The impact of the surgery itself
There are some risks and complications that can come with thyroid cancer surgery, but they are usually unlikely and tend to be temporary and recoverable, but some are more serious and can have a significant impact on future life.
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Nerve damage that causes voice changes and even affects respiratory function.
There are many important nerves distributed around the thyroid gland, especially the recurrent and superior laryngeal nerves, which innervate the vocal cords. During radical thyroid cancer surgery, there is a risk of injuring them in order to completely remove the lesion.
Injury to the laryngeal recurrent nerve on one side may lead to hoarseness; severe damage to the nerves bilaterally may lead to loss of voice, choking on food, and even difficulty breathing.
Injury to the superior laryngeal nerve may lead to low pitch, choking on water, etc.
If you experience these symptoms after surgery, seek prompt medical attention. Your doctor will determine whether the condition is temporary, or lifelong, so please follow the doctor’s instructions closely and try to recover. Be careful when drinking water and try to avoid choking and coughing.
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Hypocalcemia, may need to take calcium tablets
The parathyroid glands are located on the back of the thyroid gland, usually one above and one below, with four on the left and right. They secrete parathyroid hormone (PTH), which raises blood calcium to maintain normal calcium levels in the body. Surgery for thyroid cancer, especially total thyroidectomy, may damage or remove the parathyroid glands, causing a decrease in blood calcium and twitching of the hands and feet and numbness of the mouth and lips. Some are temporary and some do not recover for life.
If these symptoms occur, calcium and vitamin D supplements should be taken under medical supervision to maintain normal blood calcium levels, and blood calcium as well as PTH should be checked at follow-up examinations and medications adjusted accordingly.
When taking calcium tablets, care should be taken to avoid eating large amounts of spinach, which may interfere with the absorption of calcium elements. There are also foods with high phosphorus content, such as carbonated beverages and animal liver, that may interfere with calcium absorption. The actual fact is that you should not worry too much, as long as your blood calcium is reviewed regularly and there are no major abnormalities, you do not have to restrict your food intake too strictly.
Neck scarring
A neck incision for thyroid cancer may leave a scar that affects your appearance. The degree of post-operative scar growth is generally related to the individual’s body type, and will generally be more severe in younger people than in older people. If you don’t want the aesthetic impact, you can consult a plastic surgeon for a more professional opinion.
Currently, thyroid surgery can be performed with lumpectomy assistance and other modalities to narrow the incision, but the extent of resection may not be as complete as with traditional open surgery due to limited visualization. To achieve a better outcome, the surgeon will assess the extent of the lesion with imaging to determine whether lumpectomy can be performed.
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What are the effects of losing the thyroid gland
The thyroid gland secretes thyroid hormones (T3 and T4), which regulate the body’s metabolism. With surgical removal of the thyroid gland, patients may experience symptoms of hypothyroidism, such as feeling tired, memory loss, weight gain, fear of cold, and depressed mood. Therefore, all patients with surgically removed thyroid malignancies need to take thyroid hormone pills (such as “Eugenol”) for life after surgery. This serves two purposes: to replenish thyroid hormones and, in the case of differentiated thyroid cancer, to suppress thyroid-stimulating hormone (TSH) and reduce the risk of recurrence and metastasis.
The specific dose will be decided by a medical professional based on thyroid function test results, so please take the medication as prescribed by your doctor to achieve the best results.
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Can I get back on track with my life and work? What do I need to watch out for?
After thyroid cancer surgery, as long as you follow up on time, take your medications as prescribed, and do your functional exercises in a timely manner, you will be able to live and work normally.
- With regular follow-up, your doctor can detect signs of recurrence early and deal with them in time.
- The most important thing you need to do is to take your medication on time, not to stop or adjust it at will, and to have regular follow-ups as required by your doctor.
- Eat less of foods with high iodine content such as kelp and nori on a daily basis.
- Surgery may cause discomfort in the neck and shoulders, and functional exercises help recovery.
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Co-written by Dr. Weibo Xu, Cancer Hospital of Fudan University