Thyroid Cancer (cont.)
How is staging determined for thyroid cancer?
If the diagnosis is thyroid cancer, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to learn whether the cancer has spread and, if so, to what parts of the body.
The doctor may use ultrasonography, magnetic resonance imaging (MRI), or computed tomography (CT) to find out whether the cancer has spread to the lymph nodes or other areas within the neck. The doctor may use a nuclear medicine scan of the entire body, such as a radionuclide scan known as the "diagnostic I-131 whole body scan," or other imaging tests to learn whether thyroid cancer has spread to distant sites.
What is the treatment for thyroid cancer?
People with thyroid cancer often want to take an active part in making
decisions about their medical care. They want to learn all they can about their
disease and their treatment choices. However, the shock and stress that people
may feel after a diagnosis of cancer can make it hard for them to think of
everything they want to ask the doctor. It often helps to make a list of
questions before an appointment. To help remember what the doctor says, patients
may take notes or ask whether they may use a tape recorder. Some also want to
have a family member or friend with them when they talk to the doctor—to take
part in the discussion, to take notes, or just to listen.
The doctor may refer patients to doctors (oncologists) who specialize in
treating cancer, or patients may ask for a referral. Specialists who treat
thyroid cancer include surgeons, endocrinologists (some of whom are called
thyroidologists because they specialize in thyroid diseases), medical
oncologists, and radiation oncologists. Treatment generally begins within a few
weeks after the diagnosis. There will be time for patients to talk with the
doctor about treatment choices, get a second opinion, and learn more about
thyroid cancer.
Getting a second opinion
Before starting treatment, the patient might want a second opinion about the
diagnosis and the treatment plan. Some insurance companies require a second
opinion; others may cover a second opinion if the patient or doctor requests it.
Gathering medical records and arranging to see another doctor may take a little
time. In most cases, a brief delay does not make treatment less effective.
There are a number of ways to find a doctor for a second opinion:
- The patient's doctor may refer the patient to one or more specialists. At
cancer centers, several specialists often work together as a team.
- The Cancer Information Service, at 1-800-4-CANCER, can tell callers about
treatment facilities, including cancer centers and other programs supported by
the National Cancer Institute.
- A local medical society, a nearby hospital, or a medical school can usually
provide the name of specialists.
- The American Board of Medical Specialties (ABMS) has a list of doctors who
have met certain education and training requirements and have passed specialty
examinations. The Official ABMS Directory of Board Certified Medical Specialists
lists doctors' names along with their specialty and their educational
background. The directory is available in most public libraries. Also, ABMS
offers this information on the Internet at http://www.abms.org. (Click on "Who's
Certified.")
Preparing for treatment
The doctor can describe treatment choices and discuss the results expected
with each treatment option. The doctor and patient can work together to develop
a treatment plan that fits the patient's needs.
Treatment depends on a number of factors, including the type of thyroid
cancer, the size of the nodule, the patient's age, and whether the cancer has
spread.
These are some questions a person may want to ask the doctor before treatment
begins:
- What type of thyroid cancer do I have?
- Has the cancer spread? What is the stage of the disease?
- Do I need any more tests to check for spread of the disease?
- What are my treatment choices? Which do you recommend for me? Why?
- What are the benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment?
- What is the treatment likely to cost?
- How will the treatment affect my normal activities?
- Would a clinical trial (research study) be appropriate for me? Can you help
me find one?
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People do not need to ask all of their questions or understand all of the
answers at one time. They will have other chances to ask the doctor to explain
things that are not clear and to ask for more information.
Patient Discussions
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Question: What was the treatment for your thyroid cancer?
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