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Surgery is usually the first treatment for most thyroid cancers. During the procedure, surgeons remove the tumor and, if needed, nearby lymph nodes while preserving as much healthy thyroid tissue as possible. Minimally invasive techniques and real-time imaging help protect important nerves and structures in the neck. Some complex cases are performed in the Advanced Multimodality Image Guided Operating (AMIGO) Suite, a state-of-the-art operating environment equipped with advanced imaging and surgical tools. In the AMIGO Suite, a team of specialists can plan and guide the surgery with precision, using imaging before, during, and after the operation—all without moving the patient from the operating room.

Our board-certified surgical oncologists are part of a multidisciplinary team that specializes in the diagnosis and treatment of thyroid cancer. As experts in the latest minimally invasive surgical approaches and treatments for advanced and recurrent thyroid cancers, we work with each patient to develop a personalized surgical plan. Our surgeons are also renowned researchers, dedicated to identifying thyroid cancer early and developing innovative life-saving therapies.

Depending on the size and location of your cancer, your surgeon may use one of the following procedures:

• Lobectomy (Hemithyroidectomy): In this procedure, only the side of the thyroid that contains the tumor is removed. It’s the most common surgery for well-differentiated thyroid cancers, especially when the tumor is small and hasn’t spread. Some patients may need to take thyroid hormone pills after surgery, depending on how much thyroid tissue remains.
• Total Thyroidectomy: The entire thyroid gland is removed, often along with nearby lymph nodes if the cancer has spread. This surgery is usually recommended for larger tumors or cancers that have extended beyond the thyroid. After a total thyroidectomy, daily thyroid hormone replacement is required to maintain normal hormone levels.
• Isthmusectomy: If the cancer is located in the small bridge of tissue connecting the thyroid’s two lobes (the isthmus), the surgeon may remove just this portion. This approach preserves the rest of the thyroid whenever possible.
• Lymphadenectomy (Lymph Node Removal): When cancer spreads to the lymph nodes, surgeons remove the affected nodes to lower the chance of recurrence. This may involve removing nodes near the thyroid (central compartment) or along the sides of the neck. Pre-surgery imaging and sometimes needle biopsies help guide this process.
• Laryngeal Nerve Monitoring: Surgeons carefully work around nerves near the thyroid that control your voice, including the recurrent and superior laryngeal nerves. Advanced nerve-monitoring technology helps protect these nerves while ensuring complete tumor removal.
• Parathyroid Preservation: Surgeons prioritize protecting the tiny parathyroid glands next to the thyroid, which regulate calcium in the body. If a parathyroid gland must be removed, it can sometimes be re-implanted to maintain calcium balance.
• Minimally Invasive Techniques: Many thyroid surgeries are done through small incisions, often less than two inches, aligned with natural neck creases to minimize visible scarring. Imaging guidance is used during surgery to improve precision and protect surrounding structures.

Learn more about for thyroid cancer.

All surgery is performed by Brigham surgeons at Brigham and Women’s. Our surgeons use the most advanced technology available, performing minimally invasive surgeries whenever appropriate. Our team of surgeons, endocrinologists, medical and radiation oncologists, anesthesiologists and pathologists have decades of experience caring for patients with thyroid cancer.

The Day of Surgery

Planning ahead can make your recovery smoother. Arrange for someone to accompany you to and from your procedure, and line up help at home for tasks like cooking, cleaning, and laundry. Our social workers are available to assist with these arrangements if needed. In the weeks before surgery, focus on eating a balanced diet rich in protein, staying active, limiting alcohol, and avoiding tobacco. Your care team will provide detailed instructions tailored to your specific needs. Before surgery, you’ll receive a phone call from the Roberta and Stephen R. Weiner Center for Preoperative Evaluation to review your medical history, medications, and logistics for your upcoming surgery. The Weiner Center can also answer questions about preoperative appointments and help you plan for your procedure.

On the day of surgery, you will be cared for in the operating room by our surgeons, anesthesiologists and nurses who specialize in thyroid cancer surgery. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care from our experienced surgical and nursing staff. The length of your hospital stay will depend on the type of surgery you have.

You will likely experience some discomfort for the first few days after surgery, but your care team will prescribe medicine to help control pain. Before you leave the hospital, your care team will start you on an oral pain medicine. Talk with your team about your options for pain relief.

After Surgery

After thyroid surgery, most people notice their energy slowly returning over the first few weeks. It’s normal for energy levels to fluctuate for a month or two. Recovery time varies for each patient, but many people start feeling more like themselves within several months. Feeling tired or weak for several weeks is common, and your body needs time to heal fully. You may have constipation from using pain medicine, not moving around or not eating or drinking very much. Talk with your doctor about how to prevent and treat constipation.

If you have any questions about your surgery, talk with your health care team. They can help you know what to expect before, during and after your surgery. Learn more about your hospital stay and returning home.

Non-Surgical Treatment Options

Learn more about our non-surgical treatment options.