Recurrent Thyroid Cancer Treatment

If your thyroid cancer comes back (recurs) after you finish your original treatment, the treatment for the recurrence will depend on where the cancer comes back, the type of cancer you have, the treatment you had before, and your overall health.

If you did not have your thyroid removed when you received your treatment for cancer the first time, you might be treated with a total thyroidectomy.

• Total thyroidectomy - The surgeon removes the entire thyroid, and sometimes nearby lymph nodes, through an incision in the neck. In some rare cases, the surgeon also takes out other tissues in the neck that have been affected by the cancer.

If you already had a thyroidectomy, the doctor might do surgery to remove any cancer that you have still have.

Other treatment options are radioactive iodine and external beam radiation therapy.Radioactive iodine treatment can destroy cancer cells not removed by surgery and those that have spread beyond the thyroid.

• Radioactive iodine (radioiodine) - Radioiodine can destroy the rest of the thyroid gland and thyroid cancer (if the cancer takes up iodine) without affecting the rest of your body. Radioiodine is usually given as a capsule or in liquid form about 6 weeks after surgery. If you receive the usual dose, you will probably stay in the hospital for about 2 or 3 days while you are treated. If you receive a small dose, you will probably not have to stay in the hospital.

External beam radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells.

• External beam radiation therapy (EBRT) - Radiation from a high-energy x-ray machine (linear accelerator) outside the body is focused on the cancer cells. Most people are treated with EBRT for a few minutes 5 days a week for a few weeks or months as an outpatient.

Your doctor might also recommend chemotherapy, possibly in combination with radiation therapy. Chemotherapy drugs are used to kill cancer cells. Although there is no standard chemotherapy or combination of chemotherapy drugs, the following chemotherapies (alone or in combination) are sometimes used to treat recurrent thyroid cancer:

• Adriamycin^® (doxorubicin) - Doxorubicin hydrochloride belongs to the group of chemotherapy drugs known as anthracycline antibiotics. Doxorubicin stops the growth of cancer cells, which kills them. This drug is given by a shot in a vein over about 15 minutes. The dose and how often you get the medicine depend on your size, your blood counts, how well your liver works, and the type of cancer being treated. Your blood counts will be checked before each treatment; if they are too low, your treatment will be delayed.
• Blenoxane ^® (bleomycin) - Bleomycin belongs to the group of chemotherapy drugs known as antibiotics. Bleomycin interferes with cell division, which destroys the cells. Bleomycin is given by a shot into a vein, either over 10 minutes or as a continuous infusion for 24 hours, or as a shot into the muscle or under the skin. The dose is based on your size.
• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein over at least 1 hour. Your dose depends upon the type of cancer you have, your size, and how well your kidneys work.

This content has been reviewed and approved by Myo Thant, MD.