Understanding Thyroid Cancer
- Thyroid cancer survivor and mom of one, 33-year-old Brittany McKelvey, is preparing for her first national pageant nearly 20 years after her diagnosis and treatment.
- Thyroid cancer is a disease that begins in the thyroid gland, which is at the base of the neck. The cancer will often present itself as a large bump (tumor) in the neck, and symptoms of thyroid cancer can be mistaken for a common cold.
- Chances of cancer recovery increase significantly with early detection, so it’s important to address any new or unusual symptoms you’re experiencing with your doctor promptly.
- Thyroid cancer surgery carries risks, but most are uncommon or treatable. “The surgery itself is complex and delicate, but yet, it’s also a surgery that most people recover from very quickly,” Dr. Lisa Orloff, a head and neck surgeon at Stanford Medicine, tells SurvivorNet.
- Hemorrhage, low calcium, and nerve issues are some of the primary concerns, but healthcare teams are highly vigilant about spotting and addressing them early. Working with a skilled surgical team that has a strong track record with thyroid operations can significantly reduce the risk of complications.
- SurvivorNet’s “My Health Questions” AI tool helps patients and caregivers better understand breast cancer screening and treatment options by providing clinically grounded answers and personalized questions for upcoming doctor visits.
McKelvey, a cancer advocate who works with the national lung cancer nonprofit LUNGevity Foundation, and is also a military wife, recently shared her story with KALB News Channel 5, expressing how her “20-year cancerversary” is approaching—prompting immense feelings of gratitude as she previously didn’t expect to make it to her high school graduation.
Read More“Proud to be your Mrs. Louisiana American 2026! I am honored to represent Louisiana at the national Mrs. American pageant later this year,” she wrote alongside a photo of herself with her sash and crown.
“This platform gives me the opportunity to serve more of my community, share my story, and speak hope for cancer education and awareness!”
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In an earlier interview with Patient Power, McKelvey recounted playing basketball in middle school, when she noticed that her voice was weak while calling out to her teammates.
“We spent months going to different doctors to try to figure out what was wrong. And so, at that point, we finally went to an ENT [Ear, nose, & throat doctor], and they put a scope with a camera down my throat, and they looked at my vocal chords,” she explained.
She continued, “Your vocal chords normally open when you breathe and close shut when you’re talking, eating, because vibrations to allow you to be able to speak. And one of my vocal chords was completely off to the side, which was causing me to not have full closure and was affecting my voice.
Expert Thyroid Cancer Resources
- 7 Common Signs of Thyroid Cancer & How to Spot Them
- Advanced Thyroid Cancer — Managing Treatment & Quality of Life
- Caring For Mental Health During The Thyroid Cancer Journey: A Holistic Approach to Healing
- Diagnosing & Staging Thyroid Cancer
- Thyroid Cancer Surveillance — How Will I Be Monitored After Treatment?
- GLP-1 Medications and Thyroid Cancer Risk: What Patients Should Know
- Thyroid Cancer Surgery: Understanding the Risks
- Managing Worry and Anxiety During Thyroid Cancer Treatment
- Pregnancy and Fertility After Thyroid Cancer: What Patients Need to Know
- The Role of Targeted Therapy in Advanced Thyroid Cancer
- Understanding Thyroid Cancer Types & Treatment Options
“That point they said, ‘This is odd, but it can happen. Sometimes when you get sick, there can be temporary paralysis. There can be a lot of potential causes, but let’s do a scan just to make sure to rule out anything crazy.'”
Thankfully, the scans led to her diagnosis of thyroid cancer and surgery.
Understanding Thyroid Cancer Surgery
Further sharing her story with WRAL News, McKelvey said, “I had multiple tumors in my neck. One of the tumors was sitting on my vocal cord, which was causing the vocal cord paralysis and me not being able to speak.
“I’m in a way fortunate that I lost my voice because by the time they found it, it had spread pretty extensively, without any other indications.”
She told WRAL News that her treatment journey consisted of surgery to remove her thyroid and 33 lymph nodes, followed by radioactive iodine therapy and two additional procedures to help restore her voice.
“After that radioactive iodine treatment, I was declared no evidence of disease. It was a very exciting moment. I think partially you’re worried, ‘Is it really gone?’ But part of it was this weight lifted. I could get back to being a normal teen,” McKelvey said.
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We’re delighted to see McKelvey thriving nearly 20 years after her diagnosis.
She recently took to Instagram to celebrate her health while prepping for the competition.
“As I prepare for this incredible opportunity, I’m reminded that this journey has never been about a crown. It’s about the purpose behind the position,” she captioned her post.
“At 13 years old, cancer took my voice. Today, I am blessed to use my voice and position to advocate for patients, spread awareness, and build hope. Let’s do this, Louisiana!”
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Understanding Thyroid Cancer and How It Is Treated
A diagnosis of thyroid cancer can feel overwhelming, but it’s frequently very treatable. Even in cases involving more advanced or aggressive forms, medical advancements are continually enhancing treatment options. Patients can take comfort in the progress of modern medicine and the support of healthcare professionals, loved ones, and friends.
“There are certainly other modalities that can be used for more advanced cancers,” Dr. Lisa Orloff, a head and neck surgeon at Stanford Medicine, recently assured SurvivorNet.
Stephanie Giparas, a physician assistant at the Endocrine and Head and Neck Department at Moffitt Cancer Center, previously told SurvivorNet, “Our thyroid gland is a butterfly shaped endocrine gland that sits in front of our windpipe. We think of it as kind of our energy driver. Its main purpose is to produce thyroid hormone.”
“The thyroid hormone not only regulates our metabolism, but almost every organ system in our body uses thyroid hormone. It supports our heart, it supports our brain. So you cannot live without thyroid hormone.”
The thyroid is responsible for several functions throughout our body, including:
- Metabolism: The thyroid produces hormones — mainly thyroxine (T4) and triiodothyronine (T3) — that influence how fast your body uses energy (your “metabolic rate”).
- Heart Rate and Blood Pressure: These hormones help control how quickly your heart beats, which can also affect blood pressure.
- Body Temperature: By affecting the speed at which your cells operate, thyroid hormones play a part in regulating body temperature.
- Other Functions: The thyroid also works closely with the pituitary gland in your brain. This gland makes thyroid-stimulating hormone (TSH), which signals the thyroid to release more or fewer hormones based on your body’s needs.
It’s important to know that having an overactive or underactive thyroid does not necessarily increase the chance of developing thyroid cancer. Many people experience hyperthyroidism (when the thyroid produces too many hormones) or hypothyroidism (when the thyroid does not produce enough hormones) without ever developing cancer, but these conditions should be treated to correct the hormonal imbalance they represent.
Thyroid cancer occurs when cells in the thyroid gland begin to grow out of control, sometimes forming nodules or lumps. It usually grows slowly, and most cases can be successfully treated.
This disease is generally grouped based on the specific cells it develops from.
- The most common type is differentiated thyroid cancer, such as papillary thyroid cancer. Under the microscope, these cancer cells still look somewhat like normal thyroid tissue. They typically start in follicular cells, the part of the thyroid responsible for making hormones.
- Non-differentiated cancers can come from the thyroid’s calcium-controlling cells, the immune cells that fight infections within the thyroid, or from follicular cells that are so mutated that they no longer look like thyroid cells under a microscope.
“Although papillary thyroid cancer is the most common, the other types of cancers tend to be more aggressive and tend to spread more widely, at least in advanced cases,” Dr. Orloff explained to SurvivorNet.
Risk factors of thyroid cancer include:
- Exposure to Radiation: Head or neck radiation treatments during childhood, or exposure to higher radiation levels (for example, nuclear accidents), can increase risk.
- Family History: Certain genetic conditions (especially affecting the RET gene) can raise the likelihood of developing some types of thyroid cancer.
- Iodine Deficiency: The thyroid uses iodine to make hormones, so low iodine intake can sometimes be linked to certain thyroid problems. However, because salt is often iodized in many countries, this is less common in places like the U.S.
- Gender and Age: Thyroid cancer is three times more likely in women. It is frequently found in women in midlife and men in later years.
Differentiated Thyroid Cancers
“Differentiated” thyroid cancers are those in which the cancer cells still resemble normal thyroid tissue under a microscope. These cancers usually begin in the follicular cells—the cells responsible for producing thyroid hormones.
- Papillary Thyroid Cancer (PTC):
- The most common form of thyroid cancer accounts for the majority of cases. It typically grows slowly and is considered highly treatable. PTC often develops in one lobe of the thyroid, and even when it spreads to nearby lymph nodes, treatment outcomes are generally very positive.
- Follicular Thyroid Cancer:
- The second most common type. It can sometimes spread through the bloodstream to areas such as the lungs or bones, but it also tends to grow slowly and often responds well to treatment. When found early, long‑term outcomes are usually excellent.
- Oncocytic (Hürthle Cell) Thyroid Cancer:
- A less common subtype that was once grouped with follicular cancers. It can be more challenging to treat, but early detection is associated with more favorable outcomes.
WATCH: Diagnosing Thyroid Cancer.
When being diagnosed, patients may receive the following tests:
Thyroid-stimulating hormone (TSH) Test. This blood test mainly checks levels of a hormone called TSH (thyroid-stimulating hormone), which is made by a small gland in the brain (the pituitary) to regulate thyroid function.
While the test can’t tell if a thyroid issue is cancerous, it helps doctors see if a thyroid nodule is producing hormones. In many cases, hormone-producing nodules are not cancerous.
- Ultrasound. An ultrasound can detect subtle thyroid changes, ranging from small nodules to extensive changes. However, not all nodules detected are necessarily harmful.
- Biopsy. The biopsy may follow an ultrasound, which detected a nodule. In this procedure, a radiologist visualizes the nodule on a screen and directs the needle precisely into the targeted area to collect a tissue sample for further testing for signs of cancer.
- Depending on the size of the tumor and if it has spread into nearby lymph nodes or tissues, doctors determine the stage or how advanced the thyroid cancer is.
Preparing for Surgery
“Thyroid surgery tends to be a relatively low-pain operation,” Dr. Ofloff explains. “Many thyroid operations are done as outpatient surgery. Sometimes patients are kept in the hospital overnight, but in general, people are able to resume eating and drinking and walking around, getting out of bed pretty much right away once they have recovered from the anesthesia.”
Thyroid cancer patients may be faced with surgery to help treat the cancer. There are varying surgery options, including a total thyroidectomy, which involves completely removing the thyroid. In other cases, a partial thyroidectomy may be necessary, which means only a portion of the thyroid gland is removed.
A partial thyroidectomy may be optimal if the nodule is confined to one side or has smaller growths affecting a smaller portion of the thyroid.
“The benefits to partial thyroidectomy over total thyroidectomy are that many patients maintain normal thyroid function and don’t have to be on lifelong thyroid hormone medication after a partial thyroidectomy, whereas with a total thyroidectomy, you need the lifelong medication,” Dr. Otto explains.
“Additionally, it’s a shorter surgery and less invasive, so we do prefer partial thyroidectomy. There are some patients who are well suited to that, and then there are others who are not, and we can go over those details.”
Dr. Otto explains that tumors that are small and on one side of the gland are well-suited for a partial thyroidectomy.
WATCH: Understanding what goes into thyroid cancer surgery.
After the surgery, soreness at the incision site and in the throat (due to the breathing tube) is common but typically mild. Over-the-counter medications or prescribed pain relievers help manage discomfort. In some cases, a small tube may be placed in your neck to drain fluid. This is usually removed in a day or two.
Many patients leave the hospital the same day, especially if it’s a lobectomy.
“After partial thyroidectomy, most patients can go home from the hospital the same day. They actually don’t have to stay overnight. The distinction with a total thyroidectomy is that we watch patients overnight, and the main reason is actually that we have to monitor calcium levels after total thyroidectomy,” Dr. Otto explains.
Patients can usually resume light activities the next day, but avoid strenuous exercise or heavy lifting for about two weeks to let their incision heal.
For thyroid cancer patients whose cancer is at an advanced stage, in addition to possible surgery, treatment may also involve chemotherapy, thyroid-stimulating hormone therapy (stimulates hormone production), and/or radiation therapy. In some cases, when thyroid cancer is very aggressive, surgery may no longer be effective, so relying on other treatment methods may be more optimal.
Thyroid cancer has reasonable treatment success rates. However, there is a chance of recurrence, meaning the cancer can return after treatment (also called recurrence). Recurrence may happen a few months after remission or sometimes even decades later. Patients should ask their doctor after treatment what their risk of recurrence is.
Some advanced patients also have an aggressive type of disease, such as anaplastic thyroid cancer. Patients should know that there are still powerful treatment options in these settings that can yield an optimal quality of life and control disease progression.
WATCH: The Role of Targeted Therapy in Advanced Thyroid Cancer
“When patients present with more aggressive disease or high-risk disease, our focus is really on identifying how we can best treat these patients and decrease their risk for recurrence without causing unnecessarily aggressive harm from the treatments that we’re offering,” Dr. Mara Roth, an endocrinologist and associate professor at the University of Washington in the Fred Hutch Cancer Center, tells SurvivorNet.
Turning to Radiotherapy
In many cases, thyroid cancer can be treated with surgery and a treatment approach known as radioactive iodine (RAI) therapy. However, in some advanced cases of thyroid cancer, standard radiation therapy.
When people hear the word “radiation” in relation to thyroid cancer, they often think of radioactive iodine (RAI)—a treatment that works well for certain thyroid cancers that still act like normal thyroid cells. But RAI is very different from external beam radiation.
- Radioactive Iodine (RAI): Taken as a pill or liquid, it travels through the bloodstream and targets any remaining thyroid tissue.
- External Beam Radiation: Uses high-energy beams from a machine outside the body to precisely target tumors.
For advanced or more aggressive thyroid cancers, external beam radiation may be used to ease symptoms, slow tumor growth, or help control a specific problem area. It’s often most effective when used in very targeted situations or alongside other treatments.
Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic, describes this approach as “spot welding.” If a patient has one particularly troublesome tumor—such as a painful lesion in a weight-bearing bone—radiation can be directed at that single area to “zap” the problem spot while the rest of the disease remains under surveillance or systemic treatment.
WATCH: Thyroid cancer surveillance.
If a doctor finds your recurrence at an early stage, your chance of quickly regaining remission is often higher. This is why regular follow-ups, blood tests, and neck ultrasounds are essential.
Some of the more common signs and symptoms of a return include:
- A lingering cough that doesn’t go away
- A lump or swelling in the neck that you can feel or see
- Difficulty swallowing (dysphagia)
- Neck pain that isn’t explained by muscle strain or other causes
- Hoarseness or voice changes
Thyroid Cancer Surgery: Understanding the Risks
Surgery is often a part of the treatment path for people facing thyroid cancer. And while you may understand that removing your thyroid gland — known as a thyroidectomy — is the best treatment option for your condition, it’s natural to feel nervous about the risks associated with surgery, like Abela was.
SurvivorNet previously spoke with surgeons and other experts to get a breakdown of what to expect during surgery, common side effects, and less common complications patients should be aware of. Patients should also know that while this is a complex surgery, many people are able to bounce back rather quickly.
“The surgery itself is complex and delicate, but yet, it’s also a surgery that most people recover from very quickly,” Dr. Lisa Orloff told SurvivorNet.
Possible Complications
Thyroidectomy is generally considered safe, especially when performed by a skilled and experienced surgical team. Even so, every operation carries some risk.
“Thyroid surgery tends to be a relatively low pain operation,” Dr. Ofloff explains. “Many thyroid operations are done as outpatient surgery. Sometimes patients are kept in the hospital overnight, but in general, people are able to resume eating and drinking and walking around, getting out of bed pretty much right away once they have recovered from the anesthesia.”
Your medical team will work together to try to minimize any potential risks and side effects.
The most common complications associated with surgery include:
- Nerve issues impacting the voice and swallowing
- Voice hoarseness or weakness due to nerve issues
- Hypoparathyroidism (Low Parathyroid Hormone)
- Bleeding
- Infection
- Esophageal or Tracheal Injury
- Difficulty Swallowing (Dysphagia)
- Nerve Injury
“The thyroid gland is very intimately associated with the nerves that control vocal cord movement. So in any thyroid operation, there’s a possibility of injury, either temporary or permanent, more often temporary,” Dr. Orloff explains.
If the vocal cord nerves — the laryngeal nerve, the recurrent laryngeal nerve or the smaller superior laryngeal nerve — is affected, there can be a change in voice quality and control of vocal cord muscle, which Dr. Orloff explained can affect swallowing, coughing, projection, and even breathing.
“It’s important to have a dialogue between the patient and the surgeon and acknowledge the importance of those nerves and the aim to protect those nerves as much as possible. The rate of injury is very, very low, but it is something that needs to be prioritized,” she said.
During intraoperative nerve monitoring, if the monitor picks up a concern on the first side, your surgeon may complete that one side and then stop the surgery to give that nerve time to heal before taking on the second side.
Recurrent Laryngeal Nerve Injury
Why It Matters: the recurrent laryngeal nerve controls your vocal cords. If it’s harmed, you could experience changes in your voice or, in very rare circumstances, breathing difficulties if both nerves are affected.
Causes: This nerve can be bruised or accidentally cut, especially if the cancer or enlarged gland is wrapped around it. Even gentle stretching can temporarily affect nerve function.
Signs and Symptoms:
- Hoarseness: Your voice might sound weak, breathy, or harsh due to nerve issues.
- Trouble Swallowing: As the recurrent nerve is also responsible for some of the sensory functions in our throat, we may not always feel the normal triggers to start the swallowing events.
- Weakened Cough: You might not be able to clear your throat as strongly
- Aspiration: The vocal cords may not close completely to protect the airway when you swallow. Thin liquids like water can sometimes drip down to irritate the vocal cords or even slip past them.
- Prevention and Management: Many surgeons use special devices, intraoperative neuromonitoring, to help them pinpoint the nerve’s location, lowering the chance of harm.
- Recovery: Most nerve injuries are temporary, lasting weeks to months. If the nerve is severely damaged, voice therapy or an additional procedure might be needed.
- Voice Rehabilitation: A specialist such as a speech-language pathologist can help you strengthen your voice if you experience ongoing issues.
Superior Laryngeal Nerve Injury: Less Obvious but Significant
- The external branch of the superior laryngeal nerve plays a role in voice pitch and singing. When injured, it might be less noticeable than recurrent laryngeal nerve damage, but it can still affect your ability to raise your voice or sing high notes.
- Studies show varying rates of injury because patients may not realize they have an issue, especially if they don’t regularly use a wide vocal range.
- If you notice changes in your ability to speak or sing at higher pitches, mention them to your doctor. Sometimes voice therapy helps, but injuries may be long-lasting.
Questions For Your Doctor
- What type of thyroid cancer do I have?
- What is the standard of care for this type?
- How will I be monitored after treatment?
- Are there any clinical trials I should consider enrolling in?
If you have a cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet’s proprietary AI tool “My Health Questions” is designed specifically for patients and caregivers.
WATCH: How One Cancer Survivor and Her Sister Used “My Health Questions” to Navigate Care
This powerful resource is embedded across the SurvivorNet website and delivers structured responses grounded in clinical guidelines and medically reviewed research to help people better understand their treatment options and feel more confident navigating care.
My Health Questions can also help patients come up with useful questions ahead of their next appointment.
Contributing: SurvivorNet Staff
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