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  • Looking after yourself after treatment for thyroid cancer

    Contents

    Cancer can cause physical and emotional strain. It’s important to try to look after your wellbeing as much as possible.

    Nutrition

    Eating healthy food can help you cope with treatment and side effects. A dietitian can help you manage special dietary needs or eating problems, and choose the best foods for your situation.

    For more information about nutrition call Cancer Council 13 11 20 or you can download a copy of Nutrition and Cancer.

    Staying active

    Physical activity may help to reduce tiredness, improve circulation and elevate mood. The amount and type of exercise you do depends on what you are used to, how you feel and your doctor’s advice. 

    Cancer Council’s Exercise for People Living with Cancer provides more information about the benefits of exercise and outlines simple exercises that you may want to try. 

    Complementary therapies

    These therapies are used with conventional medical treatments. You may have therapies such as massage, relaxation and acupuncture to increase your sense of control, decrease stress and anxiety, and improve your mood. Let your doctor know about any therapies you are using or thinking about trying, as some may not be safe or evidence-based.

    Alternative therapies are used instead of conventional medical treatments. These therapies, such as coffee enemas and magnet therapy, can be harmful. 

    For more information about complementary therapies call Cancer Council 13 11 20 or you can download a copy of Understanding Complementary Therapies.

    Sexuality and intimacy

    Cancer can affect your sexuality in physical and emotional ways. The impact of these changes depends on many factors such as treatment and side effects, your self-confidence and if you have a partner. Although sexual intercourse may not always be possible closeness and sharing can still be part of your relationship.

    If you are able to have sex you may be advised to use certain types of contraception to protect your partner or avoid pregnancy for a certain period of time.  

    For more information, call Cancer Council 13 11 20 and ask for a free copy of Sexuality, Intimacy and Cancer.

    Contraception and fertility

    Depending on the type of cancer and treatment you have, and your sexual preferences, your doctors may advise you to use certain types of contraception, such as condoms, for some time during and after treatment.

    This is to protect your partner and to avoid pregnancy, as some treatments can be toxic to your partner or harm a developing baby.

    Your doctor will also tell you if treatment is likely to affect your fertility permanently or temporarily. If having children is important to you, talk to your doctor before starting treatment.

    Special concerns for women

    After radioactive iodine (RAI treatment) it is generally recommended not to conceive a child for six months since the ovaries are exposed to radiation during the treatment and to ensure that thyroid hormone levels are normal and stable prior to pregnancy.

    Special concerns for men

    Men who have RAI treatment may experience temporary infertility. Ask your doctors what precautions to take and discuss any fertility issues especially if you want to have children in the future.

    For more information about fertility call Cancer Council 13 11 20 or you can download a copy of Fertility and Cancer

    Body image

    Cancer treatments such as surgery, chemotherapy and radiotherapy, can cause changes to your body. Whether these changes are temporary or permanent they can change the way you feel about yourself (your self-esteem) and make you feel self-conscious. You may feel less confident about who you are and what you can do.

    It’s common to have a scar after thyroidectomy surgery, but this usually fades with time.

    Follow-up after treatment

    After treatment you will need regular check-ups.  You may have the following tests:

    Neck ultrasound – An ultrasound is used to see if there is any cancer left in the area where the thyroid was removed and to check the lymph nodes around the neck.

    Blood tests – If you have been treated for papillary or follicular thyroid cancer, you will have blood tests to check the levels of thyroglobulin (Tg). This protein is made by normal thyroid tissue and it may also be made by papillary or follicular thyroid cancer cells. After a total thyroidectomy you should have little or no Tg in your body, but levels will rise if the cancer comes back. If Tg is found in your blood your doctor may suggest having some scans.

    For medullary thyroid cancer blood levels of calcitonin and carcinoembryonic antigen (CEA), which is a protein produced by some cancer cells, will be measured periodically. Blood tests are also done regularly to check if you are on the right dose of thyroid hormone replacement. When it’s stable thyroid function blood tests are needed only every 6–12 months.

    Radioisotope scan – This test is used to check if there are any cancer cells remaining in your body after treatment. A small amount of radioactive liquid (such as iodine or technetium) is injected into a vein in your arm. After about 20 minutes you will be asked to lie under a machine called a gamma camera. The camera measures the amount of radioactive liquid taken up by the thyroid gland. A radioisotope scan is painless and causes few side effects. After the scan you will not be radioactive and it is safe to be with others.

    If further information is needed or if cancer cells are found elsewhere in your body, you may have a CT or PET scan.

    Before follow-up tests

    Usually Tg is measured when you are still on thyroid hormone replacement medication. Sometimes the doctor may want to measure stimulated Tg as the test can be more accurate when TSH is elevated.

    To raise TSH to measure stimulated Tg you will need to either withdraw from thyroid hormone replacement medication or have injections of the drug recombinant human thyroid-stimulating hormone (rhTSH) or Thyrogen®.

    Once your Tg is elevated it will be measured.

    Newer Tg tests are more sensitive and in some cases it may not be necessary to withdraw from thyroid hormone.

    This website page was last reviewed and updated March 2017.

    Information last reviewed January 2016 by:  A/Prof Julie Miller, Specialist Endocrine Surgeon, The Royal Melbourne Hospital, Epworth Freemasons and Melbourne Private Hospitals, VIC; Polly Baldwin, Cancer Council Nurse, 13 11 20, Cancer Council SA; Dr Gabrielle Cehic, Nuclear Medicine Physician, Flinders Medical Centre, Lyell McEwin Hospital and The Queen Elizabeth Hospital, SA; Dr Kiernan Hughes, Endocrinologist, San Clinic Specialist Rooms & Chatswood Rooms, Northern Endocrine Pty Ltd, NSW; Dr Chris Pyke, A/Prof of Surgery, University of Queensland, Mater Hospital, Brisbane, QLD; and Jen Young, Consumer.

     

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