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Other cancers · free patient guide
Thyroid cancer
Papillary, follicular, medullary and anaplastic thyroid cancer
Head & neck cancer clinic
What it is
Most thyroid cancer is papillary, grows slowly, and is treated with surgery and sometimes radioactive iodine. Some very small, low-risk papillary cancers may be watched rather than operated on.
Medullary thyroid cancer is different: it can be inherited, and finding it should trigger genetic testing for the whole family.
Thyroid nodules are extremely common and the overwhelming majority are benign. The clinical skill here is deciding which nodules need investigating, and avoiding over-treatment of ones that never would have caused harm.
Warning signs worth acting on
- A thyroid lump that is hard, fixed, or growing
- A thyroid nodule with a hoarse voice
- A neck node enlarged alongside a thyroid nodule
- Difficulty swallowing or breathing with a neck swelling
- A family history of thyroid cancer, particularly medullary type
- Previous radiation to the neck, especially in childhood
How it is diagnosed
- Ultrasound of the thyroid and neck nodes, with risk scoring of the nodule
- Fine-needle aspiration of nodules meeting criteria
- Thyroid function tests
- Calcitonin where medullary cancer is suspected
Molecular testing on indeterminate aspirates can help avoid unnecessary surgery. Germline RET testing is essential in medullary thyroid cancer.
Is it inherited?
Medullary thyroid cancer is inherited in a significant proportion of cases, and identifying it allows relatives to be tested and treated before disease develops. This is one of the clearest examples of cascade testing changing outcomes for a family.
Genetic counselling & family risk →
Prevention & early detection
There is no population screening, and screening healthy people for thyroid nodules causes more harm than good. Investigate a nodule that meets criteria, not every nodule.
Treatment options
What may form part of a plan
Which of these apply to you depends on your stage, your pathology, your other health and what you want from treatment. That decision belongs at a tumour board, not on a website.
Surgery
Operability assessment and planning here; the operation at the appropriate partner centre.
Conservative management & active surveillance
Sometimes the right decision is to watch carefully and treat nothing yet.
Radiotherapy
Targeted radiation to a defined area, planned in millimetres.
Hormone therapy
Treatment that removes or blocks the hormones some cancers depend on.
Targeted therapy
Medicines matched to a specific alteration found in your tumour.
Clinical trials
Most Indian patients never learn a trial exists, because nobody is looking.
At KPCIRC
The pathway for this disease
- Risk-scored ultrasound before deciding whether to aspirate, not every nodule needs a needle
- Active surveillance for selected very low-risk papillary microcarcinomas
- Genetic testing in medullary disease, with cascade testing for the family
- Lifelong thyroid hormone management and calcium monitoring after surgery
- Voice assessment where the nerve is at risk
Support that matters most here
Take this with you
Questions to ask your own doctor
These work wherever you are treated. Print the page or take a photograph of this list.
- What was the ultrasound risk score, and does this nodule actually need a needle?
- What type of thyroid cancer is it?
- Is surveillance an option instead of surgery?
- If it is medullary, should my family be tested?
This page is not an emergency service. Severe breathlessness, chest pain, uncontrolled bleeding, a high fever during chemotherapy, or a sudden change in alertness means going to your nearest emergency department now, not reading further.