Actress Marisa Abela, 29, Says The ‘Scariest’ Part Of Thyroid Cancer Surgery Was Not Knowing If She’d Speak Again

“And am I going to be able to speak again? That was the scariest thing, because you had to go through a lot of nerves to get to my thyroid. And one of the things was, you know, I had to sign a form that said, ‘if they cut, if they damage it attached to my vocal, my voice box,” she explained.

“And I remember saying to the doctor, ‘I know I’ve signed this, but please, if it looks dodgy and you think you’re gonna have to don’t wake me up, and we’ll figure out another way. … I was like, I’ll do whatever, just don’t go through.”

RELATED: Managing Worry and Anxiety During Thyroid Cancer Treatment

Abela recalled it being “a bleak time and that her worries extended beyond the diagnosis.”

Not only did she worry about whether she’d be able to speak again, but also about whether she could continue acting or find work with a noticeable scar on her neck.

She explained further, “It was the first time in 2023 I’d thought really about, ‘am I gonna wanna have children and does this affect that?’ And at the time, I went, ‘this is gonna change who I am as a person. And I am going to become a saint?’ I think that’s the right thing to do. And obviously I didn’t. And you kind of don’t change at all.”

Abela explained that while facing a serious health scare can make people more aware of their mortality, the personal transformation she expected didn’t last.

She believed at first that the experience would make her wiser and more appreciative of her body and life, however, she admits that sense of gratitude only lasted for approximately six months.

Before getting diagnosed with thyroid cancer in 2020, Abela said she initially suspected she had covid as she hadn’t been feeling well for a bit, and she was experiencing brain fog and weight gain.

When she eventually saw a doctor after securing an emergency referral, she was told she had a lump in her neck that was likely a swollen lymph node. But after feeling it again once she got home and realizing it was “massive,” she decided to pay out of pocket for an ultrasound, which led to a referral for a biopsy. A few weeks later she was told she had thyroid cancer.

Abela, who underwent an eight-hour surgery to remove the cancer and no longer has a thyroid, explained, “I had to have a total thyroidectomy, and I think 19 lymph nodes removed from the side of my neck. ”

She ultimately underwent surgery and radioactive iodine therapy to beat the disease.

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Speaking to The Times, in a recent interview, Abela explained, “I’m all in the clear now, thank God. I don’t have a working thyroid so these pills sort of create one. I’m never going to miss those appointments.

“The thyroid is all to do with your hormones, and staying on top of your hormones, as a woman, to make sure things are running as they should, is important.”

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, a head and neck surgeon at Stanford Medicine, tells SurvivorNet.

Understanding Thyroid Cancer Surgery

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 notes 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 explains.

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.

WATCH: What to Expect From Surgery: Thyroid Cancer

Other Risks & What You Can Do To Lower Risk

Other risks include low calcium levels, postoperative bleeding, infection, esophageal or tracheal Injury, and difficulty swallowing.

Like any surgery, a procedure to remove the thyroid gland does come with risks. However, patients can reduce their risk by following some basic guidance:

• Choose an Experienced Team: Surgeons who frequently perform thyroid surgeries tend to have fewer complications. Don’t hesitate to ask about your surgeon’s experience.
• Follow Instructions: If you’re asked to stop certain medications or fast before surgery, it’s vital to do so. These steps are to prevent bleeding or anesthesia complications.
• Speak Up: Before heading to the operating room, make sure your care team knows about all the medications (including herbal supplements) you take.
• Monitor Your Body: After surgery, if something seems off — like a rapidly expanding neck swelling, severe difficulty swallowing, or feeling faint and tingling in your hands, feet, or lips — contact your care team immediately.

While the list of potential complications is long, it’s important to weigh them against the benefits of removing a thyroid gland. In most cases, the chance to remove a harmful tumor or manage a dangerous hormone imbalance far outweighs the relatively small possibility of major side effects.

Many people who undergo thyroid surgery go on to live normal, healthy lives. Those who do experience complications often find that modern treatments and therapies can help manage or correct these issues.

Questions For Your Doctor

If you or someone you love has been diagnosed with thyroid cancer, you may have questions regarding treatments and what your next steps should be, so you can prepare. Here are some questions to help you begin your conversation with your care team.

• What type of thyroid cancer do I have, and how does that affect my treatment options?
• What are the recommended treatments for my specific cancer subtype, and what are the potential side effects?
• Will I need surgery, radioactive iodine, or external beam radiation—and how do these treatments differ?
• How will treatment affect my thyroid function long‑term, and will I need to take hormone replacement medication?
• What lifestyle changes or precautions should I take during and after treatment to support recovery and reduce recurrence risk?

WATCH: Thyroid cancer surveillance.

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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