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Thyroid Cancer

COVID-19 update: We know that our patients and their families have questions related to care during this time. Please see COVID-19 Information and FAQs for Patients With Cancer for the latest updates.

Thyroid cancer is usually slow-growing and considered to be one of the least dangerous cancers. It is often detected in its early stages, when the five-year survival rate is near 100 percent. 

Our patients with thyroid cancer get customized care from an experienced team of endocrinologists, oncologists and surgeons. UC San Diego Health is a recognized leader in the latest methods of diagnosing and managing thyroid cancer, which increases your chances of successful treatment.

See also: Thyroid Cancer Overview

Why Choose UC San Diego Health?

We provide:

  • State-of-the-art diagnostic tools and advanced imaging to assess thyroid cancer
  • Dedicated head and neck surgeons with extensive experience in minimally invasive thyroid surgery
  • Fewer and more efficient appointments thanks to our ability to perform the ultrasound, fine-needle biopsy and on-the-spot thyroid nodule evaluation in the same visit
  • Access to leading-edge clinical trials and innovative therapies, some which are unique to our center
  • All the resources of a world-class cancer center, including nutrition advice, support groups, and mind/body classes

Expert Diagnosis Makes A Difference

Dr. Kevin Brumund performing an ultrasound on a patient.

With access to leading-edge technology in one location, our experts can perform the diagnostic ultrasound, fine needle aspiration (FNA) and on-the-spot evaluation of thyroid nodules in the same visit. Pictured here is surgical oncologist Kevin Brumund, MD.

Thyroid nodules are common – nearly half of everyone in the U.S. will have at least one thyroid nodule by the age of 60. Fortunately, 90 percent of thyroid nodules are not cancerous.

Determining if a thyroid nodule is cancerous can be difficult. 

Our endocrinologists have received Endocrine Certification in Neck Ultrasound (ECNU) from the American College of Endocrinology (ACE). This is an advanced professional certification for physicians who perform consultations and diagnostic evaluations for patients with thyroid and parathyroid disorders using ultrasound and ultrasound-guided fine needle aspiration (FNA).

UC San Diego Health thyroid cancer experts reduce the need for unnecessary thyroid surgery through the thoughtful and selective use of molecular and genetic testing.

Diagnostic Tests for Thyroid Cancer

The best nonsurgical way to determine whether or not the nodule is cancerous is with fine needle aspiration (FNA). In this biopsy, an extremely thin needle is used to remove (or aspirate) a small amount of cells from the thyroid nodule. The aspirated samples are sent to the lab where they are carefully examined for abnormalities.

During the FNA, an ultrasound is used to make sure that samples are removed from the right place. Ultrasound-guided FNA biopsies are especially useful in cases where the thyroid nodule is small.

Other tests that may be used to diagnose a cancerous thyroid nodule:

  • Physical exam: The first test to look for thyroid cancer is a physical examination of your thyroid, lymph nodes, and throat.
  • Surgical biopsy: A surgical biopsy may be needed depending on the FNA results. This type of biopsy is done under general anesthesia.
  • Blood tests: Blood tests may be used to measure your levels of T3 and T4 (thyroid hormones), calcitonin, and thyroid stimulating hormone (TSH). Other blood tests include one that looks for mutations of the RET gene, a factor that can cause papillary thyroid cancer and medullary thyroid cancer (MTC).

Diagnostic Imaging techniques we use include:

  • Thyroid ultrasound: Solid nodules are more likely to be cancerous. An ultrasound can help determine if a thyroid nodule is solid or filled with fluid.
  • Computed tomography (CT) scan: The CT scan is an X-ray test that takes many pictures of body tissue to produce detailed, cross-sectional images. This scan can help identify the size and location of the thyroid cancer and if it has spread.
  • PET scan: A positron emission topography scan can be used to look for cancerous tumor cells and see if it has spread beyond the thyroid.
  • Radioactive iodine uptake scan: This nuclear medicine test involves swallowing a small amount of radioactive iodine (it may also be injected). Once the iodine is given time to be absorbed by the thyroid gland, a special camera is used to pinpoint the location of radioactivity.
  • Octreotide scan: People with suspected medullary thyroid cancer are injected with octreotide and a radioactive substance. Imaging tests are then performed to see how much of the octreotide has been absorbed. This test is helpful in showing if a tumor is present and, if so, its size.

Surgery for Thyroid Cancer

Surgical removal of all or part of the thyroid gland is the most common treatment for almost all cases of thyroid cancer.

Our skilled surgeons use delicate, minimally invasive surgical techniques to remove the thyroid. This means smaller incisions, shorter recovery time, and an outpatient surgery rather than a hospital stay.

The treatment option(s) that’s best for you depends on:

  • The stage of cancer
  • Size of nodule
  • Age and health
  • Type of thyroid cancer

In many cases, complete removal of the thyroid (total thyroidectomy) is recommended. This is because the likelihood that the cancer will return in the remaining thyroid tissue is high (exception: less than one centimeter of cancer is found).

If less than 1 centimeter of cancer is found, a partial thyroidectomy may be a viable option. Benefits of a partial thyroidectomy include a lower chance that hormone therapy will be needed – compared to a total thyroidectomy which results in hypothyroidism, a condition that requires hormone replacement medication for life.

The downside to a partial thyroidectomy is that if the cancer returns, a second surgery on the thyroid gland will be needed.

Radioactive Iodine Ablation

Small amounts of thyroid tissue are sometimes left over after the initial thyroid surgery. This is done to protect your parathyroid glands as well as the nerve that controls your voice box (the laryngeal nerve). Radioactive iodine ablation is used to eliminate this remaining healthy thyroid tissue.

Radiation therapy kills cancer cells and keeps them from growing. Current methods allow doctors to precisely target cancer cells for radiation treatment. As a result, we are able to deliver the maximum amount of radiation without damaging healthy cells. 

Radioactive iodine is taken by mouth or injected into the body and absorbed by the thyroid tissue. Because thyroid tissue is the only thing that takes up iodine, only thyroid cancer cells and thyroid tissue are destroyed.

Nonsurgical Treatments for Thyroid Cancer

  • External Beam Radiation: External beam radiation accurately delivers radiation using a machine that generates high-energy rays. This type of therapy is only given in rare instances of recurrent or advanced cancer.
  • Chemotherapy: During chemotherapy, anti-cancer drugs are taken by mouth or injected, and reach cancer cells through the bloodstream. Chemotherapy is sometimes combined with external beam radiation therapy to treat anaplastic thyroid cancer.
  • Targeted Therapy: A unique type of chemotherapy, targeted therapy drugs identify the programming of cancer cells that make them different than normal cells. Targeted therapy helps prevent cancer recurrence and also keeps the cancer from spreading. It is often used in conjunction with other cancer treatments.

Research

Our team is dedicated to clinical research. Your physician may discuss with you the possibility of joining a clinical trial, which could offer new treatment approaches that are not otherwise available.

Appointments & Referrals

Location

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Hillcrest

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Personalized Care

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We use genetic testing to analyze tumors and tailor treatment to individual patients. See Center for Personalized Cancer Therapy.