Diagnosis

Thyroid cancer suppressive therapy

Introduction1,2

Treatment of thyroid cancer usually consists of total thyroidectomy, followed by radioactive iodine therapy (ablation) in higher-risk cases.

Hormone suppressive therapy1-3

In cases of medium and high risk of recurrence, "TSH suppressive" hormone therapy is initiated. Hormone "suppressive" therapy performs two tasks:

  1. It replaces the thyroid hormones produced by the body, preventing hypothyroidism and ensuring normal body function.
  2. It inhibits or reduces TSH production, preventing the stimulation of any remaining cancer cells (reducing relapses). The usual dose may be around 2.1-2.7 µg/kg/day. The goal may be to achieve TSH < 0.1 or between 0.1 and 0.5 µU/L depending on the risk of recurrence.

In patients with or at risk of osteoporosis where this suppressive TSH therapy is implemented, supplementation with calcium and vitamin D is recommended.

This treatment should be limited to centres specialising in the follow-up of thyroid cancer patients. Not all thyroid cancer patients need this therapy.