Sometimes papillary and follicular cancers come back many years after the initial treatment. Surveillance for recurrence of thyroid cancer is accomplished by regular physical examinations and periodic assessment with: 1) whole body scanning using radioactive iodine, and 2) measurement of the amount of thyroglobulin protein in the blood.
Thyroglobulin is released in the bloodstream by normal thyroid tissue and by thyroid cancer cells. Ideally, thyroglobulin levels would not be measurable after the initial treatment for thyroid cancer. A thyroglobulin level that is elevated or rising can signal the recurrence of cancer. If this situation occurs in your case, you will have diagnostic tests performed to determine the cause of the elevated levels.
If there is evidence for cancer recurrence after the initial treatment, a second course of radioactive iodine, surgery or treatment with external beam radiation, precisely targeted to the tumor site, may be recommended. External beam radiation is performed at Virginia Mason by a radiation oncologist.