Thyroid Cancer Treatment and Survival Rate
June 15, 2024
This page was reviewed under our medical and editorial policy by Jee Won Cheong, D.O., assistant clinical professor, Department of Supportive Care Medicine, Sasan Fazeli, M.D., assistant clinical professor, Department of Diabetes, Endocrinology and Metabolism, and Karen Tsai, M.D., assistant clinical professor, Department of Diabetes, Endocrinology and Metabolism, City of Hope® Cancer Center Duarte.
Thyroid cancer treatment plans are tailored to the disease stage, type of cancer and the patient's general health. Many treatment types are available for thyroid cancer.
Who Treats Thyroid Cancer?
The patient's care team may consist of the following experts:
- Endocrinologists, who manage diagnosis, treatment, follow-up and hormone level evaluations.
- Geneticists, who help with genetic evaluations of thyroid cancer.
- Head and neck and endocrine surgeons, who operate on the thyroid.
- Head and neck oncologists, who stage and treat advanced thyroid cancers.
- Nuclear medicine experts, who use radioactive substances as part of thyroid cancer diagnosis and treatment.
- Pathologists, who evaluate biopsies, tissue and tumors as part of the diagnosis process.
- Pulmonologists, who treat and manage respiratory conditions such as breathing issues.
- Radiation oncologists, who use high-energy beams of radiation to treat cancer.
- Radiologists, who use diagnostic radiology tools to diagnose thyroid cancer and evaluate whether cancer has spread.
- Specialized pharmacies, which supply medications that are difficult to find elsewhere, often for hard-to-treat conditions.
- Supportive medicine providers, who manage cancer- and treatment-related side effects and symptoms.
Thyroid Cancer Surgery
Surgery is a common treatment option for thyroid cancer. Depending on the patient's specific thyroid cancer diagnosis, type and stage, the care team may recommend one of the surgery types listed below.
- Lobectomy. During this procedure, the surgeon removes the lobe (side of the thyroid) containing cancer, leaving the other healthy lobe alone. It may be performed if tumors are small and have not spread beyond the thyroid.
- Total thyroidectomy. In this surgery, the care team removes the entire thyroid gland and may also remove lymph nodes at the same time to determine whether the cancer has spread to them.
- Partial thyroidectomy: During this procedure, the surgeon removes the part of the thyroid that contains cancer. Unlike a total thyroidectomy, however, a small portion of the thyroid that doesn't contain cancer will be left behind.
Drug Therapy
Drug therapy uses medication to kill cancer cells. These therapies may include:
Hormone therapy: Hormones are substances made by glands in the body and circulated in the bloodstream. In patients whose thyroids are no longer making hormones (either due to having the thyroid surgically removed or other causes), a thyroid hormone pill called levothyroxine is prescribed as a thyroid hormone replacement. Depending on the thyroid cancer type and risk of recurrence, the thyroid cancer care team may aim for higher thyroid hormone doses to suppress thyroid cancer growth.
Immunotherapy: Some patients with follicular, papillary, oncocytic, poorly differentiated or anaplastic thyroid cancer are found to benefit from immunotherapy infusions. These medications may help stop cancer growth.
Chemotherapy: This treatment type uses drugs to kill all rapidly dividing cells, including cancer cells. Chemotherapy is not commonly used among thyroid cancer patients, but may be combined with radiation therapy for patients with anaplastic thyroid cancer. It may also be used to treat metastatic (stage 4) thyroid cancer.
Targeted therapy: Unlike chemotherapy, targeted cancer therapy attacks cancer cells while causing less harm to healthy cells in the body. Targeted cancer therapy uses anti-cancer drugs to block the growth and spread of cancer by interfering with specific molecules that are involved in the progression of cancer. Several types of targeted therapy may be used in thyroid cancer patients, depending on the type of cancer.
- RET inhibitors: Certain patients with follicular, papillary or medullary thyroid cancer may experience changes to a specific gene called the RET gene, which triggers abnormal cells to grow. RET inhibitors are developed to attack the RET protein so the cells aren’t able to grow.
- Multikinase inhibitors: Patients with papillary, follicular, poorly differentiated, oncocytic, medullary or anaplastic thyroid cancer may benefit from drugs that block certain types of kinase proteins to diminish cancer growth and spread.
- TRK inhibitors: Some patients with follicular, papillary, poorly differentiated or anaplastic thyroid cancer are found to have changes to their NTRK genes, which may prompt the cancer to grow. These medications may help stop that growth.
- BRAF inhibitors: Certain patients with papillary, poorly differentiated or anaplastic thyroid cancer are found to have changes to the BRAF gene, causing them to produce proteins that help the cancer grow. BRAF inhibitors are drugs that may help stop cancer growth.
- MEK inhibitors: In some cases, thyroid cancer patients may have gene changes that cause them to release MEK protein, which prompts the cancer to grow. MEK inhibitors target the MEK protein to reduce cancer growth.
- ALK inhibitors: Some patients with follicular, papillary, poorly differentiated or anaplastic thyroid cancer are found to have changes to their ALK genes, which may prompt the cancer to grow. These medications may help stop that growth.
The drug or drug combination used depends on the type and stage of thyroid cancer and the patient’s health and overall treatment goals. This personalized medicine approach may be further enhanced by molecular or genetic testing of the patient's cancer, which can help identify treatments that are more effective and with fewer side effects.
Radiation Therapy
Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. Some advanced thyroid cancers or thyroid cancers not amenable to surgical treatment require external beam radiation therapy, which delivers a carefully focused beam of radiation from a machine outside the body.
Radiation therapy may be recommended for patients with medullary or anaplastic thyroid cancer, as well as some patients whose thyroid cancer has spread.
Depending on the cancer, the patient’s health and desired outcomes, radiation therapy may be offered on its own, or in conjunction with surgery and drug therapy.
Patients who have radiation therapy for thyroid cancer may experience side effects such as temporary skin changes that resemble a sunburn, difficulty swallowing, fatigue, dry mouth or a hoarse voice.
The care team will develop a specific radiation therapy treatment plan to aim the radiation beam so it damages minimal tissue outside the thyroid itself, reducing the risk of side effects.
Radioactive Iodine Therapy
Following surgery for follicular cell-derived thyroid cancer, the patient may undergo radioactive iodine therapy. The goal of this treatment is to remove all remaining thyroid cells or thyroid cancer cells anywhere in the body.
Radioactive iodine is taken in capsule form, then travels through the blood to collect in thyroid cells and thyroid cancer cells. The thyroid gland absorbs nearly all the iodine in the blood, so when a large dose of radioactive iodine is taken, the radiation can destroy the thyroid gland and cancer cells with little effect on the rest of the body.
Thyroid Cancer Survival Rate
The five-year relative survival rate for people diagnosed with thyroid cancer is 98.5%, according to data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. This means that close to 99 percent of people with thyroid cancer will likely still be alive five years after their diagnosis when compared to people who don’t have that cancer type. SEER further breaks down survival rates based on how far the cancer has spread:
- Localized thyroid cancer that hasn’t spread outside the thyroid has a five-year relative survival rate of 99.9%.
- Regional thyroid cancer that has spread to nearby lymph nodes has a five-year relative survival rate of 98.3%.
- Distant thyroid cancer that has spread to organs or tissues further away from the thyroid has a five-year relative survival rate of 53.5%.
Survival rates are estimates based on large groups of people, and every patient's experience is unique. The statistics are estimates and may not account for recent treatment advances in place today. In general, early and aggressive treatment has been shown to increase the odds of survival with thyroid cancer. It’s important to talk to the care team about each patient’s individual prognosis, or outlook, when facing thyroid cancer.
Thyroid Cancer Treatment at City of Hope
At City of Hope®, your thyroid cancer will be managed by a team of experts, with expertise in all required fields and in all stages of thyroid cancers. City of Hope offers several unique features, including those listed below.
- Thyroid nodule biopsies with molecular testing, when warranted.
- Supportive medicine specialists to help with pain and symptom management associated with thyroid cancer treatments and surgeries.
- High-volume and skilled head and neck endocrine surgeons who may address advanced thyroid cancer cases and perform robotic surgeries.
- Expert groups of endocrinologists who are skilled in optimizing thyroid hormone levels for thyroid cancer treatment and are experienced in radioactive iodine treatments.
- An advanced radioactive iodine treatment process and isolation program.
- An expert team of head and neck oncologists to help patients evaluate treatment options.
- Availability of clinical trials for advanced thoracic surgeries, tracheal and bronchial evaluations and biopsies.
- Complete diagnostic genetic and molecular testing with a high level of accuracy and quick response times to help guide potential targeted therapy options.
- A specialized pharmacy with the ability to get targeted therapy and immunotherapy required for progressive and advanced cases of thyroid cancer.
- The ability to treat all types of thyroid cancer in all stages and risk levels.
- Multidisciplinary discussion and tumor boards to discuss complex and challenging cases.
- Nonsurgical treatment of noncancerous thyroid nodules that cause compressive symptoms (such as shortness of breath, swallowing problems or voice changes) via radiofrequency ablation and ethanol ablation.