The cancer is removed straight away

Removing the non-cancerous side of the thyroid as well means a second cancer cannot grow there in the future.

Removing the whole thyroid means that if you need to be treated with radioactive iodine in the future, then this can occur without needing more surgery

• Because the whole thyroid gland is removed, thyroid hormone replacement tablets must be taken for the rest of your life.
• If the calcium glands (parathyroid glands) are permanently injured during surgery, you will need to take calcium tablets for the rest of your life.  The chance of this happening is less than 5% (1 in 20)
• There may be a change in the quality or volume of your voice

• You will need to stay in hospital for 1-2 nights after the surgery
• Depending on your job, you may need to take 1-2 weeks off work to recover prior to returning to work
• There will be a small scar in your neck that will generally become less prominent over time
• You will need to take thyroid hormone replacement tablets for the rest of your life
• You will need regular blood tests after the surgery to check hormone and calcium levels, and may need to take additional tablets.

• For low-risk cancer, the chance of it coming back in the next 10 years is generally less than 5%.
• A recurrence can be detected with ultrasound or with blood tests as part of regular follow up.
• If a recurrence is detected, it is usually treated with surgical removal followed by radioactive iodine. 

The cancer is removed straight away

The chance of needing to take thyroid hormone tablets is lower than for a total thyroidectomy (about a 1 in 3 chance, or 30%)

The chance of needing to take calcium tablets for hypoparathyroidism is close to zero.

The chance of voice change after the operation is reduced (compared to total thyroidectomy)

• The remaining half of your thyroid is usually able to make enough thyroid hormone that you don’t need to take thyroid hormone tablets. However, in about 1 in 3 cases (30%), thyroid hormone tablets are required.
• If the calcium glands (parathyroid glands) are injured during surgery, the glands on the other side of your neck will usually function normally. This means that the chance of needing to take calcium tablets lifelong is close to zero.
• There may be a change in the quality or volume of your voice.
• Sometimes a second operation is required to remove the other half of the thyroid.  This can be recommended if there were unexpected features of your cancer that were detected only after it was removed.   Your surgeon can advise how likely they think this might be, but the chance could be as high as 30% (1 in 3). 

• You will need to stay in hospital for 1-2 nights after the surgery
• Depending on your job, you may need to take 1-2 weeks off work to recover.
• There will be a small scar in your neck that will generally become less prominent over time.
• You will need regular blood tests after the surgery to check hormone and calcium levels, and may need to take additional tablets.

• For low-risk cancer, the chance of it coming back in the next 10 years is generally less than 5-10%. 
• The risk of the cancer coming back is slightly higher if half the thyroid remains present (compared to having the whole thyroid removed). This is because small cancers can occasionally develop in the remaining thyroid (the chance of this happening is generally less than 5%, or a 1 in 20 chance).
• Recurrences can be detected with an ultrasound of the neck.  Blood tests are generally not useful to detect recurrences when half the thyroid remains present. 
• If a recurrence is detected, it is usually treated with surgical removal followed by radioactive iodine. 

• The cancer is closely monitored with ultrasound scans (at first every 6 months), and surgery is performed if there is sign of growth or progression.
• This option is only available at a few sites in Australia
• Your cancer must be suitable for this option. Your surgeon or endocrinologist will advise if this is an option you can consider.

• The need for neck surgery is avoided (for many people)
• The risks associated with neck surgery and anesthetic are avoided (for most people).  You can read about these risks in the total thyroidectomy and hemithyroidectomy sections above.

• Not all centres in Australia currently offer active surveillance programs.  You may have to travel to a centre that offers active surveillance.
• You will need to have regular ultrasounds with a specialist thyroid doctor who is familiar with active surveillance, usually 1-2 times per year for a minimum of 5-10 years. This is more frequently than you would require follow up if you chose to have surgery.
• You will need to be comfortable with the idea of a small cancer remaining in your body, that will be closely monitored. 

• Some people are anxious that a cancer remains in their body
• There is a small chance that the cancer could grow or spread.  However, the regular ultrasound surveillance will mean that this is usually detected early, and can usually be completely treated.