The treatment plan recommended by your doctor for differentiated thyroid cancer often depends on the stage of the disease. Patients are different and the treatment plan recommended for each specific patient may differ from what follows. It is crucial to discuss your individualized treatment plan with your doctor. Stage I and II lobectomy or subtotal/total thyroidectomy. Proximal/total thyroidectomy is more commonly performed in the United States and may be accompanied by lymph node dissection in the central region. This removes the lymph nodes near the thyroid gland. For very low-risk patients, surgery alone is sufficient, and the clinical cure rate is high. Your doctor will prescribe thyroid hormone therapy after thyroidectomy. Stage III and IV surgery usually consists of a total/proximal thyroidectomy plus a central lymph node dissection (removal of the lymph nodes near the thyroid). If the cancer has metastasized to lymph nodes elsewhere in the neck, a modified radical neck dissection is performed, which removes more lymph nodes in the neck. After surgery, radioactive iodine treatment is usually performed to remove all remaining thyroid tissue, potential cancer foci in the neck or elsewhere in the body that can take up iodine. Some patients may be treated with external irradiation. Other patients may undergo clinical drug trials or chemotherapy due to the presence of metastatic cancer that cannot take up iodine. According to the 2009 American Thyroid Association guidelines for the management of differentiated thyroid cancer, postoperative thyroid hormone therapy should be administered in amounts high enough to suppress blood thyroid stimulating hormone (TSH) levels below the normal range. Treatment of recurrent or persistent papillary, follicular and variant types of thyroid cancer 6-12 months after initial treatment, if papillary or follicular thyroid cancer remains uncleared or recurs, treatment options often depend on the site, size and extent of the cancer, and surgery is often preferred if the lesion can be removed surgically, or radioactive iodine therapy can be applied, either alone or in combination with surgery It can also be performed alone or in combination with surgery. If the cancer cannot be treated with radioactive iodine but is detected on other imaging studies such as MRI or PET scan, external radiation therapy may be considered. Chemotherapy (clinical drug trials) may be tried when the cancer has multiple metastases and cannot take up radioactive iodine (such cancer cells are called “iodine-naïve cells”).