Understanding Thyroid Cancer
Well differentiated thyroid cancer comprise of papillary and follicular carcinomas. They form the majority of all thyroid cancers, with papillary thyroid cancer being the most common. Thyroid cancer generally follows an indolent course and has excellent response to treatment.
Globally there is a rising incidence of thyroid cancers being diagnosed, as high resolution ultrasound scans of the neck for thyroid test screening becomes more widespread, and improvements in imaging capabilities allows detection of smaller nodules. Most patients with well differentiated thyroid cancer have very good outcomes, with long-term survival rates unmatched by other types of cancer.
A small subset of thyroid cancer patients deviate from the norm and succumb from the disease despite aggressive intervention. The goals of management is to minimize the morbidity associated with unnecessary treatment for the majority, and optimizing care to prolong the survival of those with poorer prognosis.
Surgical Management of Thyroid Cancer
Surgical Considerations
The National Comprehensive Cancer Network (NCCN) and American Thyroid Association (ATA) guidelines deem hemithyroidectomy as adequate for small tumors up to 4 centimeters in low risk patients. Total thyroidectomy is considered for patients with high risk features. Benefits of removing all thyroid tissue include the ease of subsequent monitoring, by increasing the sensitivity of thyroglobulin assays as a tumor marker, and allowing proper interpretation of thyroxine stimulating hormone (TSH) levels during suppression therapy. Total thyroidectomy also facilitates radioactive iodine administration for diagnostic scans when looking out for locoregional or systemic recurrence, and enhances the efficacy of radioactive iodine treatment for ablation if necessary.
Surveillance Strategies
Surveillance strategies are dictated by the patient’s initial risk profile and modified according to their response to therapy. Most patients initially undergo annual biochemical tests and thyroid ultrasound monitoring for the first 5 years, as recurrences tend to occur early. Qualitative measurements of thyroglobulin and antibodies are serially traced to look for uptrending values or absolute high levels. Any further investigations like the whole body scan will be determined by the degree of suspicion for recurrent disease, as guided by the combination of the patient’s baseline risk profile, and current clinical status at follow up.
Get your thyroid checked Today
In Singapore, maintaining optimal thyroid health begins with regular screenings and check-ups. The first step involves a simple thyroid blood test and thyroid ultrasound, to precisely evaluate the health of your thyroid gland. By consulting a thyroid specialist in Singapore, such as Dr. Natascha, you can be assured of receiving personalized and accurate care tailored to your unique needs. Dr. Natascha is dedicated to delivering the highest standard of care for thyroid patients. Schedule your consultation today to take the first step toward a healthy thyroid.