Protocol for differentiated thyroid cancer management

Nyebe Phineas Mahlangu, Mpumelelo Nyathi


Effective screening procedures and advances in medical imaging technologies have seen increased detection of the differentiated thyroid cancers (DTC). However, management of DTC patients still remains controversial owing to differences in opinion on the extent of surgery (thyroid lobectomy or total thyroidectomy) and the need of radioiodine ablation (RIA) post-surgery.

This study was aimed to establish a local protocol for DTC management at Dr George Mukhari Academic Hospital (DGMAH). The protocol emphasizes on multidisciplinary management whereby, the nuclear medicine physicians, endocrinologists and surgeons decide on the extent of thyroid resection. The protocol emphasizes on total thyroidectomy for all DTC patients since it reduces morbidity and also optimizes the management of patients for further radioiodine treatment.

A search of scholar articles for various protocols on management of DTC was conducted using Google search engine, Science Direct and Medline. Abstracts and full texts were reviewed.

The proposed local protocol for DGMAH emphasizes on a multidisciplinary management approach for DTC patients. Furthermore, only patients who have undergone total thyroidectomy should be managed with radioiodine.

Total thyroidectomy reduces morbidity and also optimizes the management of patient for further radioiodine treatment.
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