The best treatment for Follicular and Hürthle cell cancers is a total thyroidectomy (i.e. removal of the whole thyroid); however, most patients diagnosed with this type of cancer will initially present with a Follicular or Hürthle cell neoplasm on their thyroid biopsy. Therefore, most patients are initially treated with a thyroid lobectomy to remove the nodule to make a pathological diagnosis which cannot be made on fine needle aspiration (FNA) biopsy. Once a patient is diagnosed with Follicular or Hürthle cell cancer, he or she usually needs to have the rest of the thyroid removed in an operation called a completion thyroidectomy.
After thyroidectomy, patients need to take thyroid hormone replacement pills for the rest of their life. Follicular cell cancers can spread through the blood and thus can spread to the lungs or bones. Some Hürthle cell cancers will spread to lymph nodes in the neck, which may be felt pre-operatively on examination or seen on ultrasound and can be biopsied by FNA if they look suspicious; these can be removed at the same time as the thyroidectomy. Radioactive iodine ablation (RAI) is given weeks to months postoperatively depending on the aggressiveness of the cancer based on pathologic findings and whether there is any remaining thyroid tissue as demonstrated by a diagnostic uptake scan; Hürthle cell cancers tend not to take up RAI as well as other thyroid cancers.
For more information go the endocrinediseases.org:
Diseases of thyroid gland: Thyroid cancer