Treatment for Thyroid Cancer

Thyroid Cancer at Fred Hutch

There are many treatment options for thyroid cancer. The specialists who treat you at Fred Hutchinson Cancer Center are endocrine tumor experts who use a team-based approach to choose the right treatment for every patient. They will work closely with you, your family and each other to get you back to health.

At Fred Hutch, we provide all standard therapies for thyroid cancer and offer you access to the latest options through clinical trials.  

Treatment Plan

Thyroid cancer treatment at Fred Hutch is customized for each patient’s needs.

How Do We Create Your Treatment Plan?

Your Fred Hutch medical oncologist is part of an expert group of other surgeons, endocrinologists, pathologists and researchers who are looking for better ways to treat this disease.  

Every week, this team gets together in a meeting called a tumor board. Together, dozens of team members talk about their patients’ treatment plans. This approach means each patient benefits from the experience of the whole group.

With support from the larger team, your physician will:

  • Decide the best course of treatment based on your stage and type of thyroid cancer
  • Tell you about any clinical trials you may want to think about

Your medical oncologist will walk you and your caregiver through the treatment plan that the tumor board has recommended for you. You will have a chance to share your personal preferences and options, and you will decide together what happens next.

Why Do Treatment Plans Differ?

Because each person’s disease and health are unique, physicians need to customize treatment to each person.

The treatment plan we make for you depends on many things, including:

  • Your thyroid cancer subtype
  • The stage of your disease
  • If you have had treatment for thyroid cancer in the past
  • Your age and overall health
  • Your needs and preferences, like what type of treatment schedule works in your life and if you want to join a clinical trial.

What Is the Standard Therapy For Thyroid Cancer?

For most people with most types of thyroid cancer, the first treatment is surgery. The exact details of your surgery will depend on several things, like where in your thyroid the cancer is located and if it has spread to your lymph nodes. 

At Fred Hutch, our standard always involves caring for you as a whole person. We help you get relief from side effects and provide many other forms of support, like integrative medicine, nutrition counseling and physical therapy.

Treatment Process

Different subtypes of thyroid cancer start, progress and respond to treatments in different ways. We choose, combine and schedule your treatments based on what works for your subtype. Your care team makes sure you understand each type of treatment and all of your choices.


Your surgery will be done by surgeons who are experts in treating thyroid cancer, using the most up-to-date information to guide their surgical decisions. 

First, you’ll meet with your thyroid surgeon, who will carefully look at your imaging and biopsy results. They’ll find out your health needs and ask about your personal preferences. Then, they’ll explain your options, what type of surgery they recommend and what to expect. Of course, they’ll also answer all your questions. 

If cancer is only in your thyroid, you may either have half of your thyroid removed (hemithyroidectomy) or your entire thyroid removed (total thyroidectomy). This depends on the size of the tumor, how the cancer looks on ultrasound and other things.  

If cancer is also in your lymph nodes, the surgeon will remove your entire thyroid along with the group of lymph nodes involved. 

Learn More About Surgery

Radioactive Iodine Therapy

Today, Radioactive Iodine Therapy (RAI) is most often used to treat papillary thyroid cancer and follicular thyroid cancer. 

Your thyroid gland naturally takes up and holds onto the mineral iodine, which is found in some foods. In RAI therapy, you swallow a capsule that has a special radioactive type of iodine called I-131. As the capsule melts, the radioactive iodine moves through your bloodstream and collects in your thyroid cells, which destroys the thyroid cells along with the cancer cells. 

RAI therapy is used on its own and can also be used together with surgery, depending on your situation. 

Learn More About Radioactive Iodine Therapy

Targeted Therapies

Targeted therapies block the growth or spread of cancer cells through just one pathway or receptor, instead of attacking all fast-growing cells, like conventional chemotherapy drugs do. 

The medicines we use are sorafenib and lenvatinib, which are FDA-approved to treat thyroid cancer that is no longer responding to RAI therapy. 

Learn More About Targeted Therapies

Hormone Therapy

If you have surgery to remove your entire thyroid, you will need thyroid hormone therapy. If only half of your thyroid was removed, you may or may not need hormone therapy. Your care team will explain what they recommend for you and why. 

This means that you will take the pill levothyroxine every day as a hormone replacement. Your physician also may recommend taking thyroid hormone as a suppressive therapy (to stop the thyroid cancer from coming back). 

Learn More About Hormone Therapy


Chemotherapy is only used for a very small percentage of people with thyroid cancer — people who have radioiodine refractory disease. For almost everyone who has thyroid cancer, chemotherapy is not needed. 

Learn More About Chemotherapy

Monitoring Your Health

While you are in active treatment, your thyroid cancer care team will see you regularly for exams and tests to check:

  • How well your treatment is working
  •  If there is any reason to change your treatment
  • If you need help with side effects or supportive care services, like nutrition care or mental health counseling

We will update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.

Possible Results of Treatment

After treatment, your care team will study your results using guidelines established by the American Thyroid Association. Possible results include: 

  • No evidence of disease
  • Indeterminate response to therapy
  • Biochemical persistent disease
  • Anatomical persistent disease

What about “cured”? The word “cured” isn’t used in thyroid cancer. Instead, you will be classified as “no evidence of disease.” From there, you’ll be monitored for recurrence (the cancer coming back) for the rest of your life, with support from Fred Hutch’s Endocrine Survivorship Program.

Get Help with Side Effects

Before you begin treatment, we talk with you about what to expect, based on your treatment plan, and what can help if you do have side effects.

At your appointments, we want you to tell us about any side effects you are having. If you have questions or concerns between appointments, you can call or email us. We will make sure you know how to reach care providers at Fred Hutch after hours, if that is when you need us. 

We have many tools to help you feel better, such as:

  • Antibiotics, vaccines and antiviral drugs to prevent or treat infections
  • Transfusions, steroids and medicines that help the immune system treat low levels of blood cells (low blood counts)
  • Nutrition care and medicines to help with digestive problems
  • Conventional and integrative therapies for pain

Coping with Side Effects

Managing Side Effects

You might be wondering about possible side effects from treatment. If you are, it may be helpful to know that many of today’s treatments are more targeted to cancer cells, so they don’t cause as many side effects as standard chemotherapy. 

You are always at the center of everything we do. Thyroid cancer physicians, nurses and advanced practice providers are here to help prevent or help with side effects of treatment. 

Common Side Effects

Side effects are different depending on which treatment you get. Recovering from surgery is usually the focus, but people who have radioactive iodine therapy after surgery may get dry or watery eyes and chronic dry mouth, which can increase your risk of dental disease. 

Supportive Care Services

Along with treating your thyroid cancer, Fred Hutch provides a range of services to support you and your caregiver before, during and after treatment. This is part of how we take care of you — not just your disease.

From dietitians to chaplains, we have experts who specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need. 

Learn more about Supportive Care

Caregiving During Treatment

If your loved one is getting treatment for thyroid cancer, there are many ways you can help. Caregiving during active treatment often means doing tasks like these:

  • Keeping track of their appointments and driving them to and from treatment
  • Watching for changes in their condition and telling their care team about any symptoms
  • Providing physical care, like helping them take medicines
  • Spending time with them and encouraging them
  • Taking care of things at home that they may not be able to do, like grocery shopping and cleaning

Continuing Care

When your disease is in remission and your active treatment ends, it is still important to get follow-up care on a regular basis. At follow-up visits, you will see the same Fred Hutch team who treated your thyroid cancer. They will check your overall health and look for signs that your cancer has come back (signs of recurrence). 

Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).

Schedule For Follow-up Visits

Just like we personalize your treatment plan for you, we personalize your follow-up schedule, too. Your provider will base your schedule on many things, including:

  • Your thyroid cancer subtype
  • If your disease was slow-growing (indolent) or fast-growing (aggressive)
  • Which treatments you had and how your disease responded 
  • How the disease and treatments affected you 
  • How long it has been since your treatment ended

After your treatment is complete, you’ll have regular monitoring for the rest of your life. Most people also need lifelong hormone replacement therapy. At Fred Hutch, this happens through our Endocrine Survivorship Program. 

What Happens at Follow-up Visits

The screenings you’ll get after treatment depend on your stage and how long it’s been since you have finished treatment. Tests may include blood tests and ultrasounds. 

Meet the Thyroid Cancer Care Team