Diagnosis and Prognosis of Thyroid Cancer
by Rosalyn Carson-DeWitt, MD
Thyroid cancer may not have symptoms. Your doctor may notice changes to your thyroid during a normal physical exam. Something may also be found during a scan for another health issue. You may also be asked about you and your family's health history.
Suspicion of Thyroid Cancer
There are other conditions that can cause a change in the thyroid. They are more common and often easier to treat. Tests will need to be done to see if the changes may be due to cancer. Tests may include:
Diagnosis of Thyroid Cancer
A biopsy is needed to confirm cancer. A sample of tissue from the growth will be taken. It will be checked under a microscope for cancer cells.
The procedure will depend on the type, size, and location of the growth. Options include:
Staging of Thyroid Cancer
The results from a number of tests will help to know the stage of cancer. The stage is used to help make a treatment plan. Staging is based on how far the tumor has spread, what lymph nodes are involved, and if the cancer has spread to other tissue. Information about the cancer cells themselves will also be needed.
Tests that may help determine thyroid cancer stage include:
Stages of Thyroid Cancer
There are different types of thyroid cancer. The type and microscopic details are important for the cancer stage and the treatment plan.
Papillary and Follicular Thyroid Cancer
In people under 45 years old, papillary and follicular thyroid cancers are staged from I- II:
In people aged 45 years and older, papillary and follicular thyroid cancers are staged from I-IV:
Medullary Thyroid Cancer
Medullary thyroid cancer is staged from 0-IV:
Anaplastic Thyroid Cancer
Anaplastic thyroid cancer is always stage IV:
Prognosis is most often expressed as the percentage of patients who are expected to survive over 5 or 10 years. Cancer prognosis is an inexact science. This is because the predictions are based on the experience of large groups of patients with cancer in various stages. Using this information to predict the future of an individual patient is always imperfect and often flawed, but it is the only method available.
Papillary and follicular thyroid cancers are among the least dangerous cancers when treated. If detected early, nearly all people survive 5 years or more. In those with metastatic cancer, survival rates are about 55%.
Medullary thyroid cancers have similar survival rates except if metastatic cancer is present. In this case, about 25% of all people survive 5 years or more.
Anaplastic thyroid cancer is the most fatal type. About 10% of all people survive 5 years or more because it spreads rapidly and is difficult to treat. Almost all deaths occur within the first year of diagnosis.
Anaplastic thyroid cancer. EBSCO DynaMed website. Available at: http://www.dynamed.... Updated June 29, 2018. Accessed December 8, 2018.
Follicular thyroid cancer. EBSCO DynaMed website. Available at: http://www.dynamed.... Updated June 27, 2017. Accessed December 8, 2018.
Medullary thyroid cancer. EBSCO DynaMed website. Available at: http://www.dynamed.... Updated June 29, 2018. Accessed December 8, 2018.
Papillary thyroid cancer. EBSCO DynaMed website. Available at: http://www.dynamed.... Updated August 15, 2018. Accessed December 8, 2018.
Stages of thyroid cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq#section/_27. Updated August 18, 2017. Accessed December 8, 2018.
Tests for thyroid cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/how-diagnosed.html. Updated April 15, 2016. Accessed December 8, 2018.
Thyroid cancers. Merck Professional Version website. Available at:
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Updated July 2016. Accessed December 8, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq#section/_67. Updated August 18, 2017.Accessed December 8, 2018.
Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 12/18/2020
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