Thyroid Cancer

Thyroid cancer forms in the thyroid gland (an organ at the base of the throat that makes hormones that help control heart rate, blood pressure, body temperature, and weight). Four main types of thyroid cancer are papillary, follicular, medullary, and anaplastic thyroid cancer. The four types are based on how the cancer cells look under a microscope.

 

Stages of Thyroid Cancer (for papillary and follicular thyroid cancer in patients younger than 45 years):

 

Stage I: In stage I papillary and follicular thyroid cancer, the tumor is any size, may be in the thyroid, or may have spread to nearby tissues and lymph nodes. Cancer has not spread to other parts of the body.

Stage II: In stage II papillary and follicular thyroid cancer, the tumor is any size and cancer has spread from the thyroid to other parts of the body, such as the lungs or bone, and may have spread to lymph nodes.

 

Stages of Thyroid Cancer (for papillary and follicular thyroid cancer in patients 45 years and older):

 

Stage I: In stage I papillary and follicular thyroid cancer, cancer is found only in the thyroid and the tumor is 2 centimeters or smaller.

Stage II: In stage II papillary and follicular thyroid cancer, cancer is only in the thyroid and the tumor is larger than 2 centimeters but not larger than 4 centimeters.

Stage III: In stage III papillary and follicular thyroid cancer, either of the following is found:

  • the tumor is larger than 4 centimeters and only in the thyroid or the tumor is any size and cancer has spread to tissues just outside the thyroid, but not to lymph nodes; or
  • the tumor is any size and cancer may have spread to tissues just outside the thyroid and has spread to lymph nodes near the trachea or the larynx (voice box).

Stage IV: Stage IV papillary and follicular thyroid cancer is divided into stages IVA, IVB, and IVC.

  • In stage IVA, either of the following is found:
  • the tumor is any size and cancer has spread outside the thyroid to tissues under the skin, the trachea, the esophagus, the larynx (voice box), and/or the recurrent laryngeal nerve (a nerve with two branches that go to the larynx); cancer may have spread to nearby lymph nodes; or

  • the tumor is any size and cancer may have spread to tissues just outside the thyroid. Cancer has spread to lymph nodes on one or both sides of the neck or between the lungs.

  • In stage IVB, cancer has spread to tissue in front of the spinal column or has surrounded the carotid artery or the blood vessels in the area between the lungs; cancer may have spread to lymph nodes.

  • In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.

 

Stages of Medullary Thyroid Cancer:

 

Stage 0: Stage 0 medullary thyroid cancer is found only with a special screening test. No tumor can be found in the thyroid.

Stage I: Stage I medullary thyroid cancer is found only in the thyroid and is 2 centimeters or smaller.

Stage II: In stage II medullary thyroid cancer, either of the following is found:

  • the tumor is larger than 2 centimeters and only in the thyroid; or
  • the tumor is any size and has spread to tissues just outside the thyroid, but not to lymph nodes.

Stage III: In stage III medullary thyroid cancer, the tumor is any size, has spread to lymph nodes near the trachea and the larynx (voice box), and may have spread to tissues just outside the thyroid.

Stage IV: Stage IV medullary thyroid cancer is divided into stages IVA, IVB, and IVC.

  • In stage IVA, either of the following is found:
    • the tumor is any size and cancer has spread outside the thyroid to tissues under the skin, the trachea, the esophagus, the larynx (voice box), and/or the recurrent laryngeal nerve (a nerve with 2 branches that go to the larynx); cancer may have spread to lymph nodes near the trachea or the larynx; or
    • the tumor is any size and cancer may have spread to tissues just outside the thyroid. Cancer has spread to lymph nodes on one or both sides of the neck or between the lungs.
  • In stage IVB, cancer has spread to tissue in front of the spinal column or has surrounded the carotid artery or the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.

  • In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.

 

Anaplastic thyroid cancer is considered stage IV thyroid cancer.

 

Anaplastic thyroid cancer grows quickly and has usually spread within the neck when it is found. Stage IV anaplastic thyroid cancer is divided into stages IVA, IVB, and IVC.

  • In stage IVA, cancer is found in the thyroid and may have spread to lymph nodes.
  • In stage IVB, cancer has spread to tissue just outside the thyroid and may have spread to lymph nodes.
  • In stage IVC, cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.

 

Treatment: of Thyroid Cancer:

 

Four types of standard treatment are used:

  • Surgery
  • Radiation therapy, including radioactive iodine therapy
  • Chemotherapy
  • Thyroid hormone therapy

New types of treatment are being tested in clinical trials.

  • Targeted therapy

Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment.

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/types/thyroid. (Accessed July 2016)