Thyroid Cancer


Widespread – 50% population have a thyroid nodule

The majority are benign –  90-95%

No correlation with thyroid hormone levels



  • Swelling in front of the neck(most common)
  • Swelling inside of the neck
  • Change in voice
  • Difficulty in breathing/eating


Tests To Do

  • Ultrasound
  • If suspicious – USG guided FNAC
  • CT/MRI scan if necessary
  • PETCT – not much role




FNAC - no cancer what to do





FNAC negative -> No other risk factors -> Regular Follow-ups


FNAC – Cancer, what to do?

  • Cancer – Differentiated thyroid cancer – very good prognosis
  • Rare types medullary ca thyroid and anaplastic ca – poor prognosis
  • The younger age group has the best prognosis
  • 10-year survival – 90- 95%



  • Surgery is the main treatment
  • Radioiodine treatment in selected cases after surgery


Surgery For Thyroid Cancer

  • Small Tumors – total removal of the thyroid
  • Larger Tumors – total removal of thyroid with the removal of neck nodes


Thyroid Surgery and voice change

  • Why the worry?
    • Recurrent Laryngeal nerve courses underneath the thyroid
    • Direct/Indirect injury can cause temporary/permanent damage.
  • So should one avoid surgery?
    • Risk of permanent nerve injury in experienced hands < 3%.
    • No other alternatives to surgery.
  • What other problems to expect?
    • Hypocalcemia – Low calcium levels
    • Bleeding, infection
    • Superior laryngeal nerve injury
  • What happens after surgery
    • Based on the surgery report decision will be taken on the need for radioiodine therapy
    • They were usually given 4-6 weeks after surgery.
    • The patient is to be on an iodine-free diet and no thyroxine.


After Treatment

  • Regular Follow-ups.
  • Serum Thyroglobulin and scan
  • Recurrences can be treated.