Removing one side of the thyroid (called a lobectomy) has fewer complications because only one nerve and two parathyroids are at risk. It is useful in selected cases with small papillary cancers or follicular cancers with only minimal invasion. Tumor might remain, however, in a few patients.
The surgeon may select a procedure depending on the type of thyroid cancer as well as the size of the nodule and his or her own experience.
Radioactive Iodine Therapy It has been standard practice in many reputable cancer treatment centers to give radioactive iodine after surgery. There is general agreement that this therapy is useful in patients over 45 years with papillary and follicular cancers if their tumors are multiple, locally invasive, larger than 2.5 cm (1 in.) or are associated with local or distant metastases. Depending on the dose of radioactive iodine given, hospitalization with visitor restrictions for a few days may be required. Instructions for radiation protection should be followed.
This therapy has side effects, including possible temporary bone marrow suppression , inflammation of salivary glands, nausea and vomiting, scarring of the lung, pain in areas of metastasis and, rarely, leukemia. In general, however, radioactive iodine is a very well tolerated treatment.
