Follicular thyroid cancer is one of the most common varieties of thyroid cancer and is considered to have a good prognosis in most cases. As with almost all thyroid cancers, follicular cancer is usually treated with surgery. All surgeries involve some risks and side effects, with some side effects common to most surgeries and others specific to thyroid surgeries.
Definition
Follicular thyroid cancer, also called follicular carcinoma, arises in the thyroid's follicular cells. These cells create hormones that help regulate the body's metabolism. Follicular thyroid cancer is the second most common type of thyroid cancer, accounting for one in every 10 cases diagnosed, and it rarely spreads outside of the thyroid. Surgery is the most common treatment option for most thyroid cancers, although it can be used in conjunction with other treatments.
Types of Thyroid Surgery
Doctors typically use one of three surgeries to treat follicular thyroid cancer: total thyroidectomy, a near-total thyroidectomy or a lobectomy. A total thyroidectomy removes the entire thyroid gland, while a near-total thyroidectomy leaves only a small part of the gland behind. Most thyroid cancers are treated using one of these two methods. A lobectomy removes the lobe where the cancer is present and the tissue (the isthmus) joining it to the other lobe; this method is only used on some patients with follicular or papillary cancers, and it may require the remaining lobe be removed later.
Common Surgical Risks or Side Effects
Risks of surgery include post-operative pain, swelling or tenderness, or drainage. As is possible with any operation, infection is another potential risk, although surgeons and medical staff are trained to minimize these risks and antibiotics can combat or prevent most post-operative infections. Your medical team will teach you care for your surgical site to manage any side effects.
Thyroid Hormone Replacement Therapy
Because the thyroid regulates metabolism and produces vital hormones, a necessary risk of its removal is the need for hormone replacement therapy. This replacement therapy can also slow the growth of any cancer cells left behind. Few people have side effects to levothyroxine, the drug used for replacement therapy, with side effects usually happening during the early months of treatment, when the doctor uses blood work to calculate the correct dose. Levothyroxine is taken once a day, usually for life.
Nutrition and Supplements
A potential risk following surgery to remove all or part of the thyroid is difficulty swallowing or nausea, so returning to a completely normal diet may take some time. If surgery is used in conjunction with radioactive iodine therapy, a special diet may also be required to prepare for the therapy. If the parathyroid glands are also removed during surgery, you may also need to take calcium and vitamin D supplements.
Nerve Damage
One possible thyroid surgery risk is damage to the nerves or muscles connected to structures in the upper body. Damage to the nerves controlling the larynx (voice box) can result in voice problems, hoarseness or a breathy-sounding voice. These side effects can be temporary or permanent. If certain muscles are affected, one shoulder may be lower than the other.
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