Thyroid Cancer

Thyroid cancer develops when cells grow and divide abnormally in the thyroid, a small butterfly-shaped gland at the front of the neck.

Quick facts about thyroid cancerQuick facts about thyroid cancer

  • There are around 4,000 new thyroid cancer cases in the UK every year
  • Thyroid cancer is the 20th most common cancer in the UK, accounting for 1% of all new cancer cases
  • Thyroid cancer primarily develops from two types of cells: follicular cells (which produce and store the hormones T3 and T4 and the protein thyroglobulin) and parafollicular cells (which produce the hormone calcitonin and help control calcium levels in the body).

Types of thyroid cancerTypes of thyroid cancer

Thyroid cancer is classified based on the appearance of its cancerous cells. It is possible to have multiple types of thyroid cancer, however this is rare.

The types of thyroid cancer include:

Cancer treatment therapist caring for patient.

Papillary thyroid cancer

Papillary thyroid cancer is the most common type of thyroid cancer, making up 70-80% of all cases. It develops from the follicular cells and tends to grow slowly to areas such as surrounding lymph nodes.

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Follicular thyroid cancer

Follicular thyroid cancer makes up 15-25% of thyroid cancer cases and develops from follicular cells. Although it is unlikely to spread to the lymph nodes, it can spread to other parts of the body. Hürthle cell carcinoma is a rare and more aggressive type of follicular thyroid cancer.

Smiling elderly cancer patient.

Medullary thyroid cancer

Medullary thyroid cancer develops from the parafollicular cells (C-cells) and makes up 4% of all thyroid cancer cases. It can be passed down through families (hereditary thyroid cancer).

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Anaplastic thyroid cancer

Anaplastic thyroid cancer is a rare and fast-growing type of thyroid cancer, which develops from papillary or follicular thyroid cancer.

Signs and symptoms of thyroid cancerSigns and symptoms of thyroid cancer

As signs and symptoms for thyroid cancer can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a thyroid cancer diagnosis.

Symptoms for thyroid cancer tend to develop slowly and may include:

  • Lump in the neck or throat that grows over time

  • Pain in the neck or throat

  • Difficulty swallowing or breathing

  • Hoarseness or changes in your voice

  • Swollen glands (lymph nodes) in your neck

Stages of thyroid cancerStages of thyroid cancer

The TNM system is used to stage thyroid cancer and helps doctors understand what your cancer looks like.

The TNM stands for:

  • Tumour – Describes the size of the tumour and if it has affected other tissue, such as the neck
  • Node – Is a measure of whether lymph nodes have been affected
  • Metastasis – The degree to which the cancer has spread to other organs of the body, such as the lungs or bones.

The TNM information, along with other tests, helps determine the stage of your thyroid cancer using the guidelines below:

Papillary and follicular thyroid cancer

Only Stage I and Stage II apply to those under 55 years of age.

Stage 1 papillary and follicular thyroid cancer

Stage I

The cancer is no larger than 4 cm and confined to the thyroid. For those under 55, the cancer may be any size and might or might not have spread to nearby lymph nodes.

Stage 2 papillary and follicular thyroid cancer

Stage II

The cancer is no larger than 4 cm across and confined to the thyroid, but has spread to nearby lymph nodes. For those under 55, the cancer may be any size and has spread to other areas of the body such as distant lymph nodes, internal organs or bone.

Stage 3 papillary and follicular thyroid cancer

Stage III

The cancer may be any size and has spread to nearby tissue such as the larynx, trachea or oesophagus. It might or might not have spread to nearby lymph nodes.

Stage 4a papillary and follicular thyroid cancer

Stage IVA

The cancer may be any size and has spread extensively beyond the thyroid toward the spine or into nearby large blood vessels. It might or might not have spread to nearby lymph nodes.

Stage 4b papillary and follicular thyroid cancer

Stage IVB

The cancer is any size and might or might not have spread to nearby lymph nodes, but has spread to distant areas of the body such as lymph nodes, internal organs or bones.

Anaplastic thyroid cancer

All anaplastic thyroid cancers are considered Stage IV.

Stage 4a anaplastic thyroid cancer

Stage IVA

The cancer is any size and confined to the thyroid.

Stage 4b anaplastic thyroid cancer

Stage IVB

The cancer is any size and confined to the thyroid, but has spread to nearby lymph nodes. Alternatively, the cancer is any size and has grown into the strap muscles around the thyroid, but might or might not have spread to nearby lymph nodes.

Stage 4c anaplastic thyroid cancer

Stage IVC

The cancer is any size and might or not have spread to nearby lymph nodes, but has spread to distant areas of the body such as lymph nodes, internal organs or bone.

Medullary thyroid cancer

Stage 1 medullary thyroid cancer

Stage I

The cancer is no larger than 2 cm and confined to the thyroid.

Stage 2 medullary thyroid cancer

Stage II

The cancer is no larger than 4 cm across and confined to the thyroid. Alternatively, the cancer is larger than 4 cm and confined to the thyroid, or any size and growing outside of the thyroid but not involving nearby structures.

Stage 3 medullary thyroid cancer

Stage III

The cancer is any size and may be growing outside of the thyroid but not involving nearby structures. It has spread to lymph nodes in the neck.

Stage 4a medullary thyroid cancer

Stage IVA

The cancer is any size and has grown into nearby tissues in the neck, such as the larynx, trachea or oesophagus. It might or might not have spread to nearby lymph nodes. Alternatively, the cancer is any size and might be growing outside of the thyroid, but has spread to certain lymph nodes in the neck.

Stage 4b medullary thyroid cancer

Stage IVB

The cancer is any size and has grown toward the spine or into nearby large blood vessels, but might or might not have spread to nearby lymph nodes.

Stage 4c medullary thyroid cancer

Stage IVC

The cancer is any size and might have grown into nearby structures or lymph nodes, but has spread to distant areas of the body such as the liver, lung, bone or brain.

Treatment for thyroid cancer

There are many different types of treatment for thyroid cancer. Your treatment will depend on you and your cancer.

Frequently asked questions about thyroid cancerFAQs

Is thyroid cancer hereditary?

Approximately 5% of thyroid cancer cases are related to family history. Inherited genetic conditions such as familial adenomatous polyposis or Cowden syndrome can increase your risk of papillary thyroid cancer.

While a majority of people with medullary thyroid cancer do not have a family history of the disease, medullary thyroid cancer can be caused by inheriting a faulty gene called the RET gene. Inherited medullary thyroid cancer is called familial medullary thyroid carcinoma (FMTC). This faulty gene can also result in multiple endocrine neoplasia (MEN).

How is thyroid cancer diagnosed?

There are many different tests that are used to diagnose thyroid cancer, alongside a physical examination. This may include blood tests to check for the thyroid hormones levels of T3, T4 and thyroid-stimulating hormone (TSH), an ultrasound to visualise the thyroid, a biopsy (generally a fine needle aspiration (FNA) of the thyroid nodule or enlarged lymph node), or a radioiodine scan. Additional scans may include CT, FDG-PET or MRI scans to detect if the cancer has spread anywhere else within the body.

What causes thyroid cancer?

The cause of thyroid cancer is not fully known, however there are some factors which contribute to the risk of thyroid cancer developing, including: 

  • Certain life-style related factors – Such as being overweight
  • Family history – Including a family history of a faulty gene called the RET gene
  • Exposure to high levels of radiation – Such as from childhood radiation therapy treatment
  • Having non-cancerous (benign) thyroid disease – Including Hashimoto’s disease (a condition where the immune system attacks the thyroid), enlarged thyroid (goitre), thyroid nodules and inflammation of the thyroid (thyroiditis).

 

How common is thyroid cancer?

There are around 4,000 new thyroid cancer cases in the UK every year. Thyroid cancer is the 20th most common cancer in the UK, accounting for 1% of all new cancer cases.

What can I do to decrease my risk of thyroid cancer?

There are a number of lifestyle-related factors that can reduce your risk of developing thyroid cancer, like:

  • Getting regular exercise – Cancer Australia recommends at least 30 minutes of moderate-intensity exercise each day
  • Eating a healthy, balanced diet – Eat a fibre-rich diet from grain and legume sources, as well as enjoy a variety of fruit (2 serves) and vegetables (5 serves) per day, limit your intake of salt, saturated fats, and avoid all processed meat
  • Limiting alcohol intake
  • Maintaining a healthy weight

If a family member has been diagnosed with thyroid cancer and you have tested positively for the RET gene mutation, your doctor may discuss preventative treatment such as surgery to remove the thyroid.

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