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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65857_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65857_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65857_"><span class="title" itemprop="name">Thyroid Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: July 21, 2023.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000258038__223">This PDQ cancer information summary has current information about the treatment of adult thyroid cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000258038__224">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000258038__1"><h2 id="_CDR0000258038__1_">General Information About Thyroid Cancer</h2><div id="CDR0000258038__1.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258038__2">Thyroid cancer is a disease in which malignant (cancer) cells form in
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the tissues of the thyroid gland.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__229">Thyroid nodules are common but usually are not cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__232">There are different types of thyroid cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__10">Age, gender, and being exposed to radiation can affect the risk of thyroid cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__14">Medullary thyroid cancer is sometimes caused by a change in a gene that is passed from parent to child.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__17">Signs of thyroid cancer include a swelling or lump in the neck. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__20">Tests that examine the thyroid, neck, and blood are used to diagnose thyroid cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__136">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000258038__2"><h3>Thyroid cancer is a disease in which malignant (cancer) cells form in
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the tissues of the thyroid gland.</h3><p id="CDR0000258038__4">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">gland</a> at the base of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439429/" class="def">throat</a> near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> (windpipe). It is shaped like a butterfly, with a right <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> and a left lobe. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044549/" class="def">isthmus</a>, a thin piece of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, connects the two lobes. A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin. </p><div id="CDR0000258038__198" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20thyroid%20and%20parathyroid%20glands&p=BOOKS&id=593388_CDR0000719086.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000719086.jpg" alt="Anatomy of the thyroid and parathyroid glands; drawing shows the thyroid gland at the base of the throat near the trachea. An inset shows the front and back views. The front view shows that the thyroid is shaped like a butterfly, with the right lobe and left lobe connected by a thin piece of tissue called the isthmus. The back view shows the four pea-sized parathyroid glands. The larynx is also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the thyroid and parathyroid glands. The thyroid gland lies at the base of the throat near the trachea. It is shaped like a butterfly, with the right lobe and left lobe connected by a thin piece of tissue called the isthmus. The parathyroid glands are four pea-sized organs found in the neck near the thyroid. The thyroid and parathyroid glands make hormones.</p></div></div><p id="CDR0000258038__199">The thyroid uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044548/" class="def">iodine</a>, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">mineral</a> found in some foods and in iodized salt, to help make several <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044558/" class="def">Thyroid hormones</a> do the following: </p><ul id="CDR0000258038__5"><li class="half_rhythm"><div>Control <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748353/" class="def">heart rate</a>, body temperature, and how quickly food is changed into energy (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046173/" class="def">metabolism</a>). </div></li><li class="half_rhythm"><div>Control the amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045632/" class="def">calcium</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</div></li></ul></div><div id="CDR0000258038__229"><h3>Thyroid nodules are common but usually are not cancer.</h3><p id="CDR0000258038__231">Your doctor may find a lump (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044502/" class="def">nodule</a>) in your thyroid during a routine medical exam. A thyroid nodule is an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> growth of thyroid <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the thyroid. Nodules may be solid or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a>-filled. </p><p id="CDR0000258038__248">When a thyroid nodule is found, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">ultrasound</a> of the thyroid and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045691/" class="def">fine-needle aspiration biopsy</a> are often done to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000688783/" class="def">Blood tests</a> to check thyroid hormone levels and for antithyroid <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> may also be done to check for other types of thyroid disease.</p><p id="CDR0000258038__249">Thyroid nodules usually don't cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> or need treatment. Sometimes the thyroid nodules become large enough that it is hard to swallow or breathe and more tests and treatment are needed. Only a small number of thyroid nodules are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> as cancer.</p></div><div id="CDR0000258038__232"><h3>There are different types of thyroid cancer.</h3><p id="CDR0000258038__303"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445091/" class="def">Thyroid cancer</a> can be described as either:</p><ul id="CDR0000258038__304"><li class="half_rhythm"><div>Differentiated thyroid cancer, which includes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000774690/" class="def">well-differentiated</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>, poorly differentiated tumors, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044775/" class="def">undifferentiated</a> tumors; <i>or</i></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044550/" class="def">Medullary thyroid cancer</a>.</div></li></ul><p id="CDR0000258038__305"> Well-differentiated tumors (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044553/" class="def">papillary thyroid cancer</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044544/" class="def">follicular thyroid cancer</a>) can be treated and can usually be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cured</a>.</p><p id="CDR0000258038__306"> Poorly differentiated and undifferentiated tumors (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044541/" class="def">anaplastic thyroid cancer</a>) are less common. These tumors grow and spread quickly and have a poorer chance of recovery. Patients with anaplastic thyroid cancer should have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000766166/" class="def">molecular testing</a> for a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutation</a> in the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000561325/" class="def">BRAF</a></i>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a>.</p><p id="CDR0000258038__307">Medullary thyroid cancer is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044904/" class="def">neuroendocrine tumor</a> that develops in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044578/" class="def">C cells</a> of the thyroid. The C cells make a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormone</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045207/" class="def">calcitonin</a>) that helps maintain a healthy level of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045632/" class="def">calcium</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</p><p id="CDR0000258038__236">For information about childhood thyroid cancer, see <a href="/books/n/pdqcis/CDR0000789169/">Childhood Thyroid Cancer Treatment</a>.</p></div><div id="CDR0000258038__10"><h3>Age, gender, and being exposed to radiation can affect the risk of thyroid cancer. </h3><p id="CDR0000258038__12">Anything that increases your risk of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. </p><p id="CDR0000258038__237">Risk factors for thyroid cancer include the following:</p><ul id="CDR0000258038__13"><li class="half_rhythm"><div>Being between 25 and 65 years old.</div></li><li class="half_rhythm"><div>Being female.</div></li><li class="half_rhythm"><div>Being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to the head and neck as an infant or child or being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044555/" class="def">radioactive fallout</a>. The cancer may occur as soon as 5 years after exposure. </div></li><li class="half_rhythm"><div>Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642021/" class="def">history</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044545/" class="def">goiter</a> (enlarged thyroid).</div></li><li class="half_rhythm"><div>Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302456/" class="def">family history</a> of thyroid disease or thyroid cancer.</div></li><li class="half_rhythm"><div>Having certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a> such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000563950/" class="def">familial medullary thyroid cancer</a> (FMTC), <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000702095/" class="def">multiple endocrine neoplasia type 2A syndrome</a> (MEN2A), or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000702100/" class="def">multiple endocrine neoplasia type 2B syndrome</a> (MEN2B).</div></li><li class="half_rhythm"><div>Being Asian.</div></li></ul></div><div id="CDR0000258038__14"><h3>Medullary thyroid cancer is sometimes caused by a change in a gene that is passed from parent to child.
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</h3><p id="CDR0000258038__16">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> in cells carry <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045983/" class="def">hereditary</a> information from parent to child. A certain change in the <i>RET</i> gene that is passed from parent to child (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045098/" class="def">inherited</a>) may cause medullary thyroid cancer. </p><p id="CDR0000258038__250">There is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046128/" class="def">genetic test</a> that is used to check for the changed gene. The patient is tested first to see if he or she has the changed gene. If the patient has it, other family members may also be tested to find out if they are at increased risk for medullary thyroid cancer. Family members, including young children, who have the changed gene may have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> to remove the thyroid). This can decrease the chance of developing medullary thyroid cancer.</p></div><div id="CDR0000258038__17"><h3>Signs of thyroid cancer include a swelling or lump in the neck. </h3><p id="CDR0000258038__19">Thyroid cancer may not cause early signs or symptoms. It is sometimes found during a routine <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a>. Signs or symptoms may occur as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> gets bigger. Other conditions may cause the same signs or symptoms. Check with your doctor if you have any of the following:
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</p><ul id="CDR0000258038__170"><li class="half_rhythm"><div>A lump (nodule) in the neck.</div></li><li class="half_rhythm"><div>Trouble breathing.</div></li><li class="half_rhythm"><div>Trouble swallowing.</div></li><li class="half_rhythm"><div>Pain when swallowing.</div></li><li class="half_rhythm"><div>Hoarseness.</div></li></ul></div><div id="CDR0000258038__20"><h3>Tests that examine the thyroid, neck, and blood are used to diagnose thyroid cancer.</h3><p id="CDR0000258038__22">The following tests and procedures may be used:</p><ul id="CDR0000258038__23"><li class="half_rhythm"><div><b> Physical exam and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps (nodules) or swelling in the neck, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000520366/" class="def">voice box</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>, and anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046321/" class="def">Laryngoscopy</a></b>: A procedure in which the doctor checks the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a> (voice box) with a mirror or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046320/" class="def">laryngoscope</a>.
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A laryngoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. A thyroid tumor may press on <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046650/" class="def">vocal cords</a>. The laryngoscopy is done to see if the vocal cords are moving normally. </div></li><li class="half_rhythm"><div>
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<b>Blood hormone studies</b>: A procedure in which a blood sample is checked to measure the amounts of certain hormones released into the blood by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. The blood may be checked for abnormal levels of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044559/" class="def">thyroid-stimulating hormone</a> (TSH). TSH is made by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046229/" class="def">pituitary gland</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797669/" class="def">brain</a>. It stimulates the release of thyroid hormone and controls how fast follicular thyroid cells grow.
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The blood may also be checked for high levels of the hormone <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045207/" class="def">calcitonin</a> and antithyroid antibodies.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304685/" class="def">Blood chemistry studies</a></b>: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045632/" class="def">calcium</a>, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">Ultrasound</a> exam</b>: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs in the neck and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>. The picture can be printed to be looked at later. This procedure can show the size of a thyroid nodule and whether it is solid or a fluid-filled <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046461/" class="def">cyst</a>. Ultrasound may be used to guide a fine-needle aspiration biopsy.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the neck, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.<div id="CDR0000258038__225" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Computed%20tomography%20(CT)%20scan%20of%20the%20head%20and%20neck&p=BOOKS&id=593388_CDR0000753850.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000753850.jpg" alt="Computed tomography (CT) scan of the head and neck; drawing shows a patient lying on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the head and neck." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Computed tomography (CT) scan of the head and neck. The patient lies on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the head and neck.</p></div></div></div></li><li class="half_rhythm"><div><b>Fine-needle aspiration biopsy of the thyroid</b>: The removal of thyroid tissue using a thin needle. The needle is inserted through the skin into the thyroid. Several tissue samples are removed from different parts of the thyroid. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue samples under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer cells. Because the type of thyroid cancer can be hard to diagnose, patients should ask to have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045619/" class="def">biopsy samples</a> checked by a pathologist who has experience diagnosing thyroid cancer.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000563951/" class="def">Surgical biopsy</a></b>: The removal of the thyroid <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044502/" class="def">nodule</a> or one lobe of the thyroid during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> so the cells and tissues can be viewed under a microscope by a pathologist to check for signs of cancer. Because the type of thyroid cancer can be hard to diagnose, patients should ask to have biopsy samples checked by a pathologist who has experience diagnosing thyroid cancer.</div></li></ul></div><div id="CDR0000258038__136"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000258038__138">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> and treatment options depend on the following: </p><ul id="CDR0000258038__139"><li class="half_rhythm"><div>The age of the patient at the time of diagnosis. </div></li><li class="half_rhythm"><div>The type of thyroid cancer.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer.</div></li><li class="half_rhythm"><div>Whether the cancer was completely removed by surgery.</div></li><li class="half_rhythm"><div>Whether the patient has multiple endocrine neoplasia type 2B (MEN 2B).</div></li><li class="half_rhythm"><div>The patient's general health.</div></li><li class="half_rhythm"><div>Whether the cancer has just been diagnosed or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul></div></div><div id="CDR0000258038__27"><h2 id="_CDR0000258038__27_">Stages of Thyroid Cancer</h2><div id="CDR0000258038__27.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258038__28">After thyroid cancer has been diagnosed, tests are done to find out
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if cancer cells have spread within the thyroid or to other parts of the body.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__172">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__200">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__207">Stages are used to describe thyroid cancer based on the type of thyroid cancer and the age of the patient:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258038__209">Papillary and follicular thyroid cancer in patients younger than 55 years</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__212">Papillary and follicular thyroid cancer in patients 55 years and older</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__62">Anaplastic thyroid cancer in patients of all ages</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__284">Medullary thyroid cancer in patients of all ages</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258038__316">Thyroid cancer can recur (come back) after it has been treated.</a></div></li></ul></div><div id="CDR0000258038__28"><h3>After thyroid cancer has been diagnosed, tests are done to find out
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if cancer cells have spread within the thyroid or to other parts of the body.
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</h3><p id="CDR0000258038__30">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> or
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to other parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the
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staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is important to know
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the patient's age and the stage of the cancer to plan treatment. </p><p id="CDR0000258038__251">The following tests and
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procedures may be used in the staging process:</p><ul id="CDR0000258038__31"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797669/" class="def">brain</a>, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div>
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<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">Ultrasound</a> exam</b>: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>. The picture can be printed to be looked at later.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046499/" class="def">Bone scan</a></b>: A procedure to check if there are rapidly dividing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>, such as cancer cells, in the bone. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046712/" class="def">Sentinel lymph node biopsy</a></b>: The removal of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045876/" class="def">sentinel lymph node</a> during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. The sentinel lymph node is the first <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a> in a group of lymph nodes to receive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045760/" class="def">lymphatic drainage</a> from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>. It is the first lymph node the cancer is likely to spread to from the primary tumor. A radioactive substance and/or blue dye is injected near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. The substance or dye flows through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046305/" class="def">lymph</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046441/" class="def">ducts</a> to the lymph nodes. The first lymph node to receive the substance or dye is removed. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes.</div></li></ul></div><div id="CDR0000258038__172"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000258038__172_md_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000258038__172_md_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000258038__200"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000258038__200_md_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer cells break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000258038__200_md_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000258038__202">The metastatic tumor is the same type of cancer as the primary tumor. For example, if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445091/" class="def">thyroid cancer</a> spreads to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, the cancer cells in the lung are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer.</p><div id="CDR0000258038__275" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000258038__207"><h3>Stages are used to describe thyroid cancer based on the type of thyroid cancer and the age of the patient:</h3><div id="CDR0000258038__209"><h4>Papillary and follicular thyroid cancer in patients younger than 55 years</h4><ul id="CDR0000258038__211"><li class="half_rhythm"><div><b>Stage I:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789082/" class="def">stage I papillary and follicular thyroid cancer</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and may have spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> has not spread to other parts of the body.<div id="CDR0000258038__261" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20I%20papillary%20and%20follicular%20thyroid%20cancer%20in%20patients%20younger%20than%2055%20years&p=BOOKS&id=593388_CDR0000779383.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779383.jpg" alt="Stage I papillary and follicular thyroid cancer in patients younger than 55 years; drawing shows cancer in the thyroid gland. Also shown are the larynx and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage I papillary and follicular thyroid cancer in patients younger than 55 years. The tumor is any size and cancer may have spread to nearby tissues and lymph nodes. Cancer has not spread to other parts of the body.</p></div></div></div></li><li class="half_rhythm"><div><b>Stage II:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789084/" class="def">stage II papillary and follicular thyroid cancer</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> may have spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> or bones.<div id="CDR0000258038__262" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20II%20papillary%20and%20follicular%20thyroid%20cancer%20in%20patients%20younger%20than%2055%20years&p=BOOKS&id=593388_CDR0000781921.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000781921.jpg" alt="Stage II papillary and follicular thyroid cancer in patients younger than 55 years; drawing shows other parts of the body where thyroid cancer may spread, including the lung and bone. An inset shows cancer cells spreading from the thyroid gland, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage II papillary and follicular thyroid cancer in patients younger than 55 years. The tumor is any size and cancer may have spread to nearby tissues and lymph nodes. Cancer has spread from the thyroid to other parts of the body, such as the lungs or bones.</p></div></div></div></li></ul></div><div id="CDR0000258038__212"><h4>Papillary and follicular thyroid cancer in patients 55 years and older</h4><ul id="CDR0000258038__214"><li class="half_rhythm"><div><b>Stage I:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789086/" class="def">stage I papillary and follicular thyroid cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> only and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is 4 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller.<div id="CDR0000258038__255" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20I%20papillary%20and%20follicular%20thyroid%20cancer%20in%20patients%2055%20years%20and%20older&p=BOOKS&id=593388_CDR0000779378.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779378.jpg" alt="Stage I papillary and follicular thyroid cancer in patients 55 years and older; drawing shows cancer in the thyroid gland and the tumor is 4 centimeters or smaller. An inset shows 4 centimeters is about the size of a walnut. Also shown are the larynx and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage I papillary and follicular thyroid cancer in patients 55 years and older. Cancer is found in the thyroid only and the tumor is 4 centimeters or smaller.</p></div></div></div></li><li class="half_rhythm"><div><b>Stage II:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789088/" class="def">stage II papillary and follicular thyroid cancer</a>, one of the following is found: <ul id="CDR0000258038__279"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is 4 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller; cancer has spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or </div></li><li class="half_rhythm"><div>cancer is found in the thyroid, the tumor is larger than 4 centimeters, and cancer may have spread to nearby lymph nodes; or </div></li><li class="half_rhythm"><div>the tumor is any size and cancer has spread from the thyroid to nearby muscles in the neck and may have spread to nearby lymph nodes.</div></li></ul><div id="CDR0000258038__256" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20II%20papillary%20and%20follicular%20thyroid%20cancer%20(1)%20in%20patients%2055%20years%20and%20older&p=BOOKS&id=593388_CDR0000779381.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779381.jpg" alt="Stage II papillary and follicular thyroid cancer (1) in patients 55 years and older; drawing shows cancer in the thyroid gland and nearby lymph nodes. The tumor is 4 centimeters or smaller. An inset shows 4 centimeters is about the size of a walnut. Also shown are the larynx and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage II papillary and follicular thyroid cancer (1) in patients 55 years and older. Cancer is found in the thyroid and the tumor is 4 centimeters or smaller. Cancer has spread to nearby lymph nodes. </p></div></div></div></li><li class="half_rhythm"><div><b>Stage III:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789090/" class="def">stage III papillary and follicular thyroid cancer</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045882/" class="def">soft tissue</a> under the skin, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a>, or the recurrent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046317/" class="def">laryngeal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> (a nerve that goes to the larynx). Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.
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<div id="CDR0000258038__257" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20III%20papillary%20and%20follicular%20thyroid%20cancer%20in%20patients%2055%20years%20and%20older&p=BOOKS&id=593388_CDR0000779382.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779382.jpg" alt="Stage III papillary and follicular thyroid cancer in patients 55 years and older; drawing shows cancer that has spread from the thyroid gland to the esophagus, the trachea, the larynx, and the left recurrent laryngeal nerve. Also shown is the right recurrent laryngeal nerve." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage III papillary and follicular thyroid cancer in patients 55 years and older. The tumor is any size and cancer has spread from the thyroid to soft tissue under the skin, the esophagus, the trachea, the larynx, or the recurrent laryngeal nerve (a nerve that goes to the larynx). Cancer may have spread to lymph nodes. </p></div></div></div></li><li class="half_rhythm"><div><b>Stage IV:</b>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789092/" class="def">Stage IV papillary and follicular thyroid cancer</a> is divided into stages IVA and IVB.<ul id="CDR0000258038__280"><li class="half_rhythm"><div>In stage IVA, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> in front of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a> or has surrounded the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000396786/" class="def">carotid artery</a> or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> in the area between the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>. Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000258038__290" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVA%20papillary%20and%20follicular%20thyroid%20cancer%20in%20patients%2055%20years%20and%20older&p=BOOKS&id=593388_CDR0000780089.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000780089.jpg" alt="Stage IVA papillary and follicular thyroid cancer in patients 55 years and older; drawing shows cancer has (a) spread to tissue in front of the spine (inset), (b) surrounded the common carotid artery, and (c) surrounded the blood vessels in the area between the lungs. Also shown are the thyroid gland, trachea, and lymph nodes." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVA papillary and follicular thyroid cancer in patients 55 years and older. The tumor is any size and cancer has (a) spread to tissue in front of the spine; or (b) surrounded the carotid artery; or (c) surrounded the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.</p></div></div></div></li><li class="half_rhythm"><div>In stage IVB, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> or bones. Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000258038__291" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20papillary%20and%20follicular%20thyroid%20cancer%20in%20patients%2055%20years%20and%20older&p=BOOKS&id=593388_CDR0000780092.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000780092.jpg" alt="Stage IVB papillary and follicular thyroid cancer in patients 55 years and older; drawing shows other parts of the body where thyroid cancer may spread, including the lung and bone. An inset shows cancer cells spreading from the thyroid, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB papillary and follicular thyroid cancer in patients 55 years and older. The tumor is any size and cancer has spread to other parts of the body, such as the lungs or bones. Cancer may have spread to lymph nodes.</p></div></div></div></li></ul>
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</div></li></ul></div><div id="CDR0000258038__62"><h4>Anaplastic thyroid cancer in patients of all ages</h4><p id="CDR0000258038__281"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044541/" class="def">Anaplastic thyroid cancer</a> grows quickly and usually has spread within the neck when it is found. Anaplastic thyroid cancer is considered stage IV thyroid cancer. Stage IV anaplastic thyroid cancer is divided into <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789094/" class="def">stages IVA</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789097/" class="def">IVB</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789100/" class="def">IVC</a>.</p><ul id="CDR0000258038__282"><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789094/" class="def">stage IVA</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> only and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> may be any size.<div id="CDR0000258038__292" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVA%20anaplastic%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000782401.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000782401.jpg" alt="Stage IVA anaplastic thyroid cancer; drawing shows cancer in the thyroid gland. The lymph nodes are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVA anaplastic thyroid cancer. Cancer is found in the thyroid only and the tumor may be any size.</p></div></div></div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789097/" class="def">stage IVB</a>, one of the following is found: <ul id="CDR0000258038__283"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> may be any size; cancer has spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or<div id="CDR0000258038__293" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20anaplastic%20thyroid%20cancer%20(1)&p=BOOKS&id=593388_CDR0000782402.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000782402.jpg" alt="Stage IVB anaplastic thyroid cancer (1); drawing shows cancer in the thyroid gland and nearby lymph nodes." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB anaplastic thyroid cancer (1). Cancer is found in the thyroid and the tumor may be any size. Cancer has spread to nearby lymph nodes.</p></div></div></div></li><li class="half_rhythm"><div>the tumor is any size and cancer has spread from the thyroid to nearby muscles in the neck and may have spread to nearby lymph nodes; or <div id="CDR0000258038__294" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20anaplastic%20thyroid%20cancer%20(2)&p=BOOKS&id=593388_CDR0000790836.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000790836.jpg" alt="Stage IVB anaplastic thyroid cancer (2); drawing shows cancer in the thyroid gland and nearby muscles in the neck. The lymph nodes are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB anaplastic thyroid cancer (2). The tumor is any size and cancer has spread from the thyroid to nearby muscles in the neck. Cancer may have spread to nearby lymph nodes.</p></div></div></div></li><li class="half_rhythm"><div>the tumor is any size and cancer has spread from the thyroid to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045882/" class="def">soft tissue</a> under the skin, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a>, the recurrent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046317/" class="def">laryngeal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> (a nerve that goes to the larynx), or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> in front of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a>, or has surrounded the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000396786/" class="def">carotid artery</a> or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> in the area between the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>; cancer may have spread to lymph nodes.<div id="CDR0000258038__295" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20anaplastic%20thyroid%20cancer%20(3)&p=BOOKS&id=593388_CDR0000790838.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000790838.jpg" alt="Stage IVB anaplastic thyroid cancer (3); drawing shows cancer in the thyroid gland and in the esophagus, the trachea, the larynx, the left recurrent laryngeal nerve, and the tissue in front of the spine (inset). Cancer has also surrounded the common carotid artery and the blood vessels in the area between the lungs. Also shown is the right recurrent laryngeal nerve." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB anaplastic thyroid cancer (3). The tumor is any size and cancer has spread from the thyroid to soft tissue under the skin, the esophagus, the trachea, the larynx, the recurrent laryngeal nerve (a nerve that goes to the larynx), or tissue in front of the spine; or cancer has surrounded the carotid artery or the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.</p></div></div></div></li></ul></div></li><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789100/" class="def">stage IVC</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> or bones. Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000258038__296" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVC%20anaplastic%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000780096.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000780096.jpg" alt="Stage IVC anaplastic thyroid cancer; drawing shows other parts of the body where thyroid cancer may spread, including the lung and bone. An inset shows cancer cells spreading from the thyroid, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVC anaplastic thyroid cancer. The tumor is any size and cancer has spread to other parts of the body, such as the lungs or bones. Cancer may have spread to lymph nodes.</p></div></div></div></li></ul></div><div id="CDR0000258038__284"><h4>Medullary thyroid cancer in patients of all ages</h4><ul id="CDR0000258038__286"><li class="half_rhythm"><div><b>Stage I:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789103/" class="def">stage I medullary thyroid cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> only and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller.<div id="CDR0000258038__297" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20I%20medullary%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000779386.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779386.jpg" alt="Stage I medullary thyroid cancer; drawing shows cancer in the thyroid gland and the tumor is 2 centimeters or smaller. An inset shows 2 centimeters is about the size of a peanut. Also shown are the larynx and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage I medullary thyroid cancer. Cancer is found in the thyroid only and the tumor is 2 centimeters or smaller.</p></div></div></div></li><li class="half_rhythm"><div><b>Stage II:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789111/" class="def">stage II medullary thyroid cancer</a>, one of the following is found: <ul id="CDR0000258038__287"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> only and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is larger than 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>; or </div></li><li class="half_rhythm"><div>the tumor is any size and cancer has spread from the thyroid to nearby muscles in the neck.</div></li></ul><div id="CDR0000258038__298" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20II%20medullary%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000779390.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779390.jpg" alt="Stage II medullary thyroid cancer; drawing shows (a) cancer in the thyroid gland and the tumor is larger than 2 centimeters and (b) cancer has spread to nearby muscles in the neck. An inset shows 2 centimeters is about the size of a peanut. Also shown are the larynx and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage II medullary thyroid cancer. The cancer (a) is found in the thyroid only and the tumor is larger than 2 centimeters; or (b) has spread from the thyroid to nearby muscles in the neck and the tumor is any size.</p></div></div></div></li><li class="half_rhythm"><div><b>Stage III:</b> In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789108/" class="def">stage III medullary thyroid cancer</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> may have spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> to nearby muscles in the neck. Cancer has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> on one or both sides of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a>.<div id="CDR0000258038__299" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20III%20medullary%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000779393.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000779393.jpg" alt="Stage III medullary thyroid cancer; drawing shows cancer in the thyroid gland and in nearby lymph nodes. Also shown are the trachea and larynx" class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p> Stage III medullary thyroid cancer. The tumor is any size and cancer may have spread from the thyroid to nearby muscles in the neck. Cancer has spread to lymph nodes on one or both sides of the trachea or larynx.</p></div></div></div></li><li class="half_rhythm"><div><b>Stage IV:</b>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789110/" class="def">Stage IV medullary thyroid cancer</a> is divided into stages IVA, IVB, and IVC.<ul id="CDR0000258038__288"><li class="half_rhythm"><div>In stage IVA, either of the following is found:<ul id="CDR0000258038__289"><li class="half_rhythm"><div>the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045882/" class="def">soft tissue</a> under the skin, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046623/" class="def">trachea</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046026/" class="def">larynx</a>, or the recurrent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046317/" class="def">laryngeal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a> (a nerve that goes to the larynx); cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> on one or both sides of the neck; or</div></li><li class="half_rhythm"><div>the tumor is any size and cancer may have spread from the thyroid to nearby muscles in the neck; cancer has spread to lymph nodes on one or both sides of the neck.</div></li></ul><div id="CDR0000258038__300" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVA%20medullary%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000780091.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000780091.jpg" alt="Stage IVA medullary thyroid cancer; drawing shows cancer in the thyroid gland and in the larynx, the esophagus, the left recurrent laryngeal nerve, the trachea, and a lymph node on one side of the neck. Also shown is the right recurrent laryngeal nerve." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVA medullary thyroid cancer. The tumor is any size and cancer has spread from the thyroid to soft tissue under the skin, the esophagus, the trachea, the larynx, or the recurrent laryngeal nerve (a nerve that goes to the larynx), and cancer may have spread to lymph nodes on one or both sides of the neck; or cancer may have spread from the thyroid to nearby muscles in the neck, and cancer has spread to lymph nodes on one or both sides of the neck.</p></div></div></div></li></ul></div></li><li class="half_rhythm"><div>In stage IVB, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> in front of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a> or to the spine or has surrounded the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000396786/" class="def">carotid artery</a> or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> in the area between the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>. Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000258038__301" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVB%20medullary%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000780093.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000780093.jpg" alt="Stage IVB medullary thyroid cancer; drawing shows cancer has (a) spread from the thyroid gland to tissue in front of the spine and to the spine (inset), (b) surrounded the common carotid artery, and (c) surrounded the blood vessels in the area between the lungs. Also shown are the lymph nodes and trachea." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVB medullary thyroid cancer. The tumor is any size and cancer has (a) spread to tissue in front of the spine or to the spine; or (b) surrounded the carotid artery; or (c) surrounded the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.</p></div></div></div></li><li class="half_rhythm"><div>In stage IVC, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is any size and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>. Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000258038__302" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVC%20medullary%20thyroid%20cancer&p=BOOKS&id=593388_CDR0000780095.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65857/bin/CDR0000780095.jpg" alt="Stage IVC medullary thyroid cancer; drawing shows other parts of the body where thyroid cancer may spread, including the lung and liver. An inset shows cancer cells spreading from the thyroid, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVC medullary thyroid cancer. The tumor is any size and cancer has spread to other parts of the body, such as the lung or liver. Cancer may have spread to lymph nodes.</p></div></div></div></li></ul></div></div><div id="CDR0000258038__316"><h3>Thyroid cancer can recur (come back) after it has been treated.</h3><p id="CDR0000258038__318">The cancer may come back in the thyroid or in other parts
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of the body.</p></div></div><div id="CDR0000258038__67"><h2 id="_CDR0000258038__67_">Treatment Option Overview</h2><div id="CDR0000258038__67.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258038__68">There are different types of treatment for patients with thyroid
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cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__72">The following types of treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258038__74">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__79">Radiation therapy, including radioactive iodine therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__83">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__86">Thyroid hormone therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__185">Targeted therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__238">Watchful waiting</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258038__89">New types of treatment are being tested in clinical trials.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__276">Treatment for thyroid cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__174">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__176">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258038__178">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000258038__68"><h3>There are different types of treatment for patients with thyroid
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cancer. </h3><p id="CDR0000258038__70">Different types of treatment are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445091/" class="def">thyroid
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cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some
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are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>.
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A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help
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improve current treatments or obtain information on new treatments for patients
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with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the
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standard treatment, the new
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treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. </p></div><div id="CDR0000258038__72"><h3>The following types of treatment are used:</h3><div id="CDR0000258038__74"><h4>Surgery </h4><p id="CDR0000258038__76"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> is the most common treatment for thyroid cancer. One of the following procedures may be used: </p><ul id="CDR0000258038__77"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046314/" class="def">Lobectomy</a>: Removal of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046188/" class="def">lobe</a> in which thyroid cancer is found. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">Lymph nodes</a> near the cancer may also be removed and checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for signs of cancer. </div></li><li class="half_rhythm"><div>Near-total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a>: Removal of all but a very small part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a>. Lymph nodes near the cancer may also be removed and checked under a microscope for signs of cancer.</div></li><li class="half_rhythm"><div>Total thyroidectomy: Removal of the whole thyroid. Lymph nodes near the cancer may also be removed and checked under a microscope for signs of cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046625/" class="def">Tracheostomy</a>: Surgery to create an opening (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045104/" class="def">stoma</a>) into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044379/" class="def">windpipe</a> to help you breathe. The opening itself may also be called a tracheostomy.</div></li></ul></div><div id="CDR0000258038__79"><h4>Radiation therapy, including radioactive iodine therapy</h4><p id="CDR0000258038__131"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000258038__227"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the area of the body with cancer. Sometimes the radiation is aimed directly at the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> during surgery. This is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046338/" class="def">intraoperative radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def"> Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000258038__82">Radiation therapy may be given after surgery to kill any thyroid cancer cells that were not removed. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044544/" class="def">Follicular</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044553/" class="def">papillary thyroid cancers</a> are sometimes treated with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045855/" class="def">radioactive iodine</a> (RAI) therapy. RAI is taken by mouth and collects in any remaining thyroid <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, including thyroid cancer cells that have spread to other places in the body. Since only thyroid tissue takes up <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044548/" class="def">iodine</a>, the RAI destroys thyroid tissue and thyroid cancer cells without harming other tissue. Before a full treatment <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of RAI is given, a small test-dose is given to see if the tumor takes up the iodine.</p><p id="CDR0000258038__252">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated. External radiation therapy and radioactive iodine (RAI) therapy are used to treat thyroid cancer.</p></div><div id="CDR0000258038__83"><h4>Chemotherapy </h4><p id="CDR0000258038__132"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). </p><p id="CDR0000258038__253">The way the chemotherapy is given depends on the type and stage of the cancer being treated.</p><p id="CDR0000258038__192">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/thyroid" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Thyroid Cancer</a> for more information.</p></div><div id="CDR0000258038__86"><h4>Thyroid hormone therapy
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</h4><p id="CDR0000258038__88">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> is a cancer treatment that removes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a> or blocks their action and stops cancer cells from growing. Hormones are substances made by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a> in the body and circulated in the bloodstream. In the treatment of thyroid cancer, drugs may be given to prevent the body from making <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044559/" class="def">thyroid-stimulating hormone</a> (TSH), a hormone that can increase the chance that thyroid cancer will grow or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recur</a>. </p><p id="CDR0000258038__169">Also, because thyroid cancer treatment kills thyroid cells, the thyroid is not able to make enough <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044558/" class="def">thyroid hormone</a>. Patients are given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046127/" class="def">thyroid hormone replacement</a> pills.</p></div><div id="CDR0000258038__185"><h4>Targeted therapy</h4><p id="CDR0000258038__197"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. There are different types of targeted therapy:</p><ul id="CDR0000258038__311"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">Tyrosine kinase inhibitor</a></b>. Tyrosine kinase inhibitor therapy blocks signals needed for tumors to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000509041/" class="def">Sorafenib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000769612/" class="def">lenvatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000530320/" class="def">vandetanib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000743915/" class="def">cabozantinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801614/" class="def">selpercatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795811/" class="def">larotrectinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000784260/" class="def">entrectinib</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000802446/" class="def">pralsetinib</a> are used to treat certain types of thyroid cancer. New types of tyrosine kinase inhibitors are being studied to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a> thyroid cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000486603/" class="def">Protein kinase inhibitor</a>.</b> Protein kinase inhibitor therapy blocks <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> needed for cell growth and may kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">Dabrafenib</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750072/" class="def">trametinib</a> are used to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044541/" class="def">anaplastic thyroid cancer</a> in patients with a certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutation</a> in the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000561325/" class="def">BRAF</a></i>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a>.</div></li></ul><p id="CDR0000258038__196">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/thyroid" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Thyroid Cancer</a> for more information.</p></div><div id="CDR0000258038__238"><h4>Watchful waiting</h4><p id="CDR0000258038__240"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045942/" class="def">Watchful waiting</a> is closely <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitoring</a> a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> without giving any treatment until <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> appear or change.</p></div></div><div id="CDR0000258038__89"><h3>New types of treatment are being tested in clinical trials.</h3><div id="CDR0000258038__308"><h4>Immunotherapy</h4><p id="CDR0000258038__310"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This cancer treatment is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a>. Immunotherapy is being studied as a treatment for thyroid cancer.</p><p id="CDR0000258038__92">
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Information about clinical trials is available from the
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<a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000258038__276"><h3>Treatment for thyroid cancer may cause side effects.</h3><p id="CDR0000258038__276_md_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, visit our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000258038__174"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000258038__174_md_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000258038__174_md_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000258038__174_md_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000258038__176"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000258038__176_md_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000258038__176_md_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000258038__178"><h3>Follow-up tests may be needed.</h3><p id="CDR0000258038__178_md_33">As you go through treatment, you will have follow-up tests or check-ups. Some tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000258038__178_md_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). </p></div></div><div id="CDR0000258038__94"><h2 id="_CDR0000258038__94_">Treatment of Stages I, II, and III Papillary and Follicular Thyroid Cancer (Localized/Regional)</h2><p id="CDR0000258038__278">For information about the treatments listed below, see the <a href="#CDR0000258038__72">Treatment Option Overview</a> section.</p><p id="CDR0000258038__95">Treatment of stage I (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789082/" class="def">younger than 55 years</a>; <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789086/" class="def">55 years and older</a>), stage II (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789084/" class="def">younger than 55 years</a>; <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789088/" class="def">55 years and older</a>), and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789090/" class="def">stage III papillary and follicular thyroid cancer</a> may include the following: </p><ul id="CDR0000258038__96"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046314/" class="def">lobectomy</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045855/" class="def">Radioactive iodine</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> to prevent the body from making <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044559/" class="def">thyroid-stimulating hormone</a> (TSH).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a>.</div></li></ul><p id="CDR0000258038__TrialSearch_94_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258038__112"><h2 id="_CDR0000258038__112_">Treatment of Stage IV Papillary and Follicular Thyroid Cancer (Metastatic)</h2><p id="CDR0000258038__319">For information about the treatments listed below, see the <a href="#CDR0000258038__72">Treatment Option Overview</a> section.</p><p id="CDR0000258038__113"> When <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to other places in the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a> and bone, treatment usually does not cure the cancer, but can relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>. Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000789092/" class="def">stage IV papillary and follicular thyroid cancer</a> may include the following:</p><p id="CDR0000258038__203">
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<b> For tumors that take up iodine</b>
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</p><ul id="CDR0000258038__204"><li class="half_rhythm"><div>Total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045855/" class="def">Radioactive iodine</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> to prevent the body from making <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044559/" class="def">thyroid-stimulating hormone</a> (TSH).</div></li></ul><p id="CDR0000258038__205">
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<b>For tumors that do not take up iodine</b>
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</p><ul id="CDR0000258038__114"><li class="half_rhythm"><div>Total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> to prevent the body from making <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044559/" class="def">thyroid-stimulating hormone</a> (TSH).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000509041/" class="def">sorafenib</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000769612/" class="def">lenvatinib</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove cancer from areas where it has spread.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046751/" class="def">External-beam radiation therapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.
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</div></li><li class="half_rhythm"><div>A clinical trial of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">immunotherapy</a>.</div></li></ul><p id="CDR0000258038__TrialSearch_112_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258038__272"><h2 id="_CDR0000258038__272_">Treatment of Recurrent Papillary and Follicular Thyroid Cancer</h2><p id="CDR0000258038__320">For information about the treatments listed below, see the <a href="#CDR0000258038__72">Treatment Option Overview</a> section.</p><p id="CDR0000258038__273">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044553/" class="def">papillary</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044544/" class="def">follicular thyroid cancer</a> may include the following:</p><ul id="CDR0000258038__274"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045855/" class="def">radioactive iodine</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a>.</div></li><li class="half_rhythm"><div>Radioactive iodine therapy when the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> can be found only by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046570/" class="def">scan</a> and cannot be felt during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000509041/" class="def">sorafenib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000769612/" class="def">lenvatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000743915/" class="def">cabozantinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801614/" class="def">selpercatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000802446/" class="def">pralsetinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000795811/" class="def">larotrectinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000784260/" class="def">entrectinib</a>).</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046338/" class="def">intraoperative radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div>Chemotherapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">immunotherapy</a>.</div></li></ul><p id="CDR0000258038__TrialSearch_272_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258038__120"><h2 id="_CDR0000258038__120_">Treatment of Medullary Thyroid Cancer</h2><p id="CDR0000258038__321">For information about the treatments listed below, see the <a href="#CDR0000258038__72">Treatment Option Overview</a> section.</p><p id="CDR0000258038__312"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045754/" class="def">Localized</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044550/" class="def">medullary thyroid cancer</a> is in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a> only and may have spread to nearby muscles in the neck. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045955/" class="def">Locally advanced</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> thyroid cancer has spread to other parts of the neck or to other parts of the body.</p><p id="CDR0000258038__121">
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Treatment of localized medullary thyroid cancer may include the following:</p><ul id="CDR0000258038__122"><li class="half_rhythm"><div>Total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a> if the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has not spread to other parts of the body. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">Lymph nodes</a> near the cancer are also removed.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> for patients whose cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a>.</div></li></ul><p id="CDR0000258038__313">Treatment of locally advanced/metastatic medullary thyroid cancer may include the following:</p><ul id="CDR0000258038__314"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000530320/" class="def">vandetanib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000743915/" class="def">cabozantinib</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801614/" class="def">selpercatinib</a>) for cancer that has spread to other parts of the body.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> for patients whose cancer has spread to other parts of the body.</div></li></ul><p id="CDR0000258038__315"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045855/" class="def">Radioactive iodine</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> is not used to treat medullary thyroid cancer.</p><p id="CDR0000258038__TrialSearch_120_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258038__123"><h2 id="_CDR0000258038__123_">Treatment of Anaplastic Thyroid Cancer</h2><p id="CDR0000258038__322">For information about the treatments listed below, see the <a href="#CDR0000258038__72">Treatment Option Overview</a> section.</p><p id="CDR0000258038__124">
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Treatment of anaplastic thyroid cancer may include the following:</p><ul id="CDR0000258038__125"><li class="half_rhythm"><div>Total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044557/" class="def">thyroidectomy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> for patients whose <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is in or near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046036/" class="def">thyroid</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046625/" class="def">Tracheostomy</a> as palliative therapy to relieve symptoms and improve the quality of life.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000486603/" class="def">protein kinase inhibitors</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">dabrafenib</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750072/" class="def">trametinib</a>) for patients with a certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutation</a> in the <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000561325/" class="def">BRAF</a></i>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a>.</div></li></ul><p id="CDR0000258038__TrialSearch_123_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258038__180"><h2 id="_CDR0000258038__180_">To Learn More About Thyroid Cancer</h2><p id="CDR0000258038__181">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about thyroid cancer, see the following:</p><ul id="CDR0000258038__194"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/thyroid" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Thyroid Cancer Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/thyroid" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Thyroid Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Immunotherapy to Treat Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Genetic Testing for Inherited Cancer Susceptibility Syndromes</a>
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</div></li></ul><p id="CDR0000258038__180_md_40">For general cancer information and other resources from the National Cancer Institute, visit:</p><ul id="CDR0000258038__180_md_41"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors, Caregivers, and Advocates</a>
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</div></li></ul></div><div id="CDR0000258038__AboutThis_1"><h2 id="_CDR0000258038__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000258038__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000258038__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000258038__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000258038__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000258038__AboutThis_6">This PDQ cancer information summary has current information about the treatment of adult thyroid cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000258038__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000258038__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000258038__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000258038__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000258038__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000258038__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000258038__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000258038__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000258038__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000258038__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Thyroid Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389296]</p><p id="CDR0000258038__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000258038__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000258038__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000258038__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000258038__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65857</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389296" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389296</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65857/?report=reader">PubReader</a></li><li><a href="/books/NBK65857/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65857" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65857" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Thyroid Cancer Treatment (PDQ®): Patient Version. 2023 Jul 21. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm">NBK65857.17</span> July 21, 2023 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65857.16/">NBK65857.16</a></span> March 16, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65857.15/">NBK65857.15</a></span> March 30, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65857.14/">NBK65857.14</a></span> January 13, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65857.13/">NBK65857.13</a></span> May 21, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65857.12/">NBK65857.12</a></span> May 16, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65857.11/">NBK65857.11</a></span> April 9, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65857.10/">NBK65857.10</a></span> May 23, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65857.9/">NBK65857.9</a></span> March 30, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65857.8/">NBK65857.8</a></span> January 12, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65857.7/">NBK65857.7</a></span> August 18, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65857.6/">NBK65857.6</a></span> April 27, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65857.5/">NBK65857.5</a></span> August 17, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65857.4/">NBK65857.4</a></span> July 14, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65857.3/">NBK65857.3</a></span> May 27, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65857.2/">NBK65857.2</a></span> May 6, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65857.1/">NBK65857.1</a></span> June 17, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000258038__1" ref="log$=inpage&link_id=inpage">General Information About Thyroid Cancer</a></li><li><a href="#CDR0000258038__27" ref="log$=inpage&link_id=inpage">Stages of Thyroid Cancer</a></li><li><a href="#CDR0000258038__67" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000258038__94" ref="log$=inpage&link_id=inpage">Treatment of Stages I, II, and III Papillary and Follicular Thyroid Cancer (Localized/Regional)</a></li><li><a href="#CDR0000258038__112" ref="log$=inpage&link_id=inpage">Treatment of Stage IV Papillary and Follicular Thyroid Cancer (Metastatic)</a></li><li><a href="#CDR0000258038__272" ref="log$=inpage&link_id=inpage">Treatment of Recurrent Papillary and Follicular Thyroid Cancer</a></li><li><a href="#CDR0000258038__120" ref="log$=inpage&link_id=inpage">Treatment of Medullary Thyroid Cancer</a></li><li><a href="#CDR0000258038__123" ref="log$=inpage&link_id=inpage">Treatment of Anaplastic Thyroid Cancer</a></li><li><a href="#CDR0000258038__180" ref="log$=inpage&link_id=inpage">To Learn More About Thyroid Cancer</a></li><li><a href="#CDR0000258038__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65719/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper 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class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389197" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 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class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389384" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Urethral Cancer Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Urethral Cancer Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" 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