Staging and prognosis for thyroid cancer
The tests previously described help your doctors work out whether you have thyroid cancer and whether it has spread from the thyroid to other parts of the body. Working out how far the cancer has spread is called staging. It is often not possible to precisely stage thyroid cancer until after surgery.
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The TNM staging system is often used for thyroid cancer. TNM stands for tumour−nodes−metastasis. Each letter is assigned a number (and sometimes also a letter) to show how advanced the cancer is.
|Indicates the size of the tumour. T1 cancers are smaller and remain inside the thyroid, while T4 tumours are larger or have spread to other parts of the neck.|
|Indicates whether the cancer has spread to the lymph nodes. N0 means the cancer has not spread to the lymph nodes; N1 means the cancer has spread to the nodes.|
|Indicates if the cancer has spread to other parts of the body, such as the lungs or the bones (metastatic or secondary cancer). M0 means the cancer has not spread; M1 means the cancer has spread.|
To help work out the best treatment for you, your doctor will classify the cancer as low, intermediate or high risk. They will consider not only the stage but also a number of other factors, such as the cancer type and growth pattern, whether the tumour is growing into blood vessels, and your age and general health.
If you are having trouble understanding thyroid cancer staging and risk classification, ask a member of your treatment team to explain it in clearer terms.
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease. Instead, your doctor can give you an idea of what may happen, based on statistics and common issues that affect people with the same type of thyroid cancer as you.
To work out your prognosis, your doctor will consider:
- your test results
- the type of thyroid cancer you have
- the size of the tumour and how quickly it is growing
- how well you respond to treatment
- other factors such as your age, fitness and medical history.
The most common types of thyroid cancer (papillary and follicular) have an excellent long-term prognosis, especially if the cancer is found only in the thyroid or nearby lymph nodes in the neck. Even if the cancer has spread (metastasised), the outcome can still be good.
Doctors commonly use five-year survival rates as a way to discuss prognosis. This is because research studies often follow people for five years – it does not mean you will survive for only five years. Thyroid cancer has a very high five-year survival rate (97%).
A/Prof Diana Learoyd, Endocrinologist, Northern Cancer Institute, and Northern Clinical School, The University of Sydney, NSW; Dr Gabrielle Cehic, Nuclear Medicine Physician and Oncologist, South Australia Medical Imaging (SAMI), and Senior Staff Specialist, The Queen Elizabeth Hospital, SA; Dr Kiernan Hughes, Endocrinologist, Northern Endocrine and St Vincents Hospital, NSW; Yvonne King, 13 11 20 Consultant, Cancer Council NSW; Dr Christine Lai, Senior Consultant Surgeon, Breast and Endocrine Surgical Unit, The Queen Elizabeth Hospital, and Senior Lecturer, Discipline of Surgery, University of Adelaide, SA; A/Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and The University of Western Australia, WA; Ilona Lillington, Clinical Nurse Consultant (Thyroid and Brachytherapy), Cancer Care Services, Royal Brisbane Women’s Hospital, QLD; Jonathan Park, Consumer.
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