Understanding Papillary Thyroid Cancer, Preparing for Surgery, and What to Expect

When I first read the words papillary thyroid cancer in my biopsy results, I felt overwhelmed and unsure of what lay ahead. Like many, I had little knowledge about this condition or the surgery that often follows diagnosis. If you or a loved one faces this, understanding what papillary thyroid cancer is, how to prepare for surgery, and what to expect afterward can make the journey less daunting.

Papillary thyroid cancer is the most common type of thyroid cancer. It usually grows slowly and has a high survival rate when treated properly. In this post, I’ll share what I learned about this cancer, how to get ready for surgery, and what life looks like after the operation.

What Is Papillary Thyroid Cancer?

Papillary thyroid cancer starts in the thyroid gland, a butterfly-shaped organ at the base of your neck. This gland produces hormones that regulate metabolism, heart rate, and body temperature. Papillary cancer develops from the follicular cells in the thyroid and tends to grow slowly.

This cancer often appears as a small lump or nodule in the thyroid. Many people discover it during routine checkups or imaging tests done for other reasons. It rarely causes symptoms early on, but as it grows, it might cause:

• A lump in the neck

• Hoarseness or voice changes

• Difficulty swallowing

• Swollen lymph nodes in the neck

In my case, a small nodule was felt during my annual physical and the doctor suggested an ultrasound to confirm. The ultrasound was done a few weeks later and confirmed that I had a nodule that measured roughly 1.1 cm. (Generally, anything over one centimeter is biopsied). During the biopsy, the doctor and tech informed me that nodules are very common and only about 2% of them are "bad". Most people have them before the age of 50. So, when I received by biopsy results the next week I was surprised to read the words "Papillary Thyroid Cancer". I had no idea what would come next.

The good news is that papillary thyroid cancer responds well to treatment, especially surgery, and has a high cure rate.

Preparing for Surgery

Surgery is the most common treatment for papillary thyroid cancer. It usually involves removing part or all of the thyroid gland. Since the tumor identified via ultrasound was small, both surgeons we consulted with recommended a conservative approach to only remove the right side and sample some lymph nodes around the thyroid to see if they were involved. About a month after my official diagnoses I was scheduled for surgery. Your surgeon will also refer you to an endocrinologist (if you don't already have one), who will manage any further thyroid hormone treatment after surgery.

Mentally preparing from surgery is a whole other battle. Some days I felt at ease and some days I felt a huge wave of anxiety. I found it helpful to name my fears out loud. Whether I was talking to a friend, my husband, or taking time for prayer journalling. It helped. I also prioritized my normal exercise routine to make sure my body was as healthy as possible for recovery.

A friend said this to me and it will stay with me forever, "No matter how big or small the cancer, it's still cancer. It's scary. Don't minimize your feelings. It's your journey, nobody else's."

HORMONE HACK!

• If you can schedule surgery just after your next period, during the follicular phase of your cycle, do it. You'll feel so much better. Can you imagine PMS on top of surgery recovery? No thank you.

Here are some practical steps to prepare:

Understand Your Surgery Type

Your surgeon will recommend either:

• Lobectomy: Removing one lobe of the thyroid if the cancer is small and confined. The benefit of this is that your body may still be able to produce enough thyroid hormone on it's own without needing supplementation. Monitoring for future reoccurrence is then done by yearly ultrasounds.

• Total thyroidectomy: If the cancer is bigger or has spread, they might take out your whole thyroid gland. If that happens, you'll need to take thyroid replacement hormones. To keep an eye on things, they'll check your thyroglobulin levels to make sure the cancer doesn't come back. This surgery has a higher chance of messing with your parathyroid glands, which are important for managing your calcium levels.

  
  

Knowing what to expect helps you prepare mentally and physically.

Pre-Surgery Tests

Before surgery, you’ll likely have:

• Blood tests to check thyroid function and overall health

• Ultrasound or other imaging to assess the tumor and lymph nodes

• A biopsy to confirm cancer type

  
  

These tests help your medical team plan the best approach.

Discuss Medications and Health Conditions

Tell your doctor about any medications, supplements, or health issues. Some medicines, like blood thinners, may need to be paused before surgery. Most doctors recommend discontinuing any supplements up to 2 weeks before surgery, especially fish oil and omega 3s.

Plan Your Recovery Space

After surgery, you’ll need rest and limited activity. Prepare a comfortable area at home with easy access to water, snacks, and entertainment. Arrange for someone to help you for the first few days.

I found it most comfortable to sleep in a recliner for the first few night home.

Other at-home recovery tips:

• Pick a comfortable place to rest, a recliner is the best option.

• I found using a travel pillow or rolled up blanket behind my neck relieved a lot of strain on my neck while sitting back in the recliner.

• Your shoulder and neck muscles may feel pretty sour after surgery. It can be helpful to have a heat pack and some relaxing oils to help relieve muscle tension.

  • Oils: lavender, deep blue, frankincense, or peppermint (keep aways from incision site!)

• Water, water, water

• Pick a convenient place to keep track of medication times.

• Prep some easy meals to ask a friend to set up a meal train. Be specific about what kind of meals you like and if you do or do not want dessert, because you may end up with a million cookies (speaking from experience here).

• Stock up on your favorite self-care products like face wash, eye masks, and lotion.

Ask Questions!!

Don’t hesitate to ask your surgeon about:

• How long the surgery will take

• Risks and possible complications

• What to expect during recovery

• How thyroid hormone replacement will work if your whole thyroid is removed

  • Likely, they will start you on thyroid medication right away and you will follow up with your endocrinologist after a few weeks to test your thyroid levels.

If you feel the need, get a second opinion to confirm your surgical plan.

Clear information reduces fear and builds trust.

What to Expect During Surgery

On surgery day, you’ll arrive at the hospital or surgical center. Reminder for the ladies, you'll have to pee in a cup for a standard pregnancy test, so make sure you drink just a little water in the morning so that you are ready for that. The procedure usually takes 1 to 2 hours. You’ll be under general anesthesia, so you won’t feel pain. You may be waiting in pre-op for a while where they get you changed, start your IV, and ask a lot of questions. Don't be afraid to ask to use the restroom right before they take you back.

The surgeon makes a small incision at the base of your neck to access the thyroid. They carefully remove the affected tissue, sometimes including nearby lymph nodes if cancer has spread.

After surgery, you’ll spend a few hours in recovery. Nurses will monitor your breathing, pain, and vital signs. You might feel a sore throat or neck stiffness, which is normal. My surgeon liked to insert a drain tube into the neck and have patients stay at the surgery center overnight. Early the next morning they removed the drain and had me out the door by 6am.

Pro tip: Ladies, braid your hair to keep in out of the way and under control.

Recovery and Life After Surgery

Recovery varies but usually takes a few weeks. Here’s what I experienced and what you might expect:

Hospital Stay and Immediate Recovery

Most patients stay in the hospital overnight for monitoring. You’ll receive pain medication and instructions on wound care. Swelling and bruising around the neck are common but fade over time.

Because of the lymph node results after my first surgery, I ended up having a second surgery to remove the rest of the thyroid. This was not ideal, but I knew exactly what to expect the second time around.

After my first surgery I was very nauseous coming out of anesthesia and that made it more difficult to eat, which made recovery a bit tougher at first. If you think this might be an issue for you, you can ask for a scopolamine patch behind your ear. That helped so much during my second surgery and I didn't feel sick at all.

If they plan to take lymph nodes or the entire thyroid at once, you can expect a little more hoarseness and pain with swallowing. Be patient, it will fade.

Ice ice baby

What to bring with you:

• Cellphone and charger.

• Warm socks with non-slip bottoms (they may provide these).

• Clothes that are easy to take off and put back on.

  • v-neck shirt, sweat pants, and slip-on shoes.

• Any of your regular evening or morning medications approved by your doctor.

• Snacks: The surgery center I was at had a few options like crackers, applesauce, popsicles, instant mac-n-cheese, mashed potatoes, and soup. If you don't know what they have available, ask!

  • My husband was allowed to bring me food as well. I had a much better appetite the second time around and was glad I packed a plant-based protein shake (something easy on the tummy) and my husband brought me chicken noodle soup with bread. No greasy foods.

• Entertainment: Ask if they provide a tv where you can access subscriptions to netflix, hulu, etc. If not, bring your tablet or computer. I found that reading took too much energy

Another tip the nurses shared with me: Ask for pillows to go under your arms, it makes sleeping much more comfortable.

Thyroid Hormone Replacement

If your entire thyroid is removed, you’ll need daily thyroid hormone pills to replace what your body no longer produces. Your doctor will monitor your hormone levels and adjust the dose as needed.

Follow-Up Care

Regular follow-ups include blood tests and ultrasounds to check for any signs of cancer returning. Most of this will be done with your endocrinologist and primary doctor. Your doctor may also recommend radioactive iodine treatment if needed. (look for a future post about this).

Lifestyle Adjustments

Most people return to normal activities within a few weeks. Prioritize going outside and taking walks when you can. After my first surgery (a right-side lobectomy and lymph node dissection) I was surprised by how good I felt after 2 weeks. However, this was 2 weeks of REST. No lifting my kids and very limited activity. You might notice changes in energy levels or mood as your body adjusts to hormone replacement. Eating a balanced diet and staying active help support recovery.

Final Thoughts

Facing papillary thyroid cancer and surgery can feel overwhelming, but understanding the process helps you take control. Surgery offers a strong chance for cure, and with proper preparation, recovery can be smooth.

If you or someone you know is preparing for thyroid surgery, focus on learning about the procedure, asking questions, and setting up a supportive environment at home. Remember, you’re not alone in this journey, and many have successfully navigated it before you.

Take the next step by talking openly with your healthcare team and gathering the information you need to feel confident and ready.

If you need a thyroid cancer buddy, I'm here :)