How is recurrent thyroid cancer treated?

In many respects, recurrent thyroid cancer is treated with the same modes of therapy used to treat newly diagnosed thyroid cancer. Surgery is usually required to remove the main focus of recurrent thyroid cancer. The goals of surgery performed in this setting may differ, depending on the extent to which the cancer has grown or spread to invade other structures in the body. If it looks as if the cancer hasn't spread to invade adjacent or distant structures in the body, a surgeon may attempt to remove the entire mass of cancer along with margins of normal tissue. This would be considered to be an attempt at curative surgery. If it looks as if the cancer has grown to directly invade adjacent structures in the body, a surgeon may only plan to remove those parts that can be taken out without damaging or sacrificing those structures. This would be considered to be noncurative surgery. The small amounts of cancer that remain would usually have to be treated with other measures. If the cancer is growing rapidly and enlarging to a point where it is compressing other structures in the body, a surgeon may only plan to remove enough of the cancer to relieve the pressure. This would be considered to be debulking or palliative surgery, and would usually only be performed in order to relieve symptoms caused by compression.

Following surgery, further treatment with radioactive iodine may be indicated. Higher doses of 131-Iodine are usually given when radioactive iodine treatment is administered in the setting of recurrent thyroid cancer. In many cases of recurrent thyroid cancer, external beam radiation therapy may be used to try to limit the further spread of any residual cancer. All patients with recurrent thyroid cancer should continue to receive thyroid hormone treatment in addition to any other forms of therapy that may be considered.

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