How Is Thyroid Cancer Treated
Treatment for thyroid cancer depends on many things, like your cancer stage, age, overall health, and testing results. Your treatment may include some or all the following:
- Clinical trials.
Surgery
The goal of thyroid cancer surgery is to remove the tumor. There are a few ways to do so:
- Total thyroidectomy- The whole thyroid gland is removed.
- Near-total thyroidectomy– Only a small part of thyroid tissue is left. The parathyroid glands are also left, which are attached to the thyroid.
- Lobectomy– A single lobe of the thyroid gland is removed. In patients with small papillary thyroid cancers, a lobectomy may be used.
If the thyroid is not completely removed during surgery, there may be a risk of the cancer coming back in the part of the thyroid that is left. More surgery may be needed to remove the rest of the thyroid if it wasnt removed during the first surgery.
If your provider believes you may have thyroid cancer, you should also have an ultrasound of your lymph nodes done. If the cancer has spread to the lymph nodes, your surgeon will also remove these lymph nodes during surgery. Depending on the staging of your cancer, you may need more treatment after surgery.
Supplemental thyroid hormone therapy
What Is Differentiated Thyroid Cancer
Differentiated thyroid cancer includes papillary thyroid cancer and follicular thyroid cancer. Papillary thyroid cancer is the most common form of thyroid cancer in both children and adults and represents about 85 to 90 percent of all DTC diagnoses. Follicular thyroid cancer accounts for only 5 to 10 percent of pediatric patients with differentiated thyroid cancer.
Papillary thyroid cancer in children and adolescents does not behave the same as it does in adult patients. Even when PTC has spread to the lymph nodes or lungs, pediatric patients with the disorder have much better outcomes compared to adults. About 40 to 60 percent of children diagnosed with differentiated thyroid cancer will have papillary thyroid cancer that has spread to the lymph nodes for about 15 percent, the PTC has spread to their lungs.
Unlike papillary thyroid cancer, follicular thyroid cancer is usually found as a solitary thyroid nodule. While follicular thyroid cancer has less chance of spreading to the lymph nodes in the neck, there is a higher chance of the cancer spreading to distant sites in the body, such as the bones, because FTC can invade blood vessels.
No matter how much the cancer has spread, pediatric patients with differentiated thyroid cancer have more than a 95 percent survival rate 20 to 30 years after treatment. When properly evaluated and treated, the vast majority of pediatric patients with differentiated thyroid cancer will go on to lead productive and rewarding lives.
What Is The Thyroid Gland
Your thyroid gland is one of many glands that make up your endocrine system. Endocrine glands release hormones that control different bodily functions.
The pituitary gland in your brain controls your thyroid gland and other endocrine glands. It releases thyroid-stimulating hormone . As the name suggests, TSH stimulates your thyroid gland to produce thyroid hormone.
Your thyroid needs iodine, a mineral, to make these hormones. Iodine-rich foods include cod, tuna, dairy products, whole-grain bread and iodized salt.
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Thyroid Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Thyroid Gland
The thyroid is a gland at the base of the throat near the trachea . It is shaped like a butterfly, with a right lobe and a left lobe. The isthmus, a thin piece of tissue, connects the two lobes. A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin.
The thyroid uses iodine, a mineral found in some foods and in iodized salt, to help make several hormones. Thyroid hormones do the following:
- Control heart rate, body temperature, and how quickly food is changed into energy .
- Control the amount of calcium in the blood.
Papillary Thyroid Cancer: Who Gets It
Papillary thyroid cancer can occur in people of all ages from early childhood to advanced ages although it is most common in people between age 30 and 50. Papillary thyroid cancer affects women more commonly than men, and it is most common in young women. Thyroid cancer is now the fifth most common malignancy among women in the United States. Since it can occur at any age, everybody should be aware of any changes in their thyroid gland and make sure their doctor feels the thyroid gland when getting a routine check-up. For more details on who gets papillary thyroid cancer, the increasing incidence, and ages of patients affected, go to our page on the Incidence of Papillary Thyroid Cancer.
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Patient And Tumor Characteristics
The SEER database contained 23,189 adult patients treated with total thyroidectomy for PTC between 1988 and 2007. Of these, 10,955 cases contained data on lymph nodes and the patient and tumor features of this subset are listed in Table 1. The average age was 48.8 ± 3.6 years old, and 75.0% of patients were female as expected . Over 86% of the patients were Caucasian .
Certain Factors Affect Prognosis And Treatment Options
The prognosis and treatment options depend on the following:
- The age of the patient at the time of diagnosis.
- The type of thyroid cancer.
- The stage of the cancer.
- Whether the cancer was completely removed by surgery.
- Whether the patient has multiple endocrine neoplasia type 2B .
- The patient’s general health.
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
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What Are The Possible Side Effects And Complications Of Papillary Thyroid Cancer Treatment
Permanent hypothyroidism is an expected side effect of thyroidectomy and radioiodine therapy. Because of this, youll need to take replacement thyroid hormone medication for the rest of your life if you undergo either or both of these treatments.
Possible complications of thyroid surgery include:
- Accidental removal of or damage to your parathyroid glands, which help regulate your blood calcium levels.
- Damage to your recurrent laryngeal nerve, which runs behind your thyroid gland, resulting in hoarseness and a weak voice.
Potential side effects of radioactive iodine therapy include:
- Small risk of leukemia, breast or bladder cancer.
Understanding Your Cancer And Treatment
Not all breast cancers are alike. Someone elses experience with their treatment may be completely different from yours. Understanding your type and stage can help make sense of your doctors recommendations. This may help you feel better about your treatment choices.
A big part of cancer treatment is the relationship between you and your oncology team. Here are some things youll want to know about early on so youre well informed about your specific type of breast cancer:
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How Long Can You Live With Stage 4 Thyroid Cancer
Stage 4: In this stage, the tumor has spread into neck tissues under the skin, the trachea, esophagus, the larynx, or distant parts of the body such as the lungs or bones. The 10-year outlook significantly declines at this point: Only 21 percent of people diagnosed at this stage are alive after 10 years.
Survival For Different Types Of Thyroid Cancer
The survival statistics below are from a large European study. They are based on people treated in the UK and Ireland between 2000 and 2007. Treatments improve over time, so people treated now may have a better outlook.
With thyroid cancer, the most important factor that affects survival is the type and stage of thyroid cancer you have.
Survival of 86,690 patients with thyroid cancer: A population-based study in 29 European countries from EUROCARE-5
L Dal Maso and others
European Journal of Cancer Volume 77, pages 140 – 152
These statistics are for relative survival. Relative survival takes into account that some people will die of causes other than cancer. This gives a more accurate picture of cancer survival.
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What Are Some Other Papillary Thyroid Cancer Treatments
The other surgical option for patients with papillary thyroid cancer is a total thyroidectomy . An expert pre-operative evaluation of the papillary thyroid cancer patient is required to determine whether there is any involvement of the lymph nodes in the neck. In most circumstances, the involvement of neck lymph nodes can be determined prior to the thyroid surgery procedure. When there is evidence that the papillary thyroid cancer has spread to lymph nodes in the neck, surgical approaches to the central and lateral neck lymph nodes should be performed.
When neck lymph nodes are involved with papillary thyroid cancer, either during the evaluation of the papillary thyroid cancer or during surgery for the papillary thyroid cancer, the recommended operation is a total thyroidectomy.
Often, other characteristics of the tumor that can be seen under the microscope which may have an influence on whether the surgeon should remove the entire thyroid .
The surgical options are covered in greater detail in our article on for thyroid cancer. A more detailed discussion of thyroid surgery for the thyroid gland and lymph nodes of the neck can be found here.
Types Of Thyroid Cancer
There are 5 main types of thyroid cancer:
In addition, other types of cancer may start in or around the thyroid gland. For lymphoma in the thyroid, read Cancer.Nets Guide to Non-Hodgkin Lymphoma. For more information on sarcoma in the thyroid, read the Cancer.Net Guide to Sarcoma. For information on a tumor in the nearby parathyroid gland, read Cancer.Nets Guide to Parathyroid Cancer.
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Risks Of Thyroid Surgery
The two most common risks of thyroid surgery include damage to the parathyroid glands or the recurrent laryngeal nerves, structures that are directly attached to the thyroid gland.
- Parathyroid glands: There are four parathyroid glands, two attached to the back of each thyroid lobe. They are about the size of a pencil eraser or pea. The parathyroid glands control the level of calcium in the body. Damage to the parathyroid glands can affect calcium levels and cause significant health risks if left untreated.
- Recurrent laryngeal nerve : The RLN is very thin, about the diameter of a piece of angel hair pasta. The RLN controls the vocal cords and helps protect the airway so food, liquid or other items do not enter the lungs.
The risks of thyroid surgery can be decreased by having the operation performed by an experienced surgical team that completed at least 30 thyroid surgeries per year. The surgeons at the Pediatric Thyroid Center at CHOP perform more than 75 thyroid surgeries a year. The permanent complication rate for thyroid surgery patients at CHOP is less than 2 percent significantly lower than the national average.
Thyroid Cancer Stages In Survival Rates
Thyroid cancer isnt just one disease. There are multiple types of thyroid cancer. Each type has its own staging using a method called the ACJJ TNM system. However, the data researchers use for survival rates doesnt follow the ACJJ TNM system. Instead, the data are grouped into the following stage categories:
- Localized: Cancer is only in the thyroid.
- Regional: Cancer has spread to nearby lymph nodes, tissues, or structures.
- Distant: Cancer has spread to remote lymph nodes or parts of the body. This represents thyroid cancer metastasis.
The most recent survival rate data for thyroid cancer are from 2009 to 2015.
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New Uchicago Medicine Research Sheds Light On Outcomes As Cases Increase Dramatically
Thyroid cancer survivors report poor quality of life after diagnosis and treatment compared with other patients who are diagnosed with more lethal cancers, according to new research from the University of Chicago Medicine.
The findings, published Dec. 11 in the journal Thyroid, shed light on a rarely studied outcome for a growing group of patients who are expected to soon account for 10 percent of all of American cancer survivors.
Thyroid cancer patients have a nearly 98 percent five-year survival rate, according to the National Cancer Institute. More than 95 percent survive a decade, leading some to call it a “good cancer.” But those successful outcomes mean few thyroid cancer survivorship studies have been conducted.
UChicago Medicine researchers Briseis Aschebrook-Kilfoy, PhD, assistant research professor in epidemiology, and Raymon Grogan, MD, assistant professor of surgery, are trying to address that data gap. Together, they lead the North American Thyroid Cancer Survivorship Study .
For their most recent research, Aschebrook-Kilfoy and Grogan recruited 1,174 thyroid cancer survivors 89.9 percent female with an average age of 48 from across the U.S. and Canada. Participants were recruited through the thyroid cancer clinics at UChicago Chicago Medicine, the clinics of six other universities, as well as through thyroid cancer survivor support groups and social media.
The researchers will continue to track participants to further understand this data.
Understanding Thyroid Cancer And Survival Rate
Thyroid cancer occurs within thyroid cells found in the thyroid, which produces hormones that regulate various body functions, including heart rate, body temperature, blood pressure, and weight. An individual with thyroid cancer might not show symptoms immediately, but persistent pain and swelling often result as the tumor grows. Besides, some types of thyroid cancer grow slowly while others can be aggressive, although most of them are treatable.
Thyroid cancer occurs about 1% of all new cancer diagnoses in the United States alone annually, with over 2,200 deaths reported. In addition, there has been an upsurge in thyroid cancer rates over the years which is primarily associated with the advancement of technology allowing for the detection of small cancerous cells in the thyroid that could not be found in the past.
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What’s The Prognosis For Stage Iv Thyroid Cancer
If you have stage IV thyroid cancer, you may want to know about your prognosis — an estimate of how serious the disease is and how it will affect you in the future. Your outlook depends on a lot of things, including the type of thyroid cancer you have, your age, and your overall health.
Some people prefer not to learn their prognosis, and that’s OK. But if you do want the information, the best person to ask is your doctor. They know best about your specific health situation and can answer any questions you have.
How Age Affects The Risk Of Thyroid Cancer Recurrence
Several factors determine if your thyroid cancer may return or relapse after treatment, with age being an independent risk factor. Typically, the older population is at a greater risk of experiencing a reoccurrence of thyroid cancer after an initial diagnosis. However, it is not a must that thyroid cancer will return. Other factors that increase the chances of thyroid cancer reoccurrence after diagnosis and treatment include stage, obesity, and genetics.
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How Is Papillary Thyroid Cancer Treated
Treatments for papillary thyroid cancer depend on the tumor size and whether the cancer has spread .
Surgery is the most common treatment for PTC. Depending on the tumors size and location, your surgeon may remove part of your thyroid gland or all of your gland . If you have cancer present in the lymph nodes of your neck, your surgeon may remove the affected lymph nodes at the time of the initial thyroid surgery or as a second procedure.
If you have a total thyroidectomy, youll need to take thyroid hormone replacement medication for the rest of your life.
Additional treatments for PTC include:
- Radioiodine therapy: Thyroid cells and papillary thyroid cancer cells absorb iodine, a mineral found in some food. Because of this, healthcare providers sometimes use a radioactive form of iodine to destroy all remaining normal thyroid tissue and potentially destroy residual cancerous thyroid tissue after a thyroidectomy.
- Radiation therapy: Radiation kills cancer cells and stops them from growing. External radiation therapy uses a machine to deliver strong beams of energy directly to the tumor site. Internal radiation therapy involves placing radioactive seeds in or around the tumor.
- Chemotherapy: Intravenous or oral chemotherapy drugs kill cancer cells and stop cancer growth. Very few people diagnosed with thyroid cancer will ever need chemotherapy.
How Is Thyroid Cancer Staged
Staging for thyroid cancer is based on:
- The size of your tumor seen on imaging tests and what is found after surgery.
- Surgery to test if your lymph nodes have cancer cells.
- Any evidence of spread to other organs .
- Your age is also considered in staging.
The staging system is very complex. Below is a summary of the staging. Talk to your provider about the stage of your cancer.
Differentiated thyroid cancer
People who are younger than 55 years old and do not have distant spread are always considered Stage I. All patients who are younger than 55 years old and have distant spread of the cancer are considered Stage II. Staging for people of all ages is listed below:
Stage I
- Younger than 55: . The cancer is any size and might or might not have spread to nearby lymph nodes . It has not spread to distant sites .
- : The cancer is no larger than 2cm wide and is confined to the thyroid OR
- : The cancer is larger than 2cm wide but no larger than 4cm and is confined to the thyroid . It has not spread to nearby lymph nodes or to distant sites .
Stage II
Stage III
- Older than 55: : The cancer is any size and has grown beyond the thyroid gland into nearby tissues of the neck, like the larynx , trachea , esophagus , or the nerve to the larynx .
Stage IVA
- Older than 55: : The cancer is any size and has grown beyond the thyroid gland back toward the spine or into nearby large blood vessels . It may or may not have spread to nearby lymph nodes . It has not spread to distant sites .
Stage IVB
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