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Follow-up after treatment for thyroid cancer
Follow-up after treatment is an important part of cancer care. Follow-up for thyroid cancer is often shared among the cancer specialists and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.
Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:
- any new lump or swelling
- difficulty swallowing or breathing
- a sore throat or cough that doesn’t go away
The chance of thyroid cancer coming back, or recurring, depends on many factors including the type and stage of the cancer. Most thyroid cancers grow slowly so the cancer could recur 10 years or more after treatment. Many years of follow-up are usually needed.
Schedule for follow-up visits
Follow-up visits for thyroid cancer are usually scheduled every 6–12 months. They may be more often if you have an aggressive type or advanced stage of thyroid cancer.
Follow-up visits are usually continued for at least 10 years. Most people should receive follow-up care for the rest of their life.
During follow-up visits
During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping. They will also ask about any symptoms you have.
Your doctor will do a physical exam which may include:
- feeling the neck for any swelling or enlarged lymph nodes
- listening to the lungs
- checking your blood pressure and pulse
Blood tests are commonly done as a part of follow-up. You may have blood tests to check levels of the following:
- thyroglobulin (Tg) to check for any cancer left behind after treatment, check for recurrence or check how well the cancer is responding to treatments
- thyroglobulin antibodies (TgAb) to check that the Tg test is reliable
- thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3) to make sure you are receiving the right dose of hormonal therapy
- calcium to check if surgery has damaged the parathyroid glands, which help keep many other organs working properly by controlling blood calcium levels
- calcitonin and carcinoembryonic antigen (CEA) to check if medullary carcinoma is responding to treatment or continuing to grow and spread (progressing)
Imaging tests are usually done early in the follow-up schedule and when the physical exam or blood tests suggest a problem. You may have:
- ultrasound of the neck to check for a local recurrence or spread of the cancer to lymph nodes
- radioactive iodine scan to monitor response to radioactive iodine therapy
- CT scan of the neck, chest or abdomen to look for cancer that has recurred or spread
- MRI of the neck, chest or abdomen to look for cancer that has recurred or spread
If a recurrence is found, your healthcare team will assess you to determine the best treatment options.
Questions to ask about follow-up
To make the decisions that are right for you, ask your healthcare team questions about follow-up.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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