You survived thyroid cancer. What’s next?

By Jessica Saenz

Thyroid cancer cure rates are excellent, especially when caught early. It’s not unreasonable to start planning for life after treatment soon after your diagnosis.

Life after cancer looks different for everyone, and survivorship concerns vary from person to person. Talking to your healthcare professional about what's most important to your quality of life after thyroid cancer treatment can help you confidently move ahead.

Katherine Prinsen, a Mayo Clinic nurse practitioner, shares what she discusses with her thyroid cancer patients when planning for the future:

Ask questions of your care team.

Asking your care team questions can help you understand what to expect from thyroid cancer survivorship. Prinsen suggests asking these questions:

• What follow-up care will I need, and how frequently should I see my cancer care team?
• What short-term and long-term side effects of treatment can I expect?
• Can thyroid cancer or its treatment affect my ability to start a family? If so, how can I prepare?
• What are the signs and symptoms of recurrence, and what should I do if I experience them?
• What steps can I take to improve my lifestyle and reduce my chance of recurrence?

Your healthcare team is there to help. "We hope you ask questions," says Prinsen. "We're here to support you and your families through this thyroid cancer journey."

Use reliable and trusted survivorship resources.

Whether it's a support group or a blog, there are resources to help you navigate survivorship challenges, but make sure they are trustworthy.

"There's a lot of power in knowledge, and it helps to quell fears of the unknown," says Prinsen. "Learning about your treatment and the likelihood of recurrence from highly vetted sources can help patients reduce feelings of uncertainty."

Prinsen recommends these trusted resources:

• American Thyroid Association
• National Cancer Institute
• American Cancer Society Cancer Survivors Network
• Mayo Clinic Connect Thyroid Cancer Support Group
• American Society of Clinical Oncology

Tell your care team about side effects.

It's common to experience side effects from the cancer or its treatment during and after thyroid cancer treatment. Some side effects may occur in the short term, while others may persist for years or even life.

Prinsen says short-term side effects can result from surgery to remove all or part of the thyroid, which can include removal of lymph nodes or radioactive iodine treatment. These risks make finding an experienced surgeon specializing in thyroid surgery critical.

"Short-term side effects from these treatments may include pain or discomfort at the incision site, temporary voice changes after surgery and temporary low blood calcium levels," says Prinsen.

Long term, Prinsen says you may need thyroid hormone replacement medication to help your body perform the functions your thyroid used to carry out. Often, medication is needed for life or at some point after treatment, even if only part of the thyroid is removed.

It's also not uncommon for parathyroid glands, which regulate the body's blood level of calcium and phosphorus, to be injured or accidentally removed during surgery. This can lead to hypocalcemia, a condition in which the calcium level in your blood is elevated, or hypoparathyroidism, a condition in which the body produces abnormally low levels of parathyroid hormone. Laryngeal nerves can sometimes be damaged during thyroid cancer surgery, causing persistent voice hoarseness.

Thyroid cancer treatment can also affect salivary glands, leading to dry mouth. But this and many other side effects of thyroid cancer and its treatment can be treated or managed, says Prinsen, so you should discuss any concerns with your care team.

Keep up with follow-up care.

Your care team will share information about your follow-up care and what to expect after treatment. The frequency of follow-up appointments and screening will be based on whether your thyroid cancer is high risk or low risk. “We use ultrasound imaging and tumor markers in the blood to assess risk. We recommend patients continue with follow-up appointments and surveillance visits to ensure we catch recurrence early and provide treatment,” says Prinsen.

Thyroid cancer can recur even if your thyroid is removed. When the cancer recurs in the neck, it's typically treatable, says Prinsen.

Staying diligent about follow-up care is the best way to monitor for thyroid cancer recurrence and help ease recurrence-related anxiety. "After completing treatment, I think it's only natural that people worry about the possibility of thyroid cancer coming back," says Prinsen. "But I want to reassure patients that we continually assess this risk. We assess the risk when the thyroid cancer is first identified and continue to do that throughout follow-up appointments."

Seek counseling, therapy and other support.

Anxiety about thyroid cancer recurrence is normal, but Prinsen says it shouldn't make life harder. If it does, discuss it with your care team. "It's really up to the patient to decide if worry is getting out of control or becoming difficult to manage," she says. If it is, your care team should be able to connect you with counseling services or support groups that can help.

Prinsen says it's also important to lean on family and caregivers and let them know what's going on so they can support and advocate for you.

Day to day, you can also practice techniques that can help ease your worry and improve your mental health. "We recommend practicing mindfulness and relaxation techniques like deep breathing, yoga — anything that helps reduce symptoms of anxiety or worry. We also encourage patients to participate in enjoyable activities, like hobbies," says Prinsen.

Learn more

Learn more about thyroid cancer and find a thyroid cancer clinical trial at Mayo Clinic.

Join the Thyroid Cancer Support Group on Mayo Clinic Connect.

Also, read these articles:

• "Dear Mayo Clinic: How to manage dry mouth during cancer care"
• "Fertility considerations in cancer treatment: Preserving hope for the future"
• "What you should know about thyroid cancer in adolescents, young adults"
• "Emotional recovery after cancer treatment"
• "Lasting physical side effects of cancer"
• "When cancer returns: How to cope with cancer recurrence"