If you or someone you love has thyroid cancer, you want to know what treatments are available and what to expect. This depends on several things – starting with what type of thyroid cancer you have and its stage.
It’s easy to get swamped by the numbers, letters, and unfamiliar words, even when you’re not under stress. This article will help you make better sense of what is happening based on the cancer’s stage.
Types of Thyroid Cancer
The thyroid is a gland at the base of your throat. It makes hormones that help your body work properly.
There are four main types of thyroid cancer:
- Papillary (the most common type)
- Follicular
- Medullary
- Anaplastic
If your doctor finds cancer, they’ll begin the process of staging. They’ll run tests to see if it has spread to other parts of your body.
The ‘TNM’ Staging System
The American Joint Committee on Cancer created the system that’s most often used to describe the stages of thyroid cancer. It’s called the “TNM” system, and it focuses on these three things:
After your doctor runs tests to find out what type of thyroid cancer you have, they’ll add a number to each letter listed above. The higher the number, the more advanced is that aspect of the cancer. (For example, T2-T4 means a larger tumor than T1).
Next, your doctor will group this information into stages. These are represented by the Roman numerals I through IV. For the most advanced cases, the letters “A,” “B” and “C” also are used to indicate how far the cancer has spread.
What type of cancer you have, as well as your age, will have some bearing on your stage.
Here’s what each stage of thyroid cancer means, grouped by type:
Papillary or Follicular Thyroid Cancer -- Patients Under Age 55
- Stage I -- The tumor can be any size. It may have spread to nearby tissues or nearby lymph nodes. But it hasn’t spread to other parts of the body.
- Stage II -- The tumor is any size. Cancer may have spread to your lymph nodes. It also has spread to other parts of your body, like your lungs or bones.
Papillary or Follicular Thyroid Cancer -- Patients Age 55 and Older
- Stage I -- You only have cancer in your thyroid. The tumor is 2 centimeters (about the size of a nickel) or smaller and hasn't spread.
- Stage II -- The tumor is no larger than 4 centimeters across but the cance rmay or may not have spread to nearby lymph nodes.
- Stage III --The tumor is any size and has spread to tissues near your thyroid, or it’s smaller and has reached your nearby lymph nodes.
Papillary and Follicular Thyroid Cancer, Stage IV
If you are at stage IV, it means the cancer has spread. Your doctor assigns the letters “A,” “B” and “C” to show how far.
- Stage IVA -- The main tumor can be any size and has grown extensively beyond the thyroid gland back toward the spine or into nearby large blood vessels .The cancer might or might not have spread to nearby lymph nodes. It has not spread to distant parts of the body (M0).
- Stage IVB:The main tumor can be any size, and it might or might not have grown outside the thyroid or have spread to nearby lymph nodes. In this stage, the cancer may have spread to nearby tissues of the neck, such as the larynx (voice box), trachea (windpipe), esophagus (tube connecting the throat to the stomach), or the nerve to the larynx, or it has grown back toward the spine or into nearby large blood vessels
- Stage IVC -- The cancer may or may not have spread beyond the thyroid or has spread to distant sites of the body. It may be in your lungs, bones, and lymph nodes.
Medullary Thyroid Cancer
The following things apply to everyone who has this type of cancer, no matter their age.
- Stage I -- The tumor is 2 centimeters or smaller. It’s only in your thyroid.
- Stage II -- It’s larger than 2 centimeters and found only in your thyroid. Or, it’s any size but has spread to tissues beyond your thyroid. It hasn’t spread to your lymph nodes.
- Stage III -- It may be smaller or larger than 2 centimeters and may also be in the tissues beyond your thyroid. The cancer is now in the lymph nodes near your voice box and windpipe.
- Stage IV -- As with follicular and papillary thyroid cancer, stage IV means that the cancer has spread to distant sites in your body, and the letters “A,” “B,” and “C” indicate where it has gone.
Anaplastic Thyroid Cancer
This is a fast-growing type of thyroid cancer. For this reason, it’s described only as stage IVA, IVB, or IVC. By the time your doctor finds it, it may have already spread to your neck. Here’s what each stage means:
- Stage IVA -- Cancer is in your thyroid. It may have spread to nearby lymph nodes.
- Stage IVB -- It has spread beyond your thyroid. It may be in your lymph nodes.
- Stage IVC -- It has spread to other areas of your body such as your lungs and bones. It may also be in your lymph nodes.
