Cancer Survivorship and Long-term Follow-up
Cancer Survivorship and Long-term follow-up
There are currently more than 800,000 thyroid cancer survivors in the United States. The issues that develop during survivorship (which starts at the time of diagnosis) can be multiple, and have been under-addressed for decades. These needs generally fall into the categories of informational, practical, and emotional / psychosocial realms. Programs and support groups (www.Thyca.org) are beginning to help address and offer support for the growing number of the thyroid patients.
Follow-up is crucial for all patients with thyroid cancer because thyroid cancer can return (i.e. recur), even many years after successful initial treatment. It is important that you choose your surgeon and endocrinologist carefully, as both of these physicians will often follow you for years to come. (See how do I find an experienced surgeon?) Therefore, a good long-term relationship with these doctors is important.
A partnership between the patient, the thyroid surgeon, and the endocrinologist is necessary to assure that the thyroid cancer patient receives appropriate follow-up care. As is true with any partnership, clear effective communication is needed. The surgeon must relay operative findings to the treating endocrinologist and assure that he/she receives a copy of operative and pathology reports. In turn, the endocrinologist should send the thyroid surgeon copies of post-operative laboratory and imaging results. These data are used to determine the risk for developing recurrent thyroid cancer in the future.
Follow-up visits may include a careful history and physical examination, with particular attention to the neck area. An ultrasound of the neck may be performed to look for any signs of recurrence. Blood tests will be taken to measure your thyroid hormone levels to make sure you are taking enough hormone replacement and to look for an increase in a thyroid cancer marker, called thyroglobulin, that may indicate cancer recurrence. Depending on these tests, additional testing and possible further treatment with RAI and/or surgery may be needed.
Your surgeon will oversee your care immediately before and after your thyroid surgery. Your endocrinologist will oversee your long-term management, including thyroid hormone replacement, radioactive iodine treatment (if recommended) and surveillance strategy. Many surgeons may choose to play a more active role in following thyroid cancer patients by performing such things as periodic physical examinations, lymph node inspections and surgeon-performed ultrasounds. Some physicians suggest evaluating high-risk patients every 6 months and low risk patients every 12 months. It is important to emphasize that these visits to your surgeon are not meant to replace the role of the endocrinologist, but rather to supplement endocrine medical management.
https://www.thyca.org/ — This website is maintained by a non-profit organization comprised of survivors of thyroid cancer.