Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Fremont and San Leandro Medical Centers

Overview

Thyroid cancer usually begins as a small lump or nodule inside the thyroid gland. While most nodules are harmless (benign) and can be monitored, a very small percentage are cancerous. 

Rarely, thyroid cancer is diagnosed once it has spread to a lymph node in the neck.

Most thyroid cancers are treatable with good results. Treatment depends on the type and severity of thyroid cancer. 

Once we fully evaluate your diagnostic test results, we’ll create the best treatment plan for you. The most common treatment options are surgery and radioactive iodine. 

Radiation therapy and chemotherapy are rarely used to treat thyroid cancer.

Additional References:

Surgery

If your biopsy shows possible cancer, we usually recommend surgery. 

The type of surgery depends on the location and spread of the cancer and may include: 

  • Thyroid Lobectomy. Removal of part of the thyroid gland.
  • Total thyroidectomy. Removal of the entire thyroid and any nearby affected lymph nodes.
  • Cervical lymph node dissection. Removal of the affected lymph nodes in the neck.

Surgery Side Effects

If the entire thyroid gland is removed, you must take daily thyroid hormone supplements to maintain normal thyroid hormone levels. Otherwise, you will develop hypothyroidism.

If only part of the gland is removed, you may not need to take supplements.

Common side effects of thyroid hormone replacement therapy are:

  • Change in weight
  • Change in heart rate
  • Cramps
  • Diarrhea
  • Hot or cold feeling
  • Dry skin

Rare complications of surgery are:

  • Vocal cord paralysis. Nerves that control the voice box (larynx) can be damaged, leading to temporary or permanent hoarseness.
  • Hypoparathyroidism. This condition results from removal or disruption of the parathyroid glands and requires calcium and vitamin D supplements.

Radioactive Iodine

Your thyroid uses iodine to produce hormones. Radioactive iodine (called I-131) is often used to treat thyroid cancer after surgery.

Several weeks after surgery, you may have:

  • A whole-body radioactive iodine scan.
  • Radioactive iodine treatment (possibly). 

Iodine naturally occurs in your body. Before having this scan or treatment, your:

  • Iodine levels must be low. You might first need to follow a special low-iodine diet for 2 weeks.
  • TSH level must be high. You may need to stop taking a thyroid hormone supplement after surgery or have a TSH injection.

Before the scan, you’ll swallow a capsule of I-131. About 48 to 72 hours later, you’ll have a whole-body diagnostic scan so we can see:   

  • If any thyroid tissue remains, and how much. 
  • If the cancer has spread into lymph nodes or distant organs, such as lungs or bone.

Radioactive Iodine Therapy

Radioactive iodine therapy is usually given as an outpatient procedure. You’ll learn important safety precautions to avoid exposing others to unnecessary radiation.

If the scan shows activity in your body, we might give you additional radioactive iodine. This larger, oral dose of radioactive iodine:

  • Destroys any remaining thyroid cancer cells without pain.
  • Remains in your body for about 1 week while it continues to destroy these cells. 

This treatment can destroy small traces of thyroid cancer that may remain after a thyroidectomy.

Sometimes, thyroid cancer cells fail to absorb the I-131. The result is the radioactive iodine scan doesn’t show thyroid cancer, even when we strongly suspect cancer. When this happens, we may order additional imaging studies to look for signs of thyroid cancer, such as:

  • Neck ultrasound
  • MRI
  • CT scan
  • PET scan

Radioactive Iodine Side Effects

Common side effects of I-131 include:

  • Mild nausea
  • Temporary swelling and tenderness of the salivary glands
  • Temporary loss of smell
  • Dry mouth

Women who have I-131 therapy should avoid becoming pregnant for at least 6 months. 

Men may experience a temporary decrease in fertility (ability to have children) for a few months. 

Starting or restarting thyroid hormone

If you stopped taking thyroid hormone therapy to make your TSH level high, we’ll:

  • Let you know when to restart.
  • Check your thyroid hormone levels 5 to 6 weeks later.  
TSH suppression

To reduce the risk of cancer recurrence, we may adjust your thyroid hormone dose to keep your TSH at low normal or mildly suppressed (called hyperthyroidism).

You may develop mild symptoms of hyperthyroidism, including:

  • Feeling warm
  • Having a fast heartbeat
  • Having shaky hands 

If you develop symptoms, we may decrease your thyroid hormone dose.

Radiation Therapy

Radiation therapy uses high-energy waves, similar to X-rays, to treat rare, advanced forms of thyroid cancer. In these cases, it may be administered:

  • Along with surgery to treat advanced or rare types of thyroid cancer.
  • To help manage pain from advanced or rare types of thyroid cancer.

External beam radiation therapy is usually given a few times a week for several weeks. Administering a dose of radiation takes only a few minutes.

Side effects

Common side effects are: 

  • Fatigue
  • Tender skin
  • Difficulty swallowing
  • Nausea and vomiting
  • Diarrhea
  • Neck stiffness
  • Dry mouth

It’s very important to take care of your teeth during radiation therapy. It can reduce blood flow to your gums and teeth, causing dry mouth and cavities.

Additional References:

Chemotherapy

Rarely, chemotherapy may be used during thyroid cancer treatment. For example, it may help relieve symptoms when the cancer has spread to other parts of the body. 

Chemotherapy uses drugs to kill cancer cells. It’s given as pills or through intravenous (IV) injection, depending on the specific drugs used. When delivered through a vein (systemic chemotherapy), it:

  • Enters the bloodstream.
  • Destroys cancer cells throughout the body.

Clinical Trials

We’re always looking for new and better ways to treat colorectal cancer. Clinical trials are research studies that test new treatments and procedures. We can talk about available clinical trials that may be right for you.

Additional References:

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