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Reprinted with permission from Dr. Rubenfeld's book Could It Be My Thyroid?
2nd edition, 2002, copyright 1996 and 2002 by Sheldon Rubenfeld.
3rd edition available through bookstores early in 2004.

General Considerations

Some controversy exists in almost all areas of treatment of patients with differentiated thyroid cancers, but, hopefully, results from ongoing research will resolve many of these controversies. Patients with papillary or follicular thyroid cancer may receive the following treatments:

• surgery
• radioactive iodine (I131)
• levothyroxine\
• external beam radiation

Typical Treatment of a Patient with Differentiated Thyroid Cancer*

*does not apply to a patient treated with only a lobectomy

Step 1	subtotal thyroidectomy treatment of transient hypocalcemia preparations for a whole body scan
Step 2	(6 weeks after surgery) physical examination blood tests for TSH, free T4, and thyroglobulin thyroid ultrasound
Step 3	(1 or more days after Step 2) whole body scan radioactive iodine (I131) ablation thyroid hormone replacement with levothyroxine
Step 4	(5 to 7 days after I131 ablation) post-treatment whole body scan
Step 5	(6 to 12 weeks after starting levothyroxine) physical examination blood tests for TSH, free T4, and thyroglobulin
Step 6	( 8 to 12 months after I131 ablation) follow-up tests additional treatment, if necessary

The selection and the sequence of different treatments and follow-up tests may be confusing. Therefore, an overview of events following the diagnosis of papillary or follicular thyroid cancer may be helpful. The table...illustrates the steps in the typical treatment of a patient with differentiated thyroid cancer. It does not apply, however, to a patient treated with a lobectomy alone or to a patient with extensive local tumor invasion who requires external-beam radiation.

Last updated: October 23, 2006