If there is concern that the thyroid cancer has come back in the neck, an ultrasound-guided fine needle biopsy is first done to confirm that it is really cancer. Then, if the thyroid cancer appears to be resectable (removable), surgery is most often used. The extent of surgery would depend upon the location or locations of the persistent or recurrent thyroid cancer and the prior surgeries and quality of surgeries that the patient has undergone. The sections of central compartment surgery and lateral neck dissection have been written for you and are appropriate for persistent or recurrent thyroid cancer in either of those locations. We have examples of surgeries for just these types of circumstances for you to watch. Thyroid cancer surgery can be very effective at managing neck disease, sparing function and cosmetic appearance but should only be performed by the most experienced and very high volume thyroid cancer surgery experts. We have publications establishing our ability to control papillary thyroid cancer recurrences or persistence in the neck approaching 98% in both the central and lateral neck areas. No one except for Dr. Clayman has published these types of results and long term outcomes. Dr. Clayman has the largest experience in the world of managing patients with recurrent or persistent thyroid cancer. In the tab, Surgery Videos, you can view what some of these operations look like. Please be aware that these are real videos of operations and so if the concept of watching an operation is difficult for you, then this is probably not for you to see. Watch the videos and see how all disease within the lymph nodes (and remaining thyroid tissue) can be effectively removed and the patient can be cured of their disease sparing all nerves to the voice box and maintain parathyroid glands and function.
Persistent or recurrent papillary thyroid cancer in residual thyroid tissue is much more concerning for the potential for the cancer to spread directly into the breathing tube or voice box. Only the most skilled and experience thyroid cancer surgery experts should manage such circumstances. The purpose of this specific thyroid cancer surgery is to maintain vocal and swallowing function, parathyroid function, and airway control. These are the most complicated and complex of all thyroid cancer surgeries.