During a routine check-up at Tam Anh General Hospital in Ho Chi Minh City in mid-2025, Thao's ultrasound revealed unusual lymph nodes. The length-to-width ratio was less than two (normally greater than two), with altered node structure and microcalcification. Doctor Doan Minh Trong, from the Breast - Head and Neck Surgery Department, diagnosed her with recurrent thyroid cancer in the lymph nodes (metastasis). This was her second recurrence and third treatment for thyroid cancer.

Her first diagnosis came in 2019, when she had undifferentiated thyroid cancer in her right lobe. As the tumor wasn't near the isthmus, doctors removed the right lobe. Post-surgery biopsy results showed no remaining cancer cells, and she didn't require radioactive iodine treatment. Three years later, persistent throat pain led to the discovery of a tumor in her left thyroid lobe, a biopsy confirming it was malignant – her first recurrence. She underwent surgery to remove the left lobe and potentially affected lymph nodes, followed by radioactive iodine treatment to eliminate any remaining cancer cells.

This second recurrence involved surgery by Doctor Trong to remove the malignant lymph nodes and adjacent nodes at risk of metastasis. Thao then underwent further radioactive iodine therapy to destroy any residual cancer cells and prevent further spread. Post-treatment, she requires ongoing monitoring and regular check-ups for early detection of any abnormalities.

Doctor Trong and the surgical team operating on Thao. Photo: Tam Anh General Hospital

Doctor Trong and the surgical team operating on Thao. Photo: Tam Anh General Hospital

Thyroid cancer is prevalent among adults, ranking 6th among cancers in Vietnam (according to Globocan 2022), with women at higher risk than men. Common treatments include surgical removal of one or both thyroid lobes, surrounding lymph node dissection (if there is regional metastasis), and radioactive iodine therapy.

Depending on the patient's condition, surgery may be performed without the need for complete neck dissection in a single procedure. Neck lymph nodes are part of the lymphatic system, crucial for the immune system's defense against foreign cells. According to Doctor Trong, complete neck dissection in one operation can weaken the patient without necessarily improving treatment outcomes.

Thyroid cancer has a cure rate of over 90% when detected and treated early. However, some patients experience recurrence even after proper treatment. Risk factors for recurrence include tumor size, type of thyroid cancer, stage, vascular invasion, lymph node metastasis, distant metastasis (to bones, lungs, etc.), age, and non-compliance with treatment.

Doctor Trong cited research showing that differentiated thyroid cancer progresses slowly, with a cure rate exceeding 90% if detected early and a low recurrence rate. Undifferentiated thyroid cancer, like Thao's case, is more aggressive, spreads rapidly, and has a higher recurrence rate. The recurrence rate is about 1-5% in early stages, rising to 28.2% in advanced and metastatic stages. Recurrence commonly occurs in the neck lymph nodes (80%).

Recurrent thyroid cancer has a good prognosis if detected and treated promptly. Doctor Trong advises patients to undergo regular check-ups after treatment. Symptoms such as neck tightness, difficulty breathing, pain, difficulty swallowing, persistent fatigue, and unexplained weight loss warrant immediate medical attention.

To reduce the risk of recurrence, patients should maintain a balanced diet, limiting fast food and processed foods. Fresh, thoroughly cooked foods with minimal oil, salt, and proper hygiene are recommended. Regular exercise and a positive outlook also contribute to overall health and prevent recurrence.

Bao Tram

*The patient's name has been changed