Sharing her story with UC Health Today, Monsalve said that before the accident, persistent fatigue and unexplained weight gain had begun affecting her daily life and relationships.

As for what led Monsalve to the emergency room, she was sitting at a traffic light on July 25, 2025, when another vehicle crashed into her car. She spent three days in the hospital, where doctors diagnosed her with a fractured sternum and discovered an unrelated nodule on the left side of her thyroid.

Monsalve was subsequently referred to endocrinologist Dr. Jennifer Morrison at the UCHealth Anschutz Outpatient Pavilion, where she underwent a fine-needle aspiration biopsy to determine whether the thyroid nodule was cancerous.

She learned that the cancer had spread from her thyroid to the surrounding tissue in her neck.

Her treatment plan included a total thyroidectomy to remove the thyroid gland, along with a neck dissection to remove affected tissue and lymph nodes. She would then undergo radioactive iodine therapy and take an oral medication.

Radioiodine therapy aims to kill off overactive, residual normal or cancer cells to treat thyroid cancer and hyperthyroidism, which occurs when your thyroid gland makes too many hormones.

Thyroid Cancer Treatment: What to Expect with Radioactive Iodine Therapy

Dr. Kristen Otto, a head and neck surgeon at Moffitt Cancer Center in Florida, previously explained radioiodine therapy to SurvivorNet, saying, “The first thing we do is we have patients go on a low iodine diet for a couple weeks before the treatment, usually two weeks before the treatment, and typically our nurses will educate patients on what foods they have to avoid to make sure that their body iodine stores are extremely, extremely low.

“The treatment is a kind of process that lasts about three or four days, essentially. [For] the first two days, patients get the thyrogen injections [a protein designed to be identical to the natural thyroid-stimulating hormone, or TSH, our bodies make], and then on the third day, most patients will be given a small dose of radioactive iodine and they’ll have a head to toe scan, and we look for any uptake and that allows us to prepare the treatment dose.”

The treatment dose depends on how much cancer your medical team believes is left over.

“If we see some uptake in just in the neck alone, which we almost always do, even after the best thyroid surgery, we’ll see just a little bit of uptake in the neck, then we know we can treat with a slightly lower dose,” Dr. Otto explains. “If we see uptake outside the neck, for instance, in the lungs, then we assume that the thyroid cancer has already metastasized to the lungs. And for those patients, we give a higher treatment dose.”

‘Fortunate’ For Thyroid Cancer Diagnosis

Looking back on how she ignored her symptoms for nearly a decade, Monsalve said, “If I had sought medical care eight years ago, I would probably only be taking medication to manage thyroid problems.”

“I don’t think I would have developed cancer if I had acted sooner.”

Understanding Thyroid Cancer Surgery

Monsalve’s doctor, Dr. Morrison, told UC Health, ” Continued lack of detection could likely have resulted in further advancement of her cancer. Fortunately, it appears that her disease at diagnosis was limited to the neck.”

Dr. Morrison also noted that a clinical intelligence platform called Eon Health ultimately led doctors to find the suspicious nodule in her thyroid gland.

Following Monsalve’s treatment plan, Dr. Morrison said she’s “currently in the active surveillance phase of her thyroid cancer journey.”

“The radioactive iodine treatment showed the expected response in the neck, with no evidence that the thyroid cancer had spread to other parts of her body,” added Morrison.

“I would never wish a car accident on anyone. It was fortunate that the imaging performed as a result of her accident led to the identification of her incidental thyroid nodule.”

Doctors are now closely monitoring Monsalve with blood tests and neck ultrasounds to check for any signs of cancer recurrence.

RELATED: What Are My Options When Thyroid Cancer Comes Back?

Monsalve is now taking levothyroxine, a synthetic thyroid hormone, as part of her thyroid hormone replacement therapy.

Thyroid hormone replacement therapy helps restore the hormones your body needs after thyroid surgery. It may also reduce the risk of thyroid cancer recurrence by keeping thyroid-stimulating hormone (TSH) within the recommended range. Ongoing follow-up visits and blood tests can help doctors determine the right hormone dose for each patient.

RELATED: Thyroid Hormone Replacement Therapy: Do I Need It?

‘‘I take my prescribed medication every day as directed and never miss a dose. I’ve always been a very positive person. I knew I was going to overcome this disease, and I try to find something positive in every situation,” Monsalve said.

Now she’s hoping her cancer journey will inspire others not to ignore symptoms.

She concluded, “When you notice even the smallest sign that something doesn’t feel right, make a medical appointment. “It’s always better to see a doctor right away so you can find out what’s happening and get treatment if you need it.”

Understanding Thyroid Cancer and How It Is Treated

A thyroid cancer diagnosis can feel overwhelming, but it’s frequently very treatable. Even in cases involving more advanced or aggressive forms, medical advancements are continually enhancing treatment options. Patients can take comfort in the progress of modern medicine and the support of healthcare professionals, loved ones, and friends.

“There are certainly other modalities that can be used for more advanced cancers,” Dr. Lisa Orloff, a head and neck surgeon at Stanford Medicine, told SurvivorNet in a recent interview.

Stephanie Giparas, a physician assistant at the Endocrine and Head and Neck Department at Moffitt Cancer Center, previously told SurvivorNet, “Our thyroid gland is a butterfly-shaped endocrine gland that sits in front of our windpipe. We think of it as kind of our energy driver. Its main purpose is to produce thyroid hormone.”

“The thyroid hormone not only regulates our metabolism, but almost every organ system in our body uses thyroid hormone. It supports our heart; it supports our brain. So you cannot live without thyroid hormone.”

The thyroid is responsible for several functions throughout our body, including:

• Metabolism: The thyroid produces hormones — mainly thyroxine (T4) and triiodothyronine (T3) — that influence how fast your body uses energy (your “metabolic rate”).
• Heart Rate and Blood Pressure: These hormones help control how quickly your heart beats, which can also affect blood pressure.
• Body Temperature: By influencing the rate at which your cells function, thyroid hormones help regulate body temperature.
• Other Functions: The thyroid also works closely with the pituitary gland in your brain. This gland produces thyroid-stimulating hormone (TSH), which signals the thyroid to release more or less hormone based on your body’s needs.

It’s important to know that having an overactive or underactive thyroid does not necessarily increase the chance of developing thyroid cancer. Many people experience hyperthyroidism (when the thyroid produces too many hormones) or hypothyroidism (when the thyroid does not produce enough hormones) without ever developing cancer, but these conditions should be treated to correct the hormonal imbalance they represent.

Thyroid cancer occurs when cells in the thyroid gland begin to grow out of control, sometimes forming nodules or lumps. It usually grows slowly, and most cases can be successfully treated.

This disease is generally classified by the specific cells it originates from.

• The most common type is differentiated thyroid cancer, such as papillary thyroid cancer. Under the microscope, these cancer cells still look somewhat like normal thyroid tissue. They typically start in follicular cells, the part of the thyroid responsible for making hormones.
• Non-differentiated cancers can come from the thyroid’s calcium-controlling cells, the immune cells that fight infections within the thyroid, or from follicular cells that are so mutated that they no longer look like thyroid cells under a microscope.

“Although papillary thyroid cancer is the most common, the other types of cancers tend to be more aggressive and tend to spread more widely, at least in advanced cases,” Dr. Orloff explained to SurvivorNet.

Risk factors of thyroid cancer include:

• Exposure to Radiation: Head or neck radiation treatments during childhood, or exposure to higher radiation levels (for example, nuclear accidents), can increase risk.
• Family History: Certain genetic conditions (especially those affecting the RET gene) can increase the risk of developing certain types of thyroid cancer.
• Iodine Deficiency: The thyroid uses iodine to make hormones, so low iodine intake can sometimes be linked to certain thyroid problems. However, because salt is often iodized in many countries, this is less common in places like the U.S.
• Gender and Age: Thyroid cancer is three times more likely in women. It is frequently found in women in midlife and men in later years.

Differentiated Thyroid Cancers

“Differentiated” thyroid cancers are those in which the cancer cells still resemble normal thyroid tissue under a microscope. These cancers usually begin in the follicular cells — the cells responsible for producing thyroid hormones.

• Papillary Thyroid Cancer (PTC): The most common form of thyroid cancer accounts for the majority of cases. It typically grows slowly and is considered highly treatable. PTC often develops in one lobe of the thyroid, and even when it spreads to nearby lymph nodes, treatment outcomes are generally very positive.
• Follicular Thyroid Cancer: The second most common type. It can sometimes spread through the bloodstream to areas such as the lungs or bones, but it also tends to grow slowly and often responds well to treatment. When found early, long‑term outcomes are usually excellent.
• Oncocytic (Hürthle Cell) Thyroid Cancer: A less common subtype that was once grouped with follicular cancers. It can be more challenging to treat, but early detection is associated with more favorable outcomes.

WATCH: Diagnosing Thyroid Cancer.

When diagnosed, patients may receive the following tests:

Thyroid-stimulating hormone (TSH) Test. This blood test mainly checks levels of a hormone called TSH (thyroid-stimulating hormone), which is made by a small gland in the brain (the pituitary) to regulate thyroid function.
While the test can’t tell if a thyroid issue is cancerous, it helps doctors see if a thyroid nodule is producing hormones. In many cases, hormone-producing nodules are not cancerous.

• Ultrasound. An ultrasound can detect subtle thyroid changes, ranging from small nodules to extensive changes. However, not all nodules detected are necessarily harmful.
• Biopsy. The biopsy may follow an ultrasound that detects a nodule. In this procedure, a radiologist visualizes the nodule on a screen and directs the needle precisely into the targeted area to collect a tissue sample for further testing for signs of cancer.
• Depending on the size of the tumor and if it has spread into nearby lymph nodes or tissues, doctors determine the stage or how advanced the thyroid cancer is.

Preparing for Surgery

“Thyroid surgery tends to be a relatively low-pain operation,” Dr. Ofloff explains. “Many thyroid operations are done as outpatient surgery. Sometimes patients are kept in the hospital overnight, but in general, people are able to resume eating and drinking and walking around, getting out of bed pretty much right away once they have recovered from the anesthesia.”

Thyroid cancer patients may be faced with surgery to help treat the cancer. There are varying surgery options, including a total thyroidectomy, which involves completely removing the thyroid. In other cases, a partial thyroidectomy may be necessary, which means only a portion of the thyroid gland is removed.

A partial thyroidectomy may be optimal if the nodule is confined to one side or if there are smaller growths affecting a smaller portion of the thyroid.

“The benefits to partial thyroidectomy over total thyroidectomy are that many patients maintain normal thyroid function and don’t have to be on lifelong thyroid hormone medication after a partial thyroidectomy, whereas with a total thyroidectomy, you need the lifelong medication,” Dr. Otto explains.

“Additionally, it’s a shorter surgery and less invasive, so we do prefer partial thyroidectomy. There are some patients who are well suited to that, and then there are others who are not, and we can go over those details.”

Dr. Otto explains that tumors that are small and on one side of the gland are well-suited for a partial thyroidectomy.

WATCH: Understanding what goes into thyroid cancer surgery.

After the surgery, soreness at the incision site and in the throat (due to the breathing tube) is common but typically mild. Over-the-counter medications or prescribed pain relievers help manage discomfort. In some cases, a small tube may be placed in your neck to drain fluid. This is usually removed in a day or two.

Many patients leave the hospital the same day, especially if it’s a lobectomy.

“After partial thyroidectomy, most patients can go home from the hospital the same day. They actually don’t have to stay overnight. The distinction with a total thyroidectomy is that we watch patients overnight, and the main reason is actually that we have to monitor calcium levels after total thyroidectomy,” Dr. Otto explains.

Patients can usually resume light activities the next day, but avoid strenuous exercise or heavy lifting for about two weeks to let their incision heal.

For thyroid cancer patients whose cancer is at an advanced stage, in addition to possible surgery, treatment may also involve chemotherapy, thyroid-stimulating hormone therapy (stimulates hormone production), and/or radiation therapy. In some cases, when thyroid cancer is very aggressive, surgery may no longer be effective, so relying on other treatment methods may be more optimal.

Thyroid cancer has reasonable treatment success rates. However, there is a chance of recurrence, meaning the cancer can return after treatment (also called recurrence). Recurrence may happen a few months after remission or sometimes even decades later. Patients should ask their doctor what their risk of recurrence is after treatment.

Some advanced patients also have an aggressive type of disease, such as anaplastic thyroid cancer. Patients should know that there are still powerful treatment options in these settings that can yield an optimal quality of life and control disease progression.

WATCH: The Role of Targeted Therapy in Advanced Thyroid Cancer

“When patients present with more aggressive disease or high-risk disease, our focus is really on identifying how we can best treat these patients and decrease their risk for recurrence without causing unnecessarily aggressive harm from the treatments that we’re offering,” Dr. Mara Roth, an endocrinologist and associate professor at the University of Washington in the Fred Hutch Cancer Center, tells SurvivorNet.

Turning to Radiotherapy

In many cases, thyroid cancer can be treated with surgery and a treatment approach known as radioactive iodine (RAI) therapy. However, in some advanced cases of thyroid cancer, standard radiation therapy.

When people hear the word “radiation” in relation to thyroid cancer, they often think of radioactive iodine (RAI) — a treatment that works well for certain thyroid cancers that still act like normal thyroid cells. But RAI is very different from external beam radiation.

• Radioactive Iodine (RAI): Taken as a pill or liquid, it travels through the bloodstream and targets any remaining thyroid tissue.
• External Beam Radiation: Uses high-energy beams from a machine outside the body to precisely target tumors.

For advanced or more aggressive thyroid cancers, external beam radiation may be used to ease symptoms, slow tumor growth, or help control a specific problem area. It’s often most effective when used in very targeted situations or alongside other treatments.

Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic, describes this approach as “spot welding.” If a patient has one particularly troublesome tumor — such as a painful lesion in a weight-bearing bone — radiation can be directed at that single area to “zap” the problem spot while the rest of the disease remains under surveillance or systemic treatment.

WATCH: Thyroid cancer surveillance.

If a doctor finds your recurrence at an early stage, your chance of quickly regaining remission is often higher. This is why regular follow-ups, blood tests, and neck ultrasounds are essential.

Some of the more common signs and symptoms of a return include:

• A lingering cough that doesn’t go away
• A lump or swelling in the neck that you can feel or see
• Difficulty swallowing (dysphagia)
• Neck pain that isn’t explained by muscle strain or other causes
• Hoarseness or voice changes

Thyroid Cancer Surgery: Understanding the Risks

Surgery is often a part of the treatment path for people facing thyroid cancer. And while you may understand that removing your thyroid gland — known as a thyroidectomy — is the best treatment option for your condition, it’s natural to feel nervous about the risks associated with surgery, like Abela was.

SurvivorNet previously spoke with surgeons and other experts to get a breakdown of what to expect during surgery, common side effects, and less common complications patients should be aware of. Patients should also know that, while this is a complex surgery, many people bounce back rather quickly.

“The surgery itself is complex and delicate, but yet, it’s also a surgery that most people recover from very quickly,” Dr. Orloff added to SurvivorNet.

Possible Complications

Thyroidectomy is generally considered safe, especially when performed by a skilled and experienced surgical team. Even so, every operation carries some risk.

“Thyroid surgery tends to be a relatively low pain operation,” Dr. Ofloff explains. “Many thyroid operations are done as outpatient surgery. Sometimes patients are kept in the hospital overnight, but in general, people are able to resume eating and drinking and walking around, getting out of bed pretty much right away once they have recovered from the anesthesia.”

Your medical team will work together to minimize potential risks and side effects.

The most common complications associated with surgery include:

• Nerve issues impacting the voice and swallowing
• Voice hoarseness or weakness due to nerve issues
• Hypoparathyroidism (Low Parathyroid Hormone)
• Bleeding
• Infection
• Esophageal or Tracheal Injury
• Difficulty Swallowing (Dysphagia)
• Nerve Injury

“The thyroid gland is very intimately associated with the nerves that control vocal cord movement. So in any thyroid operation, there’s a possibility of injury, either temporary or permanent, more often temporary,” Dr. Orloff explains.

If the vocal cord nerves — the laryngeal nerve, the recurrent laryngeal nerve or the smaller superior laryngeal nerve — is affected, there can be a change in voice quality and control of vocal cord muscle, which Dr. Orloff explained can affect swallowing, coughing, projection, and even breathing.

“It’s important to have a dialogue between the patient and the surgeon and acknowledge the importance of those nerves and the aim to protect those nerves as much as possible. The rate of injury is very, very low, but it is something that needs to be prioritized,” she said.

During intraoperative nerve monitoring, if the monitor flags a concern on the first side, your surgeon may complete that side and then stop the surgery to allow that nerve time to heal before proceeding to the second side.

Recurrent Laryngeal Nerve Injury

Why It Matters: The recurrent laryngeal nerve controls your vocal cords. If it’s harmed, you could experience changes in your voice or, in very rare circumstances, breathing difficulties if both nerves are affected.

Causes: This nerve can be bruised or accidentally cut, especially if the cancer or enlarged gland is wrapped around it. Even gentle stretching can temporarily affect nerve function.

Signs and Symptoms:

• Hoarseness: Your voice might sound weak, breathy, or harsh due to nerve issues.
• Trouble Swallowing: As the recurrent laryngeal nerve is also responsible for some of the sensory functions in our throat, we may not always feel the normal triggers to start the swallowing process.
• Weakened Cough: You might not be able to clear your throat as strongly
• Aspiration: The vocal cords may not close completely, protecting the airway when you swallow. Thin liquids like water can sometimes drip down to irritate the vocal cords or even slip past them.
• Prevention and Management: Many surgeons use specialized devices and intraoperative neuromonitoring to help pinpoint the nerve’s location, reducing the risk of harm.
• Recovery: Most nerve injuries are temporary, lasting weeks to months. If the nerve is severely damaged, voice therapy or an additional procedure might be needed.
• Voice Rehabilitation: A specialist such as a speech-language pathologist can help you strengthen your voice if you experience ongoing issues.

Superior Laryngeal Nerve Injury: Less Obvious but Significant

• The external branch of the superior laryngeal nerve plays a role in voice pitch and singing. When injured, it might be less noticeable than recurrent laryngeal nerve damage, but it can still affect your ability to raise your voice or sing high notes.
• Studies show varying rates of injury because patients may not realize they have an issue, especially if they don’t regularly use a wide vocal range.
• If you notice changes in your ability to speak or sing at higher pitches, mention them to your doctor. Sometimes voice therapy helps, but injuries may be long-lasting.

Questions For Your Doctor

• What type of thyroid cancer do I have?
• What is the standard of care for this type?
• How will I be monitored after treatment?
• Are there any clinical trials I should consider enrolling in?

If you have a cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet’s proprietary AI tool “My Health Questions” is designed specifically for patients and caregivers.

WATCH: How One Cancer Survivor and Her Sister Used ‘My Health Questions’ to Navigate Care

This powerful resource is embedded throughout the SurvivorNet website and delivers structured responses grounded in clinical guidelines and medically reviewed research to help people better understand their treatment options and feel more confident navigating their care.

My Health Questions can also help patients prepare useful questions ahead of their next appointment.

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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