Partial thyroid removal can stop cancer, heads off thyroid replacement drugs

Sometimes in medical treatments, less is more. That's the case with thyroid cancer, where doctors now find that less drastic surgery, or no surgery at all, is the best course.

Early in his career, Dr. Varun Vendra, an otolaryngologist and surgical oncologist at Fox Chase Cancer Center, would have routinely removed all the thyroid gland in patients with thyroid cancer.

Now, he's more likely to recommend just removing part.

"We know now, as the data is supporting that, doing a partial thyroidectomy, or half of the thyroid on the side that contains the cancer, is actually appropriate treatment," says Dr. Vendra.

The thyroid is a butterfly-shaped gland which regulates many functions, including how you burn calories, your heart rate, and your body's temperature.

Removing all of the thyroid not only means a lifetime of replacing those hormones.

There can be a risk to the nerves of the voice box, which are very close, "and the separate hormone-producing glands called parathyroid glands that help regulate the calcium in our body," says Dr. Vendra.

In addition, Dr. Vendra says thyroid cancers tend to be small, grow very slowly, and are less likely to spread.

"Five-year survivals are nearly, almost 100%. We're talking high-90s. So it tends to be a better-behaving cancer, if there is such a thing," the doctor notes

Because of these factors, in 2015, the American Thyroid Association changed its guidelines to recommend partial thyroid removals whenever possible.

Dr. Vendra says there have been big pluses for patients.

"A lot of times patients can go home the same day," he says.

"Most patients that have half their thyroid remaining actually make enough hormone for their entire body."

"We don't worry about people's calcium levels dropping because we have preserved (parathyroid) glands," he says.

Dr. Vendra says doctors are picking up more thyroid nodules, as more people get CT scans for a variety of other health issues.

The change in guidelines enables doctors to deal appropriately with cancerous nodules while keeping a patient's quality of life.
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