Follow-up after treatment for thyroid cancer

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Follow-up care lets your healthcare team keep track of your health for a period of time after treatment ends. This important part of cancer care is often shared among the cancer specialists and your family doctor. They will help you recover from treatment side effects and monitor you for any signs that the cancer has come back (recurred).

Follow-up care may not seem that important to you, especially if your treatment was long or very hard. You may find the idea of follow-up care stressful because it reminds you of your cancer experience or because you are worried about what a test might reveal. Talk to your healthcare team about how you feel and about why follow-up matters. Your healthcare team is there to help.

Schedule for follow-up visits

Don't wait until your next scheduled appointment to report any new symptoms and symptoms that don't go away. Tell your healthcare team if you have:

  • any new lump or swelling
  • swallowing or breathing problems
  • a sore throat or cough that doesn't go away

The chance that thyroid cancer will come back (recur) depends on many factors including the type and stage of the cancer. Most thyroid cancers grow slowly so the cancer could recur 10 years or more after treatment. Many years of follow-up are usually needed.

Follow-up visits for thyroid cancer are scheduled:

  • every 3 to 4 months for the first 2 years
  • every 6 months for the next 2 years
  • then every year

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you are coping. They will also ask about any symptoms you have.

Your doctor may do a physical exam, including:

  • feeling the neck for any swelling or enlarged lymph nodes
  • listening to the lungs
  • checking your blood pressure and pulse

Tests are often part of follow-up care. You may have:

  • blood tests to check levels of thyroglobulin (Tg), thyroglobulin antibodies (TgAb), thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3). In the case of medullary thyroid cancer additional tests can include calcium, calcitonin and carcinoembryonic antigen (CEA) 
  • ultrasound of the neck to check for a local recurrence or spread of the cancer to lymph nodes
  • radioactive iodine scan to monitor response to radioactive iodine (RAI) therapy
  • CT scan or MRI of the neck or chest to look for cancer that has recurred or spread

If the cancer has come back, you and your healthcare team will discuss your treatment and care.

Find out more about follow-up

The following are questions that you can ask the healthcare team about follow-up after treatment for cancer. Choose the questions that fit your situation and add questions of your own. You may find it helpful to take the list to the next appointment and to write down the answers.

  • What is the schedule for follow-up visits?
  • How often is follow-up scheduled with the cancer specialist?
  • Who is responsible for follow-up visits?
  • What will happen at a follow-up visit?
  • What tests are done on a regular basis? How often are they done?
  • Are there any symptoms that should be reported right away? Who do I call?
  • Who can help me cope with long-term side effects of treatment?

Expert review and references

  • Shereen Ezzat, MD, FRCPC, FACP