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Advanced Thyroid Cancer

Overall, thyroid cancers are quite rare, but they are being diagnosed more and more commonly in recent years. The age-adjusted incidence rate was 11.6 per 100,000 men and women per year. Thyroid cancer is nearly three times more common in women than men. There has been an annual 7 percent increase in the number of thyroid cancers diagnosed each year between 1997 to 2009.1 SEER Fast Facts. http://seer.cancer.gov/statfacts/html/thyro.html Accessed February 2013. This increase in incidence might be because of some unknown cause leading to more thyroid cancers or simply because doctors are finding more early stage thyroid cancers due to the widespread use of ultrasound in physicians’ offices.

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Almost all cancers of the thyroid are differentiated tumors (papillary, follicular or Hurthle cell carcinoma). Other thyroid cancers such as medullary or anaplastic, though uncommon, are more likely to behave aggressively and have much poorer prognoses.

A thyroid cancer can be considered advanced if:

  • The type of thyroid cancer is known to behave aggressively (e.g., poorly differentiated thyroid cancer, medullary thyroid cancer).
  • The cancer in the thyroid is behaving aggressively (e.g., has spread outside the thyroid gland or paralyzed a vocal cord).
  • The cancer has spread to the neck or other parts of the body (metastatic thyroid cancer).

In this section, we are going to discuss thyroid cancer, after you’ve reached a diagnosis. Working-up and evaluating thyroid nodules and thyroid masses (most of which are not cancer) is not what we’re talking about here.

For more detailed information regarding the management of thyroid nodules and all stages of thyroid cancer, see the Thyroid Cancer Care Collaborative.

References

1 SEER Fast Facts. http://seer.cancer.gov/statfacts/html/thyro.html Accessed February 2013.

2 Hundahl SA, Fleming ID, Fremgen AM, et al.: A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995. Cancer. 1998;83:2638-2648.

3 Salerno P, De Falco V, Tamburrino A, Nappi TC, Vecchio G, Schweppe RE, Bollag G, Santoro M, Salvatore G. Cytostatic activity of adenosine triphosphate-competitive kinase inhibitors in BRAF mutant thyroid carcinoma cells. J Clin Endocrinol Metab. 2010;95(1):450-455.

4 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Thyroid Carcinoma V.2.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed July 24, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

5 Cooper, D.S., G. M. Doherty, et al. (2009). “Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: the American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer.” Thyroid 19(11): 1167-1214.

6 Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.