There are different types of thyroid cancer, depending on the cells from which they arise, and each requires its own treatment. At NewYork-Presbyterian, our thyroid cancer specialists are highly experienced in accurately diagnosing all types of thyroid cancer and matching patients with the most effective therapies, which often result in a cure. Thyroid cancer can afflict people of all ages. Many people diagnosed with thyroid cancer are young adults, perhaps going off to college or just starting their careers. Our teams understand the toll that a cancer diagnosis can take and work to cure your thyroid cancer so that it interferes as little as possible with your life.
A Team of Thyroid Cancer Experts
We offer comprehensive care through the dedicated New York Thyroid Center at NewYork-Presbyterian Columbia University Medical Center and the Thyroid Disease Center at NewYork-Presbyterian Weill Cornell Medical Center. Depending on the type and stage of your tumor, your team may include endocrinologists, endocrine surgeons, head and neck surgeons, medical and radiation oncologists, and others with experience treating people with thyroid cancer—including papillary and follicular thyroid cancer, as well as rarer types of thyroid cancer like medullary thyroid carcinoma, anaplastic carcinoma, thyroid lymphoma, and thyroid sarcoma. Team members collaborate to customize a plan of treatment that meets your needs.
Genetic Counseling and Testing
Some types of thyroid cancer are linked to genes passed down in families. We provide genetic counseling and testing for patients and their families for uncommon tumors such as medullary thyroid carcinoma. If you learn your family has a genetic mutation that increases your risk of thyroid cancer, we may monitor you or recommend prophylactic surgical removal of the thyroid to prevent cancer.
In-Office Biopsies and a Rapid Diagnosis
NewYork-Presbyterian offers ultrasound-guided fine needle aspiration biopsy to remove and analyze cells from thyroid nodules.
- You can often have a needle biopsy on the same day as your initial evaluation. Our experts will perform an ultrasound scan of your thyroid, decide whether the findings require a biopsy, and if needed, perform the biopsy.
- The team collaborates with an onsite cytopathologist (a specialist who studies and diagnoses the disease at the cellular level), who determines if an adequate sample was obtained or if another sample is needed. This immediate feedback may reduce the number of passes required with the biopsy needle and spares you from the possibility of having to make repeat visits to obtain more thyroid tissue samples.
- The results of your biopsy are typically available in two to three days.
Precision Medicine for Thyroid Cancer Treatment
We offer genetic testing of thyroid cancer tissue to look for mutations linked to cancer growth. The identification of certain genetic mutations can help guide your doctors' choice of treatment—an approach called "precision medicine."
Thyroid Cancer Surgery
Most thyroid cancers are curable and are treated with surgery to remove part or all of the gland, depending on the extent of growth of your tumor. Our surgeons are every experienced performing these procedures using minimally invasive approaches, including transoral or robotic surgery. You may have:
- Lobectomy. Removal of the lobe in which thyroid cancer is found.
- Near-total thyroidectomy. Removal of all but a very small part of the thyroid.
- Total thyroidectomy. Removal of the whole thyroid.
- Lymphadenectomy. Removal of nearby lymph nodes to see if they contain cancer cells.
If you need thyroid surgery, you might be concerned about having a visible scar on your neck afterward. With an innovative approach, NewYork-Presbyterian surgeons can use a surgical robot to access the thyroid from under the arm in some patients, reducing the visibility of the incision. We offer this technology to patients who want to avoid a neck scar and to those whose skin does not heal well after surgery.
There is a risk of nerve injury with thyroid surgery that can affect the quality of your voice, as well as certain other risks. Due to their expertise and experience, our surgeons have minimized these risks to some of the lowest in the country.
Thyroid Hormone Replacement Therapy
The thyroid normally produces thyroid hormone, which the body needs to help maintain normal metabolism. After your thyroid is surgically removed, your doctor will prescribe thyroxine (thyroid hormone) to replace your thyroid function. Your team will perform blood tests to monitor your thyroid hormone levels, specifically thyroid stimulating hormone (or TSH), to make sure you are taking a dose that works best for you. When treating papillary or follicular thyroid cancers, typically the goal is to keep the TSH in the low normal range since high levels of TSH can fuel the growth of any thyroid cancer cells remaining in your body.
Radioactive Iodine for Thyroid Cancer
Radioactive iodine is sometimes recommended for more aggressive thyroid cancers. It is given as a single dose of radiation taken in a small capsule to try to kill any thyroid cancer cells that may remain in your body after surgery, and thus to reduce the chance of the cancer coming back. We typically prescribe this treatment if you had papillary or follicular thyroid cancer (and some Hurthle cell carcinomas) that spread to lymph nodes or other parts of your body. Radioactive iodine is preferentially taken up by thyroid cells and some thyroid cancer cells, and so toxicity associated with radioactive iodine treatment is generally minimal.
Targeted Therapies for Thyroid Cancer
People with thyroid lymphoma, anaplastic thyroid cancer, and medullary thyroid cancer may have chemotherapy to shrink the tumor (such as the drug paclitaxel). We give these therapies in our modern and comfortable infusion suites, which are staffed by experienced and compassionate oncology nurses who monitor and support you.
There are also several targeted therapies approved to treat persistent thyroid cancers. Examples include cabozantinib and vandetanib for inoperable or advanced medullary thyroid cancer, and lenvatinib and sorafenib for advanced thyroid cancers that do not respond well to radioactive iodine. Because these targeted medications can be taken by mouth, you can take them at home. Your doctor will tell you if any of these treatments is an option for you.
Highly Focused Radiation Therapy
If your thyroid cancer has spread or cannot be effectively treated with radioactive iodine or other therapies, you may have traditional external radiation therapy. NewYork-Presbyterian's state-of-the-art radiation treatment centers offer highly focused radiation therapy that takes aim at tumors while sparing as much nearby healthy tissue as possible, reducing the risk of side effects.
Clinical Trials for Thyroid Cancer
NewYork-Presbyterian participates in clinical studies evaluating novel treatments to advance the care of people with thyroid cancer, especially those whose disease does not respond well to standard therapies. Your doctor will let you know if you may be eligible to participate in a clinical trial.