Prognosis and survival for thyroid cancer

If you have thyroid cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for thyroid cancer.

Type of tumour

The type of tumour is the most important prognostic factor for thyroid cancer. Papillary thyroid cancer has the best outcome and most favourable prognosis. It tends to respond well to treatment. Follicular thyroid cancer or medullary thyroid cancer has a good prognosis, but less favourable than papillary thyroid cancer. Anaplastic thyroid cancer has a very poor prognosis.

Age

Age is an important prognostic factor for papillary and follicular thyroid cancer. People under 40 years of age have a more favourable prognosis.

Stage

The lower the stage at diagnosis, the better the prognosis. Tumours that are larger than 4 cm or have grown through the thyroid to surrounding tissues and structures have a less favourable prognosis. Thyroid cancer that has spread to other parts of the body (called distant metastases) also has a less favourable prognosis.

Multiple endocrine neoplasia type 2B (MEN2B)

People who have medullary thyroid cancer associated with the hereditary condition MEN2B tend to have a poor prognosis. They are often diagnosed with more advanced thyroid cancer.

Expert review and references

  • American Joint Committee on Cancer. AJCC Cancer Staging Handbook. 7th ed. Chicago: Springer; 2010.
  • BC Cancer Agency (BCCA). Cancer Management Guidelines: Head and Neck - Thyroid Malignancies. 2004: http://www.bccancer.bc.ca/.
  • Davidge-Pitts CJ, Thompson GB . Thyroid tumors. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 82:1175-1188.
  • Davidson BJ, Newkirk KA, Burman KD . Cancer of the thyroid and the parathyroid: general principles and management. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 28A:779-824.
  • Haugen BR, Alexander DK, Bible KC, et al . 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer . Thyroid . 2015 .
  • Jonklaas J, Bianco AC, Bauer AJ, et al . Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement . Thyroid . 2014 .
  • National Cancer Institute. Thyroid CancerTreatment (PDQ®) Patient Version. 2015: http://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq#section/all.
  • National Cancer Institute. Thyroid Cancer Treatment for Health Professionals (PDQ®). 2015: http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq.

Risk groups for papillary or follicular thyroid cancer

Papillary thyroid cancer and follicular thyroid cancer may be described as low risk, intermediate risk or high risk.

Survival statistics for thyroid cancer

Survival statistics for thyroid cancer are very general estimates. Survival is different for each stage and type of tumour.