Types of surgery for thyroid cancer

There are different types of surgery to treat thyroid cancer. The operation you have depends on the type and stage of your thyroid cancer.

Surgery is the most common treatment for follicular, papillary and medullary thyroid cancers. You might have surgery to remove:

  • all of your thyroid gland (total thyroidectomy)
  • part of your thyroid (lobectomy, partial thyroidectomy or hemithyroidectomy)
  • lymph nodes in the front or side of your neck (neck dissection)

Total thyroidectomy

A total thyroidectomy means your surgeon removes all your thyroid gland. It is the most common surgery for thyroid cancer.

You might also have a total thyroidectomy if you haven't been diagnosed, but you have an abnormal gene Open a glossary item. This abnormal gene increases your risk of developing medullary cancer.

Diagram showing before and after a thyroidectomy

Partial thyroidectomy

A partial thyroidectomy means your surgeon removes part of your thyroid gland. Doctors also call this operation a lobectomy or a hemithyroidectomy. The surgeon removes:

  • half of your thyroid gland (one lobe)
  • the bridge of thyroid tissue connecting the 2 thyroid lobes (the isthmus)

You sometimes have this operation to diagnose your thyroid cancer. This is called a diagnostic hemithyroidectomy. Or you might have this surgery to treat a very small thyroid cancer.

You might need a second operation to remove the other lobe. This is called a completion thyroidectomy.

Diagram showing a lobectomy of the thyroid gland

Removing lymph nodes

Lymph nodes Open a glossary item are part of a network of lymph vessels throughout your body. Cancer can spread to your lymph nodes. Your surgeon might remove some lymph nodes on the front, or the front and side of your neck. They do this at the same time as your thyroidectomy.

Neck dissection

Your surgeon might know before the operation that you have cancer in some lymph nodes. They remove these lymph nodes. This is called a neck dissection. They may remove all the nodes on that side of your neck or in the centre of your neck.

Diagram showing the position of the lymph nodes in the neck

Prophylactic lymph node dissection

The surgeon removes the lymph nodes in the central area of your neck if you have:

  • medullary thyroid cancer
  • high risk differentiated thyroid cancer

This is because the lymph modes may contain cancer cells. This is called a prophylactic lymph node dissection.

Your surgeon might also remove the lymph nodes on one or both sides of your neck.

Diagram showing after surgery for medullary thyroid cancer with the central lymph nodes and thyroid gland removed

If the surgeon removes some of your lymph nodes, you should take extra care of the area where the lymph nodes were. For example, it is important to avoid infection. You should talk to your healthcare team if you notice any swelling. 

Having thyroid surgery

Partial and total thyroidectomy are big operations. You need to be fit enough for a long operation and to make a good recovery afterwards. You have a pre assessment appointment before your surgery.

You will have some tests and meet your healthcare team. You can talk to the surgeon about what to expect after surgery. You can also discuss where exactly they plan to make the cut in your neck, and where the scar will be.

You have your operation under a general anaesthetic, so you won’t be aware of anything or feel anything. Your surgeon makes a cut in your lower neck to get to the thyroid gland.

After surgery and side effects

After the operation you may have a dressing over the area on your neck. There will be stitches or staples in your wound and you may have one or two tubes (drains) coming from your wound.

Side effects following thyroid surgery can include:

  • infection
  • blood clots or bleeding
  • voice changes, such as a hoarse voice

Your neck and throat will feel sore and uncomfortable for a few days

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