Thyroid Cancer: Follow-Up Care

Approved by the Lineagotica Editorial Board, 03/2019

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with thyroid cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care and may include:

  • Physical exams and medical tests. Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. People treated for thyroid cancer are typically asked to return to the doctor’s office every 6 months to a year. At a follow-up care visit, the doctor will conduct a physical examination and blood tests to watch the level of TSH suppression and to test for Tg (see Diagnosis). If the thyroid gland has been removed, there should be little or no Tg in the blood. An elevated level may indicate the cancer has returned.

    Other blood tests may be done depending on the specific type of thyroid cancer treated. Blood tests also help the doctor determine the correct dosage of the patient’s thyroid replacement medication (if needed), which may be adjusted over time as the patient gets older.

  • Other follow-up tests. Other follow-up tests may include a chest x-ray, an ultrasound of the neck, a full-body scan, or other imaging tests. If the doctor recommends a procedure that uses I-131, patients may have to stop taking their thyroid medication for up to 6 weeks or they may be asked to follow a low-iodine diet for up to 2 weeks before having the test.

  • Tests for long-term side effects. Based on the type of treatment received, the doctor will determine what examinations and tests are needed to check for long-term side effects, including the possibility of secondary cancer. This is particularly important for people who have received I-131 treatment, who may be at higher risk of leukemia and urinary bladder cancer.

  • Breast cancer screening. Young women who are treated for papillary or follicular thyroid cancer have a higher risk of developing breast cancer in the future. They should talk with their doctor about appropriate breast cancer screening recommendations.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer originally diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist or endocrinologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.