At the OHSU Knight Cancer Institute, a team of specialists will make sure you receive the best possible care. We offer you:

• Highly trained doctors and other experts who specialize in thyroid treatment.
• Oregon’s most experienced thyroid cancer surgeons.
• Advanced testing to spare some patients from unneeded surgery.
• The latest radiation therapy technology, plus targeted therapy for rare cancers.
• Complete rehabilitation care and support services.

See the bottom of our Understanding Thyroid Cancer page to learn about our treatment for parathyroid cancer.

Diagnosing thyroid cancer

We provide the most advanced tests in the Northwest, including molecular testing that helps some patients avoid surgery.

• Ultrasound exam: We use high-energy sound waves to look at your thyroid. This can show the size of a thyroid nodule and whether it is solid or filled with fluid. At OHSU, this test is done by a highly trained thyroid expert.
• Fine-needle aspiration biopsy: We use a needle to extract tissue for analysis. At OHSU, samples are examined by a thyroid expert.
• Surgical biopsy: We remove a nodule or one lobe of the thyroid to look for signs of cancer.
• Blood test: The level of hormones or substances such as calcium in your blood can indicate thyroid cancer.
• CT scan: A computed tomography scan uses X-rays to create detailed images of your thyroid.
• MRI scan: A magnetic resonance imaging scan uses a powerful magnetic field and radio waves to generate detailed images of your thyroid.
• PET scan: Positron emission tomography uses a special camera and a small amount of radioactive material. The material is injected, swallowed or inhaled. The scan can detect medullary thyroid cancer and cancer that has spread outside the thyroid.
• Radioiodine scan: A small amount of radioactive iodine is swallowed or injected. Then a special camera is used to look for cancer cells.

Molecular testing

Sometimes scans and biopsy results are unclear. They can’t confirm a diagnosis.

At other hospitals, it’s common for surgeons to remove all or part of the thyroid to be safe, and then  test it for cancer.

Unfortunately, this means some patients have surgery first, and then find out they don’t have cancer. Others need a second surgery to remove the rest of the thyroid.

At OHSU, we can do a biopsy and look for molecular markers of thyroid cancer. These are strands of DNA that only show up in cancer cells. This can help us confirm your diagnosis and plan your treatment.

Treatment for thyroid cancer

Your treatment depends on the type and stage of your cancer. Most patients have surgery to remove the cancer. Some patients also get radiation therapy to lower the risk of cancer coming back.

Thyroid cancer surgery

Surgery is the most common treatment for thyroid cancer. 

Our thyroid surgeons are the most experienced in the state, each performing hundreds of surgeries a year. Precision is especially important because the thyroid is near the vocal cords and other sensitive tissues. We’re proud of our high success rate in protecting them.

We use advanced techniques to minimize scarring and shorten recovery times:

• Minimally invasive surgery that often requires only a 1-inch incision.
• Video-assisted technology.
• A device that monitors your vocal cord nerves during surgery to preserve your voice.

Surgery types:

• Lobectomy: The surgeon removes one of the thyroid’s two lobes. They may also remove the strip of tissue (isthmus) that connects them. Most lobectomy patients go home the same day.
• Near-total thyroidectomy: All but a tiny section of the thyroid is removed.
• Total thyroidectomy: The thyroid is removed. This is the most common surgery. Patients with full removal usually stay one night.

Radiation therapy

Radiation therapy is often used after surgery to eliminate any cancer cells that may have been left behind. We may recommend:

Radioactive iodine therapy: Radioactive iodine homes in on thyroid cells, including thyroid cancer cells, and kills them anywhere in the body. You usually take it by swallowing capsules or liquid.

External beam radiation therapy: This type may be used for medullary or anaplastic thyroid cance. This uses a machine outside the body to pinpoint an area with high-energy X-rays. We use state-of-the-art equipment that is faster and more precise.

Chemotherapy

This therapy is used only for aggressive or advanced thyroid cancers. Medications that kill cancer cells are given intravenously.

Targeted therapy

As the region’s leading hospital for difficult-to-treat thyroid cancers, we often see rare cases. The cancer may be advanced or it may not be responding to other treatment. In these cases, we can often use targeted therapy to home in on cancer cells while mostly leaving healthy cells alone.

Follow-up care

We monitor hundreds of cancer patients through the OHSU Thyroid and Parathyroid Center. You'll receive complete and continuing follow-up care.

If your thyroid is removed as part of cancer treatment, you will most likely need daily hormone-replacement pills. After active cancer treatment, we offer:

• A discussion of all aspects of your case with an endocrinologist who specializes in thyroid cancer.
• A full medical evaluation and possibly more imaging.
• Thyroid hormone replacement therapy, if needed.
• Bone tests to check for hyperparathyroidism (overactive parathyroid) and the risk of bone loss in older patients.
• Lab tests to monitor your thyroid hormone levels. We'll also check for signs of cancer after three, six and 12 months, then yearly or as needed.
• Ultrasound scans and doctor visits after six and 12 months, or as needed. Then you'll probably have scans yearly for at least five years.

Rehabilitation and support services

OHSU provides a full range of support services for your health and well-being, such as:

• Voice and swallowing: Thyroid cancer surgery may affect your voice box, windpipe and neck muscles. We offer rehabilitation services at our Northwest Clinic for Voice and Swallowing.
• Physical therapy: Specialists at the OHSU Rehabilitation Services provide physical therapy and other services to help you reach your full potential.
• Support for young adults: OHSU’s Adolescent and Young Adult Oncology Program provides Oregon’s only specialized services for cancer patients ages 15 to 39.
• Cancer social workers to help you cope and to address financial, transportation or other issues.
• Fertility services for patients who need radiation therapy or chemotherapy.
• Survivorship services: We offer services to help you transition to life after cancer.

Learn more

• Thyroid Cancer Treatment, National Cancer Institute
• Treating Thyroid Cancer, American Cancer Society
• After Treatment, American Cancer Society
• What is Thyroid Hormone Replacement Therapy?, EndocrineWeb