose of radioactive iodine. It travels through the bloodstream and destroys thyroid cancer cells.