The University of Michigan’s Multidisciplinary Thyroid Cancer Clinic, part of the U-M Comprehensive Cancer Center Endocrine Oncology Program, offers comprehensive interdisciplinary care for patients with all types of thyroid cancers. Our team includes endocrine surgeons, endocrinologists, oncologists, nuclear medicine specialists, pathologists, radiation oncologists, genetic counselors and others who are leaders in their fields. Cases are reviewed weekly by our Multidisciplinary Thyroid Tumor Board. We are often referred patients with complex problems requiring care not available elsewhere. Our physicians routinely treat patients with the most advanced forms of thyroid cancer.

What is thyroid Cancer?

The thyroid is a small butterfly-shaped gland located in the lower portion of the neck. It produces hormones that help control your body’s metabolism and organ function. Thyroid nodules occur when thyroid tissue grows excessively. These nodules can be noncancerous (benign) or cancerous (malignant). Thyroid cancer is found in just 5% of all thyroid nodules.

There are five main types of thyroid cancer:

• Papillary and follicular carcinomas, which combined make up almost 80-90% of all thyroid cancers 
• Hurthle cell carcinoma (a variant of follicular carcinoma)
• Medullary thyroid carcinoma
• Anaplastic thyroid carcinoma

In general, the most common types of thyroid cancer are very treatable and have excellent long-term prognoses. It is very rare to die from thyroid cancer. Rates of thyroid cancer have increased over the past several years and U-M physicians serve on committees that develop national guidelines for care.

Diagnosis

Some patients first become aware of a thyroid nodule when a family member or healthcare provider notices a lump on their neck. In other instances, thyroid nodules are incidentally found when receiving a CT scan, MRI, or ultrasound to evaluate another medical condition.

Our endocrinology team will begin by thoroughly evaluating the patient’s nodule to determine if it is cancerous. At U-M, we use the latest thyroid ultrasound techniques, which provide physicians with a precise method for identifying nodules, determining if they are cancerous, and gathering important information for long-term follow-up. Other testing may include lab work and obtaining a tissue sample from the nodule to biopsy, a procedure known as fine needle aspiration. To make your visit more efficient and convenient, we may perform both an ultrasound and biopsy at your initial visit. U-M endocrine surgeons perform their own thyroid ultrasounds, allowing them to gather necessary information to formulate a specific plan for surgery, if needed.

Treatment

Our multidisciplinary team of experts will always ensure you receive individualized care, getting all the treatment you need, and only the treatment you can benefit from. 

If we are concerned your nodule is cancerous, surgery is usually recommended. Some nodules remain in the indeterminate category after testing, and your physician will discuss options with you regarding this category of nodules. Hormone therapy may also be used to stop cancer cells from growing. If thyroid cancer is advanced when diagnosed, initial treatment may also include chemotherapy or radiation therapy.

Surgery is the most common form of treatment for thyroid cancer. If surgery is required, it is important to find an experienced surgeon to ensure the procedure is performed safely and gives you the best chance for cure and long-term survival. Treating patients with thyroid cancer is a main focus of the U-M Endocrine Surgery Division, where we use the newest techniques both in and out of the operating room.

Surgical options range from removing only the side of the thyroid gland that contains the nodule to removing the entire thyroid gland. U-M is one of only a few major medical centers in the United States offering minimally invasive video-assisted surgery for the treatment of thyroid disease, which may be an option in certain cases, including patients with indeterminate nodules that need to be removed.

Our surgeons will discuss the appropriate choices with you, always ensuring that your surgery is performed in the safest manner possible. We use the most advanced surgical techniques including intraoperative nerve monitoring to help preserve the quality of the patient’s voice and ultrasonic technology to decrease bleeding and operative time.

After surgery, many patients receive radioactive iodine treatment to get rid of any microscopic amounts of remaining thyroid cancer. After this, daily thyroid hormone replacement therapy can be started. It is important to follow up with your physician on a regular basis to ensure the cancer has not recurred. We utilize state-of-the art radiological imaging and Thyrogen testing to evaluate patients for recurrence. For patients who cannot be treated adequately by standard therapies, we offer clinical trials and/or external beam radiotherapy where appropriate. The appropriate care, including diagnostic testing, the initial surgery and subsequent management, is discussed at our weekly Tumor Board meetings.

At U-M Multidisciplinary Thyroid Cancer Clinic, we also offer patients an opportunity to meet with a dietitian to discuss concerns or special needs, comprehensive patient education materials, individual and family support through support groups, social workers and psychiatrists, and access to U-M Cancer Center Patients and Families Support Services.

Remember, most types of thyroid cancer have a very good prognosis when diagnosed early and treated by an experienced physician. Our multidisciplinary team focuses on using their expertise to ensure all patients receive the best and most appropriate treatment possible, minimizing the risks of complications from care while optimizing the chance for a complete cure.