Thyroid Cancer (cont.)
What about followup care for thyroid cancer?
Followup care after treatment for thyroid cancer is an important part of the
overall treatment plan. Regular checkups ensure that any changes in health are
noted. Problems can be found and treated as soon as possible. Checkups may
include a careful physical exam, x-rays and other imaging tests (such as a
nuclear medicine scan), and laboratory tests (such as a blood test for
calcitonin). The doctor can explain the followup plan—how often the patient
must visit the doctor and which types of tests are needed.
An important test after thyroid cancer treatment measures the level of
thyroglobulin in the blood. Thyroid hormone is stored in the thyroid as
thyroglobulin. If the thyroid has been removed, there should be very little or
no thyroglobulin in the blood. A high level of thyroglobulin may mean that
thyroid cancer cells have returned.
For six weeks before the thyroglobulin test, patients must stop taking their
usual thyroid hormone pill. For part of this time, some patients may take a
different, shorter-lasting thyroid hormone pill. But all patients must stop
taking any type of thyroid hormone pill for the last two weeks right before the
test. Without adequate levels of thyroid hormone, patients are likely to feel
uncomfortable. They may gain weight and feel very tired. It may be helpful to
talk with the doctor or nurse about ways to cope with such problems. After the
test, patients go back to their usual treatment with thyroid hormone pills.
The doctor may request an I-131 scan of the entire body. This may be called a
"diagnostic I-131 whole body scan." For a short time (usually six weeks) before
this scan, the patient stops taking thyroid hormone pills. Thyroid cancer cells
anywhere in the body will show up on the scan. After the test, the doctor will
tell the patient when to start taking thyroid hormone pills again.
Support for people with thyroid cancer
Living with a serious disease such as cancer is not easy. Some people find
they need help coping with the emotional and practical aspects of their disease.
Support groups can help. In these groups, patients or their family members get
together to share what they have learned about coping with the disease and the
effects of treatment. Patients may want to talk with a member of their health
care team about finding a support group. Groups may offer support in person,
over the telephone, or on the Internet.
People living with cancer may worry about caring for their families, keeping
their jobs, or continuing daily activities. Concerns about treatments and
managing side effects, hospital stays, and medical bills are also common.
Doctors, nurses, and other members of the health care team can answer questions
about treatment, working, or other activities. Meeting with a social worker,
counselor, or member of the clergy can be helpful to those who want to talk
about their feelings or discuss their concerns. Often, a social worker can
suggest resources for financial aid, transportation, home care, or emotional
support.
The Cancer Information Service can provide information to help patients and
their families locate programs, services, and publications.
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