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Differentiated Thyroid Cancers (DTC)

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Differentiated Thyroid Cancers (DTC)

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Differentiated thyroid cancers (DTCs) include follicular and papillary thyroid cancers. These have a high cure rate and may be treated with a single therapy or multiple therapies.

We make use of the latest diagnostic tools, state-of-the-art research, and advanced thyroid cancer knowledge to help you achieve optimal health. Our experts specialize in your exact type of cancer. This allows us to provide a highly accurate diagnosis — often at the genetic level so we can identify the best treatments.

Why Choose Sylvester Comprehensive Cancer Center?

One of only 71 NCI-designated cancer centers in the United States. Sylvester is one of only two cancer centers in Florida that have been recognized by the National Cancer Institute. The team earned this distinction through its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

Only center in South Florida with a specialty endocrine testing center. We provide more accuracy in your diagnosis, leading to more precise treatments and better results. Located at the University of Miami Miller School of Medicine, the center is staffed by specialized nurses and technical assistants who perform complex hormone tests.

Leading-edge radiation therapy technology. From our pioneering work in MRI-guided techniques and HyperArc™ radiosurgery to our new addition of proton beam therapy, we can precisely target cancer cells with utmost accuracy. We offer advanced treatment options, including intensity-modulated radiation therapy, stereotactic body radiation therapy, stereotactic radiosurgery, and more, to improve outcomes, while preserving healthy organs and tissues.

More cancer clinical trials than any other South Florida hospital. Ease of access. If appropriate for your cancer and stage, our clinical trials provide you with the newest ways to treat and potentially cure your cancer.

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Treatments

  • Lobectomy 

    This type of surgery removes only the side of your thyroid that's affected by cancer. Your surgeon may also remove lymph nodes in the area to see if they contain cancer. This procedure may be used for small differentiated thyroid cancers or those that show no signs of spreading beyond the thyroid gland. The cancerous lobe is removed, usually along with the isthmus (the part that connects the two lobes).

  • Near-Total Thyroidectomy

    This surgery removes most of the thyroid, leaving only a small portion intact.

  • Total Thyroidectomy 

    This surgery removes the entire thyroid. After the thyroid gland is removed, most people receive radioactive iodine to destroy any remaining cancer cells. Also, you will need to take synthetic thyroid hormone to replace the hormones secreted by your thyroid gland. 

  • Lymph Node Dissection

    Your surgeon will remove any lymph nodes in your neck that contain cancer cells. Lymph node removal is especially important for treatment of medullary thyroid cancer and anaplastic cancer.

  • Voice and Vocal Nerve Preservation 

    Thyroid cancer and its treatment can affect your voice box, airway and vocal cord nerves. Sylvester head and neck surgical oncologists have expertise in voice and vocal nerve preservation for people with thyroid cancer.

  • Radioactive Iodine Treatment 

    You receive radioactive iodine treatment as a pill or liquid you swallow. The radioactive iodine is absorbed by thyroid cells and thyroid cancer cells primarily, so there's a lower risk of it harming other cells in your body. This treatment may be used after thyroidectomy for differentiated thyroid cancers to destroy microscopic areas of thyroid cancer that weren't removed during surgery. It's not used to treat medullary or anaplastic thyroid cancers. It also can be used to treat cancers that recur after treatment or that have spread to other areas of the body.

    Protocol for this treatment includes:

    • Following a low-iodine diet before and during treatment. By following a low-iodine diet for about six weeks, we can be sure that body scans after treatment will show only iodine activity from the treatment and not from iodine-rich foods you eat.

    • Two intramuscular injections of recombinant thyroid-stimulating hormone (TSH) to prepare your body for the treatment.

    During radioactive therapy, you must take special precautions for about a week after the treatment to protect the health of others. You’ll be asked to be in radioactive quarantine, which may include a day or more at the hospital and then a week at home. Also, you'll need to avoid close contact with other people (particularly children and pregnant women) and avoid sharing bedding, food preparation or bathroom facilities until the radiation is cleared from your body.

  • Intensity Modulated Radiation Therapy (IMRT) 

    This advanced form of external-beam radiation therapy allows radiation specialists to shape, or conform, radiation doses to the exact shape of your tumor. It's ideal for irregularly shaped thyroid tumors. Radiation specialists can control the amount of radiation in each beam targeted at the tumor. The control and flexibility of IMRT help minimize the amount of radiation to surrounding healthy tissue. IMRT may be an option if you can't undergo surgery and your cancer continues to grow after radioactive iodine treatment. It's also used to slow the growth of cancer that has spread to the bones.

  • Chemotherapy 

    Systemic medical therapy, called chemotherapy, is rarely used in DTC. When needed, it works by interfering with the cancer cell’s ability to grow or reproduce. These medicines may be given as a pill or intravenously (via a needle).

  • Hormone Therapy 

    If recommended, taking daily thyroid hormone pills can serve two purposes:

    • Maintain your body’s normal metabolism by replacing missing thyroid hormones

    • Stop cancer cells from growing by lowering thyroid-stimulating hormone (TSH) levels

  • Targeted Therapy

    Targeted therapies are medicines that stop a cancer cell's ability to grow and spread. These approaches target only cancer cells, rather than all rapidly growing cells (like chemotherapy). DTC that doesn't respond to the usual treatments may be treated with targeted therapy. Targeted therapies are usually taken at home as pills once a day. There are currently two FDA-approved targeted drugs for the treatment of DTC.

Tests

  • Ultrasound 

    Ultrasound can help your doctor determine if a thyroid nodule is solid or fluid-filled. It can also be used to check the number and size of thyroid nodules and to highlight nearby enlarged lymph nodes. Ultrasound uses high-energy sound waves, which bounce off internal tissues or organs to form a picture (sonogram).

  • CT (Computed Tomography) Scan

    A CT scan, also called a CAT scan, takes a series of detailed pictures of inside your body, taken from different angles. It's used to determine the extent of cancer and plan treatment. 

  • MRI (Magnetic Resonance Imaging) Scan 

    MRI combines a magnet, radio waves, and a computer to create a series of detailed pictures of the inside of your body. As with CT scans, MRI can help to determine the extent of cancer and plan treatment.

  • Biopsy 

    A biopsy is a tissue sample that’s examined for cancer cells. If cancer is found, a tumor genetic mutation analysis may be done to look for specific molecular features in the tumor. This helps us to create the most precise treatment recommendation.

  • Thyroid-stimulating Hormone (TSH) Blood Test 

    This test measures levels of thyroid-stimulating hormone and checks the overall activity of your thyroid gland. It can also help determine if you would benefit from thyroid hormone replacement therapy after surgery.

  • T3 and T4 (Thyroid Hormones) Blood Test 

    This test measures the levels of T3 and T4 hormones, the main hormones made by your thyroid gland. The levels tell your doctor about your thyroid gland function.

  • Thyroglobulin Test 

    Thyroglobulin is a protein made by your thyroid gland. This test is used after surgery to determine how your body responded. Treatment should lead to a very low level of thyroglobulin in the blood. If levels are high, you may need further treatment.

  • Calcitonin test 

    Calcitonin is a hormone that helps control how your body uses calcium. It's made by C cells in your thyroid, which can develop into medullary thyroid cancer. This test is used to diagnose this type of cancer or its possible recurrence after treatment.

  • Carcinoembryonic Antigen (CEA) Test 

    People with medullary thyroid cancer often have high blood levels of this protein. This test can be used after treatment to monitor its effects.

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