Problems after thyroid cancer surgery

There is a risk of problems or complications after any operation. Many problems are minor but some can be life threatening. Treating them as soon as possible is important.

After thyroid surgery, you might have voice changes and swelling around the wound. You might also have changes to thyroid hormones and calcium levels. 

General risks after an operation

After any major operation there is a risk of:

Infection

You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. You will have antibiotics to reduce the risk of developing an infection after surgery. Tell your doctor or nurse if you have any symptoms of infection.

They include:

• a high temperature
• shivering
• feeling hot and cold
• feeling generally unwell
• cough
• feeling sick
• swelling or redness around your wound and your wound might feel hot
• a strong smell or liquid oozing from your wound
• loss of appetite

Rarely for an infection in your wound, you may need another operation.

Chest and breathing problems

Chest infections, including pneumonia, can be serious. 

You can lower your risk by:

• stopping smoking before your operation
• getting up and moving as soon as possible after your operation
• doing any breathing exercises your physiotherapist teaches you

If you get an infection you have antibiotics to treat it. 

Blood clots

Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.

There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:

• shortness of breath

• chest pain

• coughing up blood

• feeling dizzy or lightheaded

To prevent clots it's important to do the leg exercises that your nurse or physiotherapist taught you. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.

Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.

It's important to continue wearing compression stockings if you have been told to by your doctor.

Bleeding

There is a risk that you will bleed after your operation. The team looking after you will monitor you closely for signs of bleeding. The risk of bleeding is greatest straight after your operation.

The treatment you need depends on what is causing the bleeding and how much blood you lose.

You might need a blood transfusion. Rarely, you might need to go back for urgent surgery. 

Problems after thyroid cancer surgery

Voice changes

You might have voice changes after thyroid surgery. Your voice may be hoarse or sound different.

The thyroid gland lies close to your voice box (larynx). So surgery can damage the nerve to your voice box. This usually gets better within a few weeks.

It’s rare to have permanent changes. Your team might refer you to a voice therapist or speech therapist if you continue to have problems.

A change in thyroid hormones

After surgery, you might need to take thyroid hormone replacement tablets. This depends on what surgery you have.

If the surgeon removes your whole thyroid gland, you will need to take tablets. These replace the hormones that your thyroid would normally make. This is called thyroid hormone replacement. You will need to take thyroid hormone replacement for the rest of your life.

You don’t generally need to take thyroid hormones if the surgeon only removes part of your thyroid gland. Your remaining thyroid usually makes all the hormones you need. But you have blood tests to check that it is working well.

If you have had follicular or papillary thyroid cancer, the hormones may also help to stop the cancer from coming back. They stop your body from producing another hormone called thyroid stimulating hormone (TSH). TSH encourages these types of thyroid cancer cells to grow.

A change in calcium levels

The parathyroid glands control the levels of calcium in your blood. Surgery to your thyroid gland can damage the nearby parathyroid glands. Or your surgeon might need to remove some of the parathyroid glands. 

Any damage can mean that these glands don’t work so well and your calcium levels fall. If this happens, you will need to take calcium tablets. You might also need to take extra vitamin D.

This is usually a temporary side effect, but could be permanent in some people.

Swelling and lymphoedema

After surgery, it is normal to have some swelling close to the wound. This usually goes away after a few weeks as the wound heals. The area around the wound might also be numb.

If the surgeon removes some lymph nodes in your neck, the swelling may continue to be there. Sometimes it gets worse. This is called lymphoedema .

Tell your doctor if you continue to have swelling in your neck after a few weeks. You may need some more exercises to help the swelling go down.

Life after thyroid cancer surgery

We have more information about these problems on our page about life after thyroid cancer surgery.

Follow up appointments

You have follow up appointments to check your recovery. This may include blood tests to check thyroid hormone and calcium levels if you need them. Your appointments are also an opportunity to raise any concerns you have about your progress.