Thyroid cancer diagnosis

If you or your healthcare provider notice signs and symptoms of thyroid cancer, several approaches will likely be taken to diagnose the condition. Your healthcare provider will likely begin by assessing your medical history and performing a physical examination.

Some tests and procedures used to diagnose¹⁷ thyroid cancer include:

• Physical exam: Your healthcare provider will look and feel for physical changes in your thyroid. He or she will also ask about your risk factors, such as radiation exposure and family history of related conditions.
• Blood tests: Blood testing can help determine whether the thyroid is functioning normally.
• Thyroid tissue sample: If you have thyroid nodules, the results of a procedure called a fine-needle biopsy can help support a diagnosis of thyroid cancer. During this procedure, your provider inserts a long, thin needle guided by ultrasound imaging through your skin and into a nodule. This sample is then analyzed for the presence of cancer cells.
• Imaging tests: One or more tests may be used to help determine whether your thyroid cancer has metastasized. These may include computerized tomography (CT) scans, positron emission tomography (PET), or ultrasound imaging.
• Genetic testing: Some people with medullary thyroid cancer may have genetic changes associated with other endocrine cancers. Your provider may recommend genetic testing to look for genes that increase your risk for cancer if you have a family history of thyroid cancer or related conditions.

As always, see your healthcare provider if you believe you may have thyroid cancer. He or she will be able to provide the proper diagnosis and treatment.

Thyroid cancer prognosis

Survival rates¹⁸ are used to show what percentage of people with a particular type and stage of cancer are still alive after a certain amount of time (usually 5 years) after diagnosis. While survival rates can’t tell you exactly how long you will live with a certain condition, they can help you to better understand the likelihood of your treatment being successful.

Relative survival rates compare people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for one stage of thyroid cancer is 90%, people with that stage of cancer thyroid are, on average, about 90% as likely to live for at least 5 years after diagnosis as people who don’t have that cancer.

A patient’s prognosis (chance of recovery) and treatment options for thyroid cancer depend on multiple factors:

• Patient age at the time of diagnosis
• Type of thyroid cancer
• Stage of cancer (I–IV)
• Whether cancer was completely removed by surgery
• Patient’s general health
• Whether the cancer has just been diagnosed or has recurred
• Whether the patient has multiple endocrine neoplasia type 2B (MEN 2B)

The SEER database tracks 5-year relative survival rates for thyroid cancer in the United States based on how far the cancer has spread (rather than grouping cancers by stage). The groups of cancer used by the SEER database are localized (has not spread beyond the thyroid), regional (cancer has spread to nearby structures), and distant (cancer has spread to distant parts of the body, such as the bones).

The database also provides 5-year relative survival rates for each form of thyroid cancer that combine all three SEER stages. These rates are as follows:

• Papillary thyroid cancer: Near 100%
• Follicular thyroid cancer: 98%
• Medullary thyroid cancer: 90%
• Anaplastic thyroid cancer: 7%

It is important to note that these combined rates may not accurately represent survival rates for more aggressive or distant thyroid cancers. The 5-year relative survival rate for distant medullary thyroid cancer, for example, is 39%, despite the combined rate of 90%.

It is also important to keep in mind, however, that despite the low overall survival rates for anaplastic thyroid cancer (the 5-year relative survival rate for localized anaplastic is 31%), there are long-term survivors of the disease.