Follow-Up Care for Thyroid Cancer

Thyroid cancer is one of the most treatable forms of cancer, and the long-term prognosis for thyroid cancer patients — particularly those who've had the most common forms of the disease — is usually excellent.
However, researchers have found that up to 35 percent of patients with papillary or follicular thyroid cancer experience recurrences, sometimes 10 years or more after treatment. Fortunately, many of these recurrences are treatable, so follow-up care for thyroid cancer is vitally important.

Thyroid Cancer Follow-Up

After your initial treatment for thyroid cancer, you and your doctor will determine a schedule of follow-up visits to check for cancer symptoms and see if your cancer has returned. These thyroid cancer follow-up exams are commonly scheduled every six months for the first few years after treatment, and then shift to an annual basis (though each case will be unique). Even if you haven't noticed any cancer symptoms, it's important to maintain this schedule. Thyroid cancer symptoms can be subtle, and your prognosis is much better if a recurrence is caught early.
Regular screenings will also help you address health problems that may result from your thyroid cancer treatment. Since patients treated with radioactive iodine and external-beam radiation have a greater risk for other cancers, any potential cancer symptoms between check-ups should be checked out by a doctor.

What Happens In Thyroid Cancer Follow-Up Exams?

Thyroid cancer follow-up exams may include:
  • Blood tests for thyroid-stimulating hormone (TSH) and thyroglobulin (Tg), a protein made by thyroid cells
  • Imaging exams, such as chest X-rays and ultrasounds
  • A physical exam
  • Whole body scans (WBS).
Once your cancer has been successfully treated, little or no thyroglobulin should remain in your bloodstream. Higher-than-normal Tg levels could signal that your thyroid cancer has returned. Similarly, after treatment, your body should have few thyroid cells. A couple of days after taking a small, safe dose of radioactive iodine — which is absorbed only by the body's thyroid cells — a whole body scan will reveal any lingering or returning thyroid cells as hotspots on an X-ray.
If any of these tests suggest a possible thyroid cancer recurrence, your doctor may order more tests, such as an ultrasound, computerized tomography (CT) scan or magnetic resonance imaging (MRI).

Preparing for Thyroid Cancer Follow-Up Exams

Getting ready for your follow-up exam might be the toughest part of the whole process.
After thyroid cancer treatment, many patients go on thyroid hormone replacement therapy to maintain their metabolic functions. But they may need to stop taking these medications before follow-up exams so doctors can do an accurate scan for thyroid cells and potential thyroid cancer recurrences.
Going off thyroid hormones can make you temporarily experience the symptoms of hypothyroidism, such as:
  • Depression
  • Fatigue
  • Trouble concentrating
  • Weight gain.
Ask your doctor for advice on dealing with these symptoms before your thyroid cancer follow-up.

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