Thyroid cancer update (Nice, December 2022)

5th February 2023 by Dr Louise Hudman

Thyroid cancer update (Nice, December 2022)

This is a new guideline from NICE on managing thyroid cancers. It was published in December 2022. Much of it is aimed at secondary care, but there are a few elements useful for us, or things that I was not aware of that may be worth knowing about which I will highlight.

Key learning points for me were:

  • The use of thyrotropin alfa before radioactive iodine treatment.
  • Not all patients need thyroid stimulating hormone (TSH) suppression after thyroid cancer. Even if they do need TSH suppression, they probably won’t need it lifelong.
  • Thyroglobulin levels should be checked as part of routine follow up.

When may active surveillance be useful rather than surgery?

Active surveillance is not suitable for most people with thyroid cancer. However it can be considered for people with a small (ie less than 1cm) solitary microcarcinomas. Even in this population, the evidence is limited on the benefits of active surveillance over surgery, so surgery can still be considered.

What is thyrotropin alfa and when is it used?

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