Understanding Thyroid Cancer Types & Treatment Options

“Our thyroid gland is a butterfly shaped endocrine gland that sits in front of our windpipe. We think of it as kind of our energy driver. Its main purpose is to produce thyroid hormone,” Stephanie Giparas, a physician assistant at the Endocrine and Head and Neck Department at Moffitt Cancer Center, tells SurvivorNet.

“The thyroid hormone not only regulates our metabolism, but almost every organ system in our body uses thyroid hormone. It supports our heart, it supports our brain. So you cannot live without thyroid hormone.”

The thyroid is responsible for several functions throughout our body, including:

• Metabolism: The thyroid produces hormones — mainly thyroxine (T4) and triiodothyronine (T3) — that influence how fast your body uses energy (your “metabolic rate”).
• Heart Rate and Blood Pressure: These hormones help control how quickly your heart beats, which can also affect blood pressure.
• Body Temperature: By affecting the speed at which your cells operate, thyroid hormones play a part in regulating body temperature.
• Other Functions: The thyroid also works closely with the pituitary gland in your brain. This gland makes thyroid-stimulating hormone (TSH), which signals the thyroid to release more or fewer hormones based on your body’s needs.

It’s important to know that having an overactive or underactive thyroid does not necessarily increase the chance of developing thyroid cancer. Many people experience hyperthyroidism (when the thyroid produces too many hormones) or hypothyroidism (when the thyroid does not produce enough hormones) without ever developing cancer, but these conditions should be treated to correct the hormonal imbalance they represent.

What Is Thyroid Cancer?

Thyroid cancer occurs when cells in the thyroid gland begin to grow out of control, sometimes forming nodules or lumps. It usually grows slowly, and most cases can be successfully treated.

In the United States, close to 53,000 people receive a thyroid cancer diagnosis each year. Although it can happen at any age, it’s most frequently diagnosed in women in their 40s and 50s and in men in their 60s and 70s.

Risk factors include:

• Exposure to Radiation: Head or neck radiation treatments during childhood, or exposure to higher radiation levels (for example, nuclear accidents), can increase risk.
• Family History: Certain genetic conditions (especially affecting the RET gene) can raise the likelihood of developing some types of thyroid cancer.
• Iodine Deficiency: The thyroid uses iodine to make hormones, so low iodine intake can sometimes be linked to certain thyroid problems. However, because salt is often iodized in many countries, this is less common in places like the U.S.
• Gender and Age: Thyroid cancer is three times more likely in women. It is frequently found in women in midlife and men in later years.

Types of Thyroid Cancer

Thyroid cancer is generally grouped based on the specific cells it develops from. Understanding these differences can help you work with your healthcare team to decide on the right treatment plan.

Differentiated Thyroid Cancers

“Differentiated” means that the cancer cells still look somewhat like normal thyroid tissue under the microscope. These typically start in follicular cells, the part of the thyroid responsible for making hormones.

• Papillary Thyroid Cancer (PTC): This is the most common type, making up about 80% of thyroid cancer diagnoses. It tends to grow slowly and is highly treatable, with an excellent cure rate. It usually develops in just one part (lobe) of the thyroid. Even when it spreads to nearby lymph nodes, most patients do very well with treatment. Papillary Thyroid Cancer has a near-100% five-year survival rate if found early and still localized. Even when it spreads, the survival rate is very encouraging.
• Follicular Thyroid Cancer: This is the second most common, making up about 10% of thyroid cancers in the U.S. It can spread through the bloodstream to lungs or bones. It still usually grows slowly and often responds well to treatment. Follicular Thyroid cancers have excellent long-term outcomes when diagnosed early.

• Oncocytic Thyroid Cancer (Hürthle Cell Cancer): This is a less common type once considered part of follicular cancer. It can be more challenging to treat but, if detected early, outcomes can still be good.

“Although papillary thyroid cancer is the most common, the other types of cancers tend to be more aggressive and tend to spread more widely, at least in advanced cases,” Dr. Orloff explains.

Non-differentiated Thyroid Cancers

Non-differentiated cancers can come from the thyroid’s calcium-controlling cells, from the immune cells that fight infections within the thyroid, or from follicular cells that are so mutated that they no longer look much like thyroid cells under a microscope.

• Medullary Thyroid Cancer (MTC): This type of cancer arises from the C cells of the thyroid, which make the hormone calcitonin. These make up about 2% to 5% of all thyroid cancers and can sometimes be inherited (through changes in the RET gene). This inherited form, called Multiple Endocrine Neoplasia type 2 (MEN2), can appear in childhood or early adulthood. MTC can spread to lymph nodes, lungs, or liver before a noticeable thyroid nodule appears. The prognosis for MTC depends on how early it’s found and whether it’s inherited or sporadic. Ongoing research and targeted therapies show positive results for many.
• Anaplastic Thyroid Cancer: This is the rarest and most aggressive type, making up about 1% to 2% of all thyroid cancers. It occurs mostly in older adults and often grows and spreads rapidly, sometimes from a pre-existing papillary or follicular cancer that has gained new mutations. It can be hard to treat successfully, but a combination of surgery (if possible), chemotherapy, targeted therapy, and radiation may help slow progression.

“Medullary thyroid cancer is a completely different cell of origin,” Dr. Orloff explains. “Medullary cancer is treated with surgery. There are targeting agents that can treat it when it’s wide-spread. It is monitored through a separate blood test called calcitonin.”

Targeted therapies have also been successful at shrinking aggressive anaplastic thyroid cancers, Dr. Orloff explains, to the point where they can be surgically removed.

“Then the patient can go onto have additional chemotherapy and radiation therapy and can actually achieve a cure,” she says. “Anaplastic is a horribly aggressive cancer, but if it’s caught early and it is treated in a multidisciplinary way, it actually has become a type of cancer that can be cured.”

Finding Strength and Moving Forward

Thyroid cancer, like any cancer, brings a flood of emotions — fear, uncertainty, sadness, and sometimes anger. Yet there is genuine hope on the horizon for most people diagnosed with this disease. With proper treatment, the vast majority reach remission (no evidence of disease) and go on to live full, active lives. Even in more complex cases, advancements in medical science are continually improving outcomes and opening new possibilities.

• Stay Informed, Stay Empowered: Ask your doctor questions about the type of thyroid cancer you have, potential side effects of treatments, and what to expect down the road.
• Lean on Loved Ones: Friends, family, and significant others can provide both emotional comfort and practical assistance (rides to appointments, help with cooking, etc.).
• Seek Support Groups: Hearing from others who have faced or are facing thyroid cancer can help you feel less alone. These groups often share coping strategies and help everyone involved find a sense of camaraderie and understanding.
• Take It Day by Day: Recovery — whether it’s physical or emotional — doesn’t happen overnight. Celebrate small milestones, like finishing radiation or noticing improved energy levels.

Questions To Ask Your Doctor

• What type of thyroid cancer do I have?
• What is the standard of care for this type?
• How will I be monitored after treatment?
• Are there any clinical trials I should consider enrolling in?

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