Everything You Need to Know About Thyroid Carcinoma

Medically Reviewed By Faith Selchick, DNP, AOCNP
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Thyroid carcinoma is a type of cancer that starts in the thyroid gland, which regulates your metabolism, blood pressure, and other body processes. There are several types of thyroid cancers, some of which develop slowly, while others are more aggressive. Read on to learn more about the types, causes, symptoms, and treatments of thyroid carcinomas. This article also discusses diagnostic processes, outlook, and potential complications. 

Overview

A woman looking in the mirror and touching the front of her neck
Constantinis/Getty Images

Cancer begins when cells in your body multiply, and old cells do not die out as they should. The cancer cells grow out of control and crowd out your healthy cells, preventing them from working effectively.

There are different types of cancer. A carcinoma is a form of cancer that begins in the skin or the tissues that line or cover internal organs.

Thyroid carcinoma begins in the thyroid gland. This bowtie-shaped gland sits in the front of your neck, just below your Adam’s apple. The thyroid gland contains many types of cells, and different types of cancer may develop from each of these cells.

Research shows that about 1% to 4% of all cancers are thyroid carcinomas.

An illustration pointing out the thyroid gland in the neck
The thyroid gland sits in the front of the neck. The gland has different types of cells and different types of cancer may develop from each kind of cell. Treatment for thyroid carcinoma may involve the removal of part or all of the thyroid gland. Illustration by Wenzdai Figueroa

Types

There are several main types of thyroid carcinomas.

Differentiated thyroid carcinoma

Differentiated thyroid carcinoma (DTC) may develop in the thyroid follicular cells. This type of thyroid carcinoma makes up 90% to 95% of all thyroid cancers. It includes papillary, follicular, and Hürthle cell thyroid carcinomas.

  • Papillary carcinoma: This cancer usually develops in only one lobe of your thyroid gland. It grows slowly but may spread to lymph nodes in your neck. Treatment for papillary cancer is often successful. Some less common subtypes of papillary cancer may grow and spread more quickly.
  • Follicular carcinoma: This cancer does not usually spread to your lymph nodes but may spread to other parts of your body, such as your lungs or bones. Treatment is usually successful.
  • Hürthle cell carcinoma: About 5% of differentiated thyroid carcinomas are this type. It can be harder to treat.

Medullary thyroid carcinoma

Medullary thyroid carcinoma (MTC) may develop in the parafollicular cells. MTC makes up around 1–2% of thyroid carcinomas. MTC can spread to your lymph nodes, lungs, or liver. It can be more difficult to treat.

Anaplastic thyroid carcinoma

Anaplastic thyroid carcinoma makes up less than 1% of all thyroid carcinomas. This cancer often spreads quickly, and you may not receive a diagnosis until it has already spread. This can make treatment more difficult.

Causes and risk factors

The exact cause of many thyroid cancers is still unknown. However, several factors may increase the risk of developing the disease.

Hereditary conditions

Most people who develop thyroid cancer do not have a family history of thyroid carcinoma. However, about 5% of papillary and follicular carcinomas and 15–30% of medullary carcinomas are inherited.

According to the American Cancer Society, inherited medullary carcinoma often develops during childhood or early adulthood and spreads early.

Other hereditary conditions that may lead to thyroid carcinoma include:

  • familial adenomatous polyposis (FAP)
  • Cowden syndrome
  • familial nonmedullary thyroid carcinoma

Radiation therapy and radiation exposure

People who undergo radiation therapy in infancy or childhood for conditions such as an enlarged thymus, tonsils, or adenoids may develop thyroid cancer. According to experts, cancer can develop as early as 5 years after radiation therapy or 20 or more years later.

Exposure to radiation from nuclear fallout is also associated with a high risk of thyroid cancer, especially in children.

Weight

People who maintain a moderate body weight have a lower risk of developing thyroid cancer. The risk appears to go up as your body mass index increases.

Sex assigned at birth

People assigned female at birth are three times more likely to develop thyroid cancer than those assigned male at birth.

Symptoms

Symptoms of thyroid carcinoma may include the following:

Diagnosis

Your doctor may use the following tests to reach a thyroid carcinoma diagnosis:

  • ultrasound to examine the thyroid gland
  • imaging tests, such as CT and MRI scans, to check if the cancer has spread
  • thyroid scan using a small amount of radioactive iodine
  • biopsy of the thyroid nodule to examine cells from the thyroid
  • blood tests to measure thyroid hormone levels

Treatments

Your treatment plan will depend on the type of thyroid carcinoma you have, its size, and whether it has spread. Treatment options include surgery, radioiodine ablation, and thyroid hormone therapy. In advanced stages, your doctor may recommend radiation therapy and chemotherapy.

Surgery

Surgery is the main treatment option. The type of surgery that your doctor recommends will depend on the size of the tumor, whether it has spread, your age, and whether you have additional health conditions.

If your doctor determines that a lobectomy is necessary, a surgeon will remove the lobe with cancer and, usually, the part of the gland that joins the left and right lobes.

For a thyroidectomy, your surgeon will remove your thyroid gland.

Learn more about thyroidectomy.

Radioiodine ablation

After a thyroidectomy, your doctor may recommend radioiodine ablation (RAI) therapy to target residual thyroid tissue. Your thyroid gland absorbs nearly all of the iodine in your body. Radioactive iodine targets the cells that contain this iodine and has little effect on the rest of your body.

Thyroid hormone suppression therapy

Your pituitary gland makes a hormone called TSH, which helps the thyroid gland make thyroid hormone for the body. This may encourage the production of thyroid cancer cells.

Thyroid hormone suppression therapy helps minimize the amount of TSH hormone your body produces, which may suppress the production of thyroid cancer cells. Most people undergo this therapy after surgery.

Outlook

The outlook for people with thyroid carcinoma varies depending on several factors, such as the type, size, the extent to which it has spread, and other factors, including age.

The outlook is generally good. Researchers estimate that, on average, people with the condition have up to a 95% 5-year survival rate.

A relative survival rate shows how long someone with a specific condition may live after their diagnosis compared with someone without the condition. 

For example, a 5-year relative survival rate of 70% means that 70 out of 100 people diagnosed with a condition are still living at least 5 years from the time of diagnosis.

It’s most important to remember that figures are estimates, and everyone is different. Talk with your doctor about your specific condition.

Complications

If thyroid carcinoma is left untreated, it can spread to your airways, esophagus, or blood vessels. It can also spread to your lungs, bones, and other soft tissues.

In some cases, surgery may lead to a hoarse voice.

Summary

Thyroid carcinoma is a type of cancer that starts in the thyroid gland. There are several types of thyroid carcinomas.

Surgery is the most prevalent treatment option. When treated early, the outlook for people with thyroid carcinoma is good.

Talk with your doctor about the right treatment plan for your situation.

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Medical Reviewer: Faith Selchick, DNP, AOCNP
Last Review Date: 2022 Dec 8
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