After treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects and check that the cancer hasn’t come back or spread. How often you will need to see your doctor will depend on the type of thyroid cancer and which treatments you had.
During these check-ups, you will also be able to discuss how you’re feeling and mention any concerns, and you may have some blood tests and scans.
Blood tests to measure Tg
If you have been treated for papillary or follicular thyroid cancer, you will have blood tests to check the levels of thyroglobulin (Tg). This protein is made by normal thyroid tissue and it may also be made by papillary or follicular thyroid cancer cells.
After a total thyroidectomy, you should have little or no Tg in your body, but levels will rise if the cancer comes back. If Tg is found in your blood, your doctor may suggest having some scans.
A small number of people have Tg antibodies. The antibodies cause no harm but they make it hard to accurately measure Tg. They tend to fade after RAI treatment.
Other blood tests
For medullary thyroid cancer, blood levels of calcitonin and carcinoembryonic antigen (CEA, a protein made by some cancer cells) will be measured periodically.
Blood tests are also done regularly to check if you are on the right dose of thyroid hormone replacement. Once this dose is stable, thyroid function blood tests are needed only every 6–12 months.
An ultrasound is used to see if any cancer is left or has come back in the area where the thyroid was removed. It also checks for cancer in the lymph nodes around the neck.
This test is used to check if there are any thyroid cancer cells remaining in your body after treatment. It is used less often now as the Tg blood test and neck ultrasound usually provide enough information. If you are having a radioisotope scan, you may need to raise your TSH levels beforehand.
For the scan, a small amount of radioactive dye is injected into a vein in your arm. You will lie under a machine called a gamma camera, which takes the scan and measures the amount of radioactive dye taken up by any remaining thyroid tissue or other areas of disease. A radioisotope scan is painless and causes few side effects. After the scan, you will not be radioactive and it is safe to be with other people.
If your doctor needs more information, or if cancer cells are found elsewhere in your body, you may also need a CT or PET scan.
Anxiety about follow-up appointments
When a follow-up appointment or test is approaching, many people find that they think more about the cancer and may feel anxious. Talk to your treatment team or call Cancer Council on 13 11 20 if you are finding it hard to manage this anxiety.
Check-ups will become less frequent if you have no further problems. Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.
For most people, thyroid cancer does not come back (recur) after the initial treatment. However, some people do have a recurrence. This is why it’s important to have regular check-ups.
If thyroid cancer does come back, it will often just be in the lymph nodes and you may be offered further surgery, sometimes with a repeat of radioactive iodine (RAI) treatment. If the cancer has spread into other parts of the body, the first treatment will usually be RAI. Additional treatments such as targeted therapy, external beam radiation therapy or chemotherapy may also be used.
Asking your doctor questions will help you make an informed choice about your treatment and care. You may want to include some of the questions below in your own list:
- What type of thyroid cancer do I have?
- Has the cancer spread? If so, where has it spread? How fast is it growing?
- Are the latest tests and treatments for this cancer available in this hospital?
- Will a multidisciplinary team be involved in my care?
- What treatment do you recommend? What is the aim of the treatment?
- Are there other treatment choices for me? If not, why not?
- If I don’t have the treatment, what should I expect?
- How long do I have to make a decision?
- I’m thinking of getting a second opinion. Can you recommend anyone?
- How long will treatment take? Will I have to stay in hospital?
- Are there any out-of-pocket expenses not covered by Medicare or my private health cover? Can the cost be reduced if I can’t afford it?
- How will we know if the treatment is working?
- Are there any clinical trials or research studies I could join?
- What are the risks and possible side effects of each treatment?
- Can I work, drive and do my normal activities while having treatment?
- Will the treatment affect my sex life and fertility?
- Should I change my diet or physical activity during or after treatment?
- Are there any complementary therapies that might help me? Will these affect my thyroid hormone replacement medicine?
- How often will I need check-ups after treatment?
- How will my thyroid hormone levels be monitored?
- If the cancer returns, how will I know? What treatments could I have?
Understanding Thyroid Cancer
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Expert content reviewers:
A/Prof Diana Learoyd, Endocrinologist, Northern Cancer Institute, and Northern Clinical School, The University of Sydney, NSW; Dr Gabrielle Cehic, Nuclear Medicine Physician and Oncologist, South Australia Medical Imaging (SAMI), and Senior Staff Specialist, The Queen Elizabeth Hospital, SA; Dr Kiernan Hughes, Endocrinologist, Northern Endocrine and St Vincents Hospital, NSW; Yvonne King, 13 11 20 Consultant, Cancer Council NSW; Dr Christine Lai, Senior Consultant Surgeon, Breast and Endocrine Surgical Unit, The Queen Elizabeth Hospital, and Senior Lecturer, Discipline of Surgery, University of Adelaide, SA; A/Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and The University of Western Australia, WA; Ilona Lillington, Clinical Nurse Consultant (Thyroid and Brachytherapy), Cancer Care Services, Royal Brisbane Women’s Hospital, QLD; Jonathan Park, Consumer.
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The information on this webpage was adapted from Understanding Thyroid Cancer - A guide for people with cancer, their families and friends (2020 edition). This webpage was last updated in July 2021.