Thyroid cancer, like all other types of cancer, is given a stage. This stage is used to identify the size of any tumors that are present, as well as how much it has spread in the body. Staging a thyroid cancer is dependent on blood test results, thyroid scans, MRI, CT, and ultrasound results, physical examinations, and the results of a biopsy. Your doctor will use the information from these tests along with information from the pathologist to determine the stage of your cancer, and the appropriate treatment options.
The TNM System
The TNM system is used to delineate the different stages of thyroid cancer. This system uses three different types of information:
- T (Tumor) – This is used to designate the overall size of the main tumor, and whether it has already spread to other organs in the same area.
- N (Nodes) – This is used to identify whether, and how many of, the lymph nodes in the neck are affected by the spread of the cancer. The lymph nodes are generally the first areas affected by the spreading of the primary tumor.
- M (Metastasized) – This is an indicator used to describe whether the cancer has already spread to the lungs, bones, liver, or other organs in the body.
During the staging process, the pathologist will assign numbers between zero (least severe) and four (most severe) to each of the indicators to provide a better understanding of the severity of the thyroid cancer. Once these have been assigned, the cancer is given a Roman numeral of I, II, III, or IV and grouped into the appropriate stage depending on the patient’s age and type of cancer.
Follicular or Papillary Thyroid Cancer Patients Under 45
- Stage I – This designation means there is a tumor present that may or may not have begun to affect the neck lymph nodes, and has not metastasized to other organs.
- Stage II – This cancer has already spread to other organs, with or without spreading to the lymph nodes in the neck.
Follicular or Papillary Cancer Patients 45 and Over
- Stage I – This is used for tumors that are 2cm or less, and have not spread to other parts of the body.
- Stage II – The tumor is less than 4cm, and has not spread to other parts of the body.
- Stage III – This is used for tumors that are 4cm or larger that have not spread, or for tumors of any size that have spread to lymph nodes located near the thyroid.
- Stage IVA – This is used for tumors that have spread only into nearby neck tissues, or those that have spread to lymph nodes in the neck, chest, or throat.
- Stage IVB – Used for tumors that are approaching the spine or large blood vessels in the area.
- Stage IVC – Used for tumors that have spread to other organs in the body
Anaplastic Thyroid Cancer
This type of thyroid cancer is always listed as stage IV due to their severity, and poor prognosis:
- Stage IVA – The tumor is localised to the thyroid, and may have spread to lymph nodes in the neck.
- Stage IVB – The tumor is no longer localised, and may have spread to lymph nodes in the area.
- Stage IVC – The tumor has spread to other organs in the body.
The staging process for cancer may seem quite complicated, but it is a very important part of thyroid cancer diagnosis. Understanding this process, will allow you to have a better grasp on your health situation, and will allow your doctor to choose the best treatment options.
If you have questions or concerns about thyroid problems see your local doctor who will arrange for you to see a thyroid surgeon.
