Care pathway for thyroid cancer

The most common symptom of thyroid cancer is a hard, painless lump in the thyroid area. The lump may also be located elsewhere on the lower neck.

Thyroid cancer is sometimes discovered by chance during other medical examinations.

There are several different types of thyroid cancer. The most common type is papillary thyroid cancer, which also has the best prognosis. With a few exceptions, thyroid cancer is generally very treatable.

Thyroid cancer examinations are usually initiated in primary healthcare.

Any lump found on the neck area should always be examined. The primary diagnostic method is an ultrasound examination of the neck, which can often distinguish between benign lumps (e.g., goitrous nodule) and malignant ones. A sample is taken from suspicious lumps using a fine needle for microscopic examination.

Sometimes a thyroid nodule is discovered incidentally during other tests.

If thyroid cancer cells are found in the biopsy sample, the physician will refer you to the Endocrine Surgery Clinic at HUS for additional examinations and treatment.

When your referral arrives at HUS, the specialist will review it, assess its urgency, and schedule the necessary additional examinations. After that, you will receive an invitation for an appointment with the surgeon. You will receive an invitation letter by mail and in the Maisa Portal.

An ultrasound scan of the neck is a basic diagnostic test that is generally the best and most important examination for thyroid cancer. An ultrasound scan should have been performed before arriving at HUS. In some cases, however, the surgeon may request another neck ultrasound and a biopsy of the tumor.

In certain cases, we may also perform magnetic resonance imaging (MRI) or computed tomography (CT) scan of the neck. Thyroid cancer cannot be diagnosed through blood tests, but in some cases, these tests can influence treatment planning.

During your appointment, we will review your test results, your overall condition, and possible treatment options, as well as related considerations, such as the risks of surgery. If we decide to proceed with surgery, you will see the nurse after your appointment with the physician. You will be provided more information about your treatment at the nurse’s appointment.  

After surgery, we will refer you either to the endocrinology outpatient clinic for monitoring or to the Comprehensive Cancer Center to assess your need for further treatment.

You will be booked for an initial visit to the oncology outpatient clinic or the radiation therapy unit, depending on the treatment you require. At the appointment, we will discuss your treatment plan and give you instructions.

The standard treatment for thyroid cancer is surgery. During the surgery, we will remove either one lobe of the thyroid gland or the entire thyroid gland. If the disease has spread to the lymph nodes in the neck, we will remove them during the same surgery, if possible.

After a total thyroidectomy, we assess the need for further treatment based on the risk of cancer recurrence. For papillary and follicular cancer types, we may administer radioiodine therapy after surgery if we deem it necessary based on a risk assessment. For the most aggressive forms of thyroid cancer, we consider external beam radiation therapy to the neck area following surgery.

Surgery is not always an option. In this case, we will evaluate treatment options at the Comprehensive Cancer Center.

A multiprofessional treatment team is in charge of the treatment of thyroid cancer. You can reach your treatment team in the Maisa Portal and by phone. You will find the contact information for the unit treating you on the invitation letter.

• The Comprehensive Cancer Center helpline at 09 471 74900 is open Monday through Friday from 7:30 a.m. to 4:00 p.m.
• If your condition deteriorates suddenly or your fever rises above 38 degrees Celsius, contact the 24-hour emergency Medical Helpline at 116 117 (toll-free) or the nearest hospital with on-call services.
• In an emergency, always call 112.

For patients with the best prognosis for thyroid cancer, surgery alone is sufficient, and no follow-up is needed after the procedure. Depending on the risk of recurrence, we sometimes schedule follow-up visits at the endocrinology outpatient clinic 1 to 5 years after treatment.

If you have received radioiodine therapy or radiation therapy following thyroid cancer surgery, your follow-up care will take place at the oncology outpatient clinic. We tailor your follow-up care individually based on the type of cancer and the treatment you have received.

Often, your follow-up care will be transferred to primary healthcare at some point. 

If your entire thyroid gland has been removed, you will need to take thyroxine medication for the rest of your life. The dosage of thyroxine medication is monitored in primary healthcare or occupational healthcare services. Once follow-up at HUS is complete, we will, if necessary, issue a personalized recommendation to primary healthcare regarding the need for additional thyroid value testing or an ultrasound scan of the neck.