A patient had two thyroid lobectomies due to presence of cancerous thyroid nodules. After radiation treatment it was fine for a while and was keeping up with regular levothyroxine medication. However cancer is found again ..doctors says possibly due to leftover thyroid tissue. Would you advise to go back in surgically and remove the rest given the possible risk of damage to parathyroid glands and nerves that control the voice box or would you advice to go under radiation again?
I would go for surgery. Voice box could be affected during surgery, however, voice therapy is available to improve the quality of the patient’s voice.
Radioactive isotope of iodine I-131 can be administered in therapeutic dose (if the nodule is hot on radioiodine assay& if age of pt<45). If the nodule is cold, surgery should be opted.
