Thyroid Cancer

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Most thyroid cancers can be cured if caught early and treated promptly. Duke endocrinologists, surgeons, oncologists, and others use the latest medical advances and minimally invasive procedures to ensure you receive the highest level of care. Your team may include endocrinologists, endocrine surgeons, head-and-neck surgeons, oncologists, pathologists, nuclear medicine specialists, and interventional radiologists. They are all experts in differentiating between benign thyroid nodules and thyroid cancers, including papillary, follicular, onocytic (Hurthle cell), medullary, and anaplastic types.

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Diagnosing Thyroid Cancer

We perform a variety of tests to determine whether your thyroid nodule is benign or cancerous. About 5% to 10% of cases involve cancer.

Blood Tests

Blood tests measure thyroid hormone levels to determine thyroid function. This information helps us identify and adjust hormones levels to treat abnormal thyroid behavior. Blood tests also detect tumor markers -- changes in your cells that can indicate cancer growth. Along with other tests, tumor marker tests help your doctor diagnose and plan your treatment. Common markers for thyroid cancer include thyroglobulin for differentiated thyroid cancer and calcitonin and carcinoembryonic antigen (CEA) for medullary thyroid cancer.

Ultrasound

Targeted ultrasound imaging of your neck pinpoints the location, size, and possibly the stage of a tumor. This type of imaging also helps determine if the cancer has spread to nearby lymph nodes.

Needle Biopsy and Molecular Testing

An ultrasound-guided needle is used to collect a tissue sample from thyroid nodules to be tested for thyroid cancer. Sometimes the specimen is sent for additional molecular testing. This helps your doctor determine how to tailor your treatment plan.

Laryngoscopy

This outpatient procedure helps determine if tumors have spread to the nerves that help move the vocal cords and to evaluate of extent of disease in the neck area.

Advanced Imaging

Radioactive iodine scans, CT scans, MRI, or PET-CT scans may be performed after surgery to determine if the cancer has been completely removed or if tumors have spread to other locations in the body.

Genetic Counseling and Testing

When inherited thyroid cancers and related endocrine tumors are suspected, genetic counseling may be recommended. Testing for tumor mutations in the blood may also be done.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Thyroid Cancer Surgery

It’s common to undergo surgery as a first step to remove thyroid cancer. Whenever possible, our doctors use minimally invasive techniques that require small incisions to help speed recovery. These procedures may be performed in the outpatient setting. Complex surgeries may be required for patients with advanced cancer, recurrent cancer, or goiters. Sometimes surgery is also needed when a tumor has affected nearby organs.

Thyroid Lobectomy

This procedure removes remove cancerous cells and half of the thyroid gland to minimize risk of your cancer spreading. Medicine is sometimes prescribed following this surgery to help balance hormone levels, control metabolism, and regulate other bodily functions.

Thyroidectomy

This surgery removes most or all of the thyroid gland to ensure that all cancer is removed. Afterward, you’ll be prescribed medicine to help balance your hormone levels because your body will no longer produce thyroid hormones.

Lymph Node Removal

If your cancer has spread (metastasized), lymph nodes in your neck that contain cancer may be removed to stop or slow the spread of the cancer. This procedure may be performed independently or as part of a thyroidectomy.

Neck Dissections

In these surgeries, cancer that has spread to other areas of the neck is removed.

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Non-Surgical Treatments for Thyroid Cancer

If surgery isn’t an option for you or you need additional treatments for thyroid cancer, we offer non-surgical treatments to destroy cancer cells. Our endocrinology and oncology teams review your case and treatment options during weekly meetings. We discuss with you which treatment may best meet your needs.

Thyroid Hormone Therapy

An endocrinologist may prescribe medication to adjust and control thyroid-stimulating hormone (TSH) levels. This is done to replace your thyroid hormone if a thyroidectomy is performed. It can also help prevent recurrence or progression of cancer cell growth.

Targeted Therapies

These treatments are used in combination with other treatments.

Radioactive iodine: In pill, capsule, or liquid form, it is typically administered after surgery to target and destroy thyroid cancer cells. The radioactive iodine destroys the thyroid gland and other thyroid cells -- including cancer cells -- that absorb the iodine.
Kinase inhibitors for medullary thyroid cancer: These specially designed medications block cancer cells' ability to grow and divide. The non-specific inhibitors we use are called Vandetanib (Caprelsa) and Cabozantinib (Cometriq). The specific inhibitor for those with RET mutations is called Selpercatinib (Retevmo).
Kinase inhibitors for non-medullary metastasized thyroid cancer: If your cancer has returned or spread to other parts of your body and can't be treated with radioactive iodine, we may prescribe medication that prevents cancer cells from multiplying. The inhibitors we use are called Sorafenib (Nexavar) and Lenvatinib (Lenvima). The specific inhibitors used for certain tumor mutations include Selpercatinib (Retevmo), Pralsetinib (Gavreto), Larotrectinib (Vitrakavi), Entrectinib (Rozlytrek), Repotrectinib (Augtyro), Dabrafenib (Tafinlar), and Trametinib (Mekinist).

Cryoablation or Alcohol Ablation

If your thyroid cancer returns and other treatments have proven unsuccessful, this outpatient procedure may be recommended to destroy abnormal tissue. An interventional radiologist with expertise in image-guided surgery uses ultrasound to help insert a needle into the tumor. Extreme cold or a concentrated alcohol is released to destroy the tumor growth. Your provider will discuss with you whether cryoablation or alcohol ablation is best based on the size and exact location of your thyroid cancer.

Radiation Therapy

Though uncommon, radiation therapy may be used in advanced cases of thyroid cancer. Radiation therapy uses high-energy rays to help destroy cancer cells and reduce the tumor size.

Clinical Trial Access

We offer many opportunities for you to participate in research, which may include clinical trials related to thyroid cancer.

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Why Choose Duke

Nationally Ranked Cancer Program
As a National Cancer Institute-designated Comprehensive Cancer Center, we are recognized for exploring new treatment opportunities through ongoing clinical trials. We offer you the latest research discoveries before they are available elsewhere.

Surgical Experience and Team Expertise
Your team may include board-certified surgeons and endocrinologists as well as medical and radiation oncologists, medical oncologists, interventional radiologists, nuclear medicine specialists, cytopathologists, and nutritionists. For your convenience, we've made it possible for you to see your team and undergo appropriate testing all in one day. Our specialists meet weekly to discuss patients, develop optimal care plans, and offer advanced surgical, medical, and follow-up care. Our goals are low complication rates, shorter hospital stays, fewer repeat operations, and less likelihood your cancer will recur.

Latest National Practice Standards
We work with the American Thyroid Association, the American Association of Endocrine Surgeons, and the National Comprehensive Center Network to help set the national standards for best practice treatment guidelines. We were also one of the first institutions to work with the Collaborative Endocrine Surgery Quality Improvement Program to improve quality in endocrine surgery.

Support for You and Your Family
Our comprehensive support services range from helping you minimize the side effects of cancer treatment to helping you and your family cope with the emotional and psychological effects of diagnosis and treatment. View all of our cancer support groups in our event calendar.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

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This page was medically reviewed on 06/10/2025 by

Randall P. Scheri, MD | Endocrine Surgeon