Most of the time, papillary thyroid cancer has a good outlook. Doctors can cure it if they can treat it correctly and early enough.
This type of thyroid cancer is the most common form. It makes up about 80% of all cases.
Your doctor will recommend a treatment for papillary thyroid cancer based on the type of cancer you have, the stage of the disease, and your overall health.
What Are the Treatment Options?
Many therapies and procedures are available to treat papillary thyroid cancer.
Some studies even suggest that if you have a very small tumor, you might not need treatment right away. Instead, your doctor can safely keep track of it with routine tests.
Doctors treat most papillary cancers with surgery. There are two main types:
- Thyroidectomy: Surgeons remove most or all of the thyroid gland.
- Thyroid lobectomy: Surgeons remove only half (one lobe) of the thyroid gland.
During these surgeries, doctors may also remove nearby lymph nodes -- small glands in your neck that are part of your immune system. They’ll check the lymph nodes for signs of cancer.
Risks of surgery include:
- Damage to the parathyroid glands, which can lead to low calcium levels
- Vocal cord problems, which can cause hoarseness, voice changes, a hard time breathing, or vocal cord paralysis
If you have thyroid surgery, you may need to take the medication levothyroxine (Levoxyl, Synthroid) for the rest of your life.
This medicine replaces the missing hormone that your thyroid would normally make. It also slows down your pituitary gland’s production of something called thyroid-stimulating hormone (TSH). High TSH levels could trigger growth in cancer cells that are still in the body.
Radioactive iodine treatment
Radioactive iodine comes as a capsule or liquid. When you swallow it, the radioactive iodine enters your bloodstream, and cells in your thyroid take it in. It essentially gives off radiation that destroys cancer cells.
Doctors often use this treatment after thyroid surgery to destroy microscopic cancer cells that may still be in your body. They also use it to treat thyroid cancer that comes back after treatment or spreads to other areas of the body.
You might have side effects, such as:
- Dry mouth or mouth pain
- Eye swelling
- A distorted sense of smell or taste
After treatment, your doctor will give you instructions to follow. You may need to eat a low-iodine diet for a day or so. You shouldn’t have close contact with other people for a while, especially pregnant women and children.
Most papillary thyroid cancers can be treated with surgery and radioactive iodine therapy. But if these don’t work, your doctor might recommend targeted medicines, which zero in on specific defects in cancer cells.
Two common targeted treatments for papillary thyroid cancer are:
- Lenvatinib (Lenvima)
- Sorafenib (Nexavar)
These medicines are in the category of kinase inhibitors. You take them by mouth.
Common side effects include:
- Loss of appetite
- High blood pressure
- Hand-foot syndrome (a condition that causes pain, redness, swelling, or blisters on the palms of the hands or soles of the feet)
People with papillary thyroid cancer rarely need radiation therapy. But your doctor may suggest it if your cancer has spread to other places, such as your esophagus or windpipe.
Radiation uses high-energy beams to kill cancer cells.
Some possible side effects are:
- Skin changes
- Trouble swallowing
- Dry mouth
Doctors don’t usually use chemo to treat papillary thyroid cancer, but if the condition has advanced, it may help.
This treatment uses medicines to kill cancer cells in the body. You take them by mouth or as a shot.
It can cause side effects, such as:
- Hair loss
- Mouth sores
- Loss of appetite
- Easy bruising or bleeding
- A higher risk for infections
A newer procedure, called alcohol ablation, may help treat small papillary thyroid cancers that have spread to other areas of the body or come back after treatment.
With alcohol ablation, doctors use ultrasound imaging to inject small thyroid cancers with alcohol. This causes the tumors to shrink.
If your papillary thyroid cancer spreads or comes back after surgery, it can be harder to treat. You may want to look into clinical trials, which offer cutting-edge options that might not be available to the general public.
What Happens After Treatment?
Even after successful treatment, your health care provider will keep an eye on your condition.
You’ll likely have regular blood tests to check how well your thyroid is working.
If your thyroid gland was completely removed, your doctor may suggest you have at least one radioactive iodine scan about 6 months to a year later. You probably won’t need any more scans if your results are negative and you don’t have other symptoms.
For those who have only one lobe of their thyroid removed, doctors will usually do routine physical exams, thyroid ultrasounds, and blood tests.
The good news is most people with papillary thyroid cancer respond well to treatment and live long lives. In fact, the 5-year survival rate for those with cancers that haven’t spread beyond the thyroid gland is close to 100%.