Is Stage 4 Thyroid Cancer Curable?

Reviewed on 4/30/2021

Thyroid cancer is abnormal growth and uninhibited multiplication of the cells of the thyroid gland.
Thyroid cancer is abnormal growth and uninhibited multiplication of the cells of the thyroid gland.

Thyroid cancer is abnormal growth and uninhibited multiplication of the cells of the thyroid gland. It ultimately results in a gradual decline in the function of the normal cells and eventual deterioration of human health.

The thyroid gland is part of the endocrine system that regulates hormones in the body. The thyroid gland absorbs iodine from the bloodstream to produce thyroid hormones that regulate a person’s metabolic rate. A healthy thyroid gland is barely palpable. If a tumor develops in the thyroid, it is felt as a lump in the neck. A tumor can be cancerous or benign. A tumor is considered malignant when it can grow and spread to other parts of the body. The staging of thyroid cancer and prognosis varies depending on the type of thyroid cancer.

Stage IV thyroid cancer is advanced disease, and cancer has spread beyond the thyroid gland and to distant organs. Stage IV thyroid cancer is difficult to treat, and the prognosis is not as good. Sometimes, only palliative care may be possible if cancer has spread to the brain. A complete cure may not be possible once cancer reaches stage IV. Most types of thyroid cancer have a 100% cure rate in the early stages (stages I and II). Hence, patients should seek treatment as early as possible.

5-year survival rate for thyroid cancer

5-year survival rates for types of thyroid cancer as per the American Thyroid Association
Type of thyroid cancer Stage I Stage II Stage III Stage IV Overall
Papillary 98%-100% 98% 93% 51% 93%
Follicular 98%-100% 98%-100% 71% 50% 8%
Medullary 98% 98% 81% 28% 75%
Anaplastic Always stage IV Always stage IV Always stage IV 7% No data

Types of thyroid cancer

Types of thyroid cancer include:

  • Papillary thyroid cancer: This is the most common form of thyroid cancer. It arises from the follicular cells (cells in the thyroid gland that produce and store thyroid hormones). It occurs most commonly in people between the ages of 30 and 50 years, but it can occur at any age. The prognosis is good, especially in the early stages, with around 98 percent cure rate.
  • Follicular thyroid cancer: It also arises from the follicular cells of the thyroid. It commonly presents in those older than 50 years. Hurthle cell cancer is a rare variant of follicular thyroid cancer, and it is more aggressive. Papillary thyroid cancer and follicular thyroid cancer are sometimes referred together as differentiated thyroid cancer.
  • Anaplastic thyroid cancer: Anaplastic thyroid cancer is a rare type of thyroid cancer that usually occurs in patients older than 60 years. It is very aggressive and grows rapidly. It is very difficult to treat this cancer with a poor prognosis.
  • Medullary thyroid cancerIt arises in the C cells in the thyroid gland. C cells produce a hormone called calcitonin. Elevated levels of calcitonin in the blood may indicate medullary thyroid cancer at an early stage. Calcitonin levels also help monitor treatment.
  • Other rare types: Although extremely rare, some types of cancer can arise in the thyroid such as thyroid lymphoma (arises from the immune cells of the thyroid) or thyroid sarcoma (arises from the connective tissue cells in the thyroid).

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How is thyroid cancer treated?

Treatment for thyroid cancer depends on the tumor size, type of cancer and whether cancer has spread. Treatment options include:

  • SurgerySurgery is the most common treatment for thyroid cancer. Depending on the tumor’s size and location, the surgeon may perform a lobectomy (removing part of the thyroid gland) or thyroidectomy (all of the gland) and may remove nearby lymph nodes where the cancer cells have spread.
  • Radioiodine therapy: In this, the surgeon asks patients to swallow a pill or liquid containing a higher dose of radioactive iodine. The radioiodine shrinks and destroys the diseased thyroid gland along with the cancer cells. This treatment is very safe. The thyroid gland absorbs almost all the radioiodine. The rest of the body has minimal radiation exposure.
  • Radiation therapy: Radiation kills the cancer cells and stops them from growing. External radiation therapy uses a machine to deliver strong beams of energy directly to the tumor site. Brachytherapy (Internal radiation therapy) involves placing radioactive seeds in or around the tumor.
  • Chemotherapy: Intravenous or oral chemotherapy drugs kill the cancer cells and stop cancer growth. Very few patients diagnosed with thyroid cancer will ever need chemotherapy.
  • Hormone therapyThis treatment blocks the release of hormones that can cause cancer to spread or recur.
  • Targeted drug therapy: Targeted drug treatments focus on specific abnormal proteins in the cancer cells. The drugs block abnormalities and can cause death of the cancer cells.
  • Injecting alcohol into cancer: Alcohol ablation involves injecting small thyroid cancers with alcohol using radiological guidance that causes thyroid cancer to shrink.
  • Palliative (supportive) care: This is specialized medical care that focuses on providing relief to patients from pain and other serious symptoms.

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References
https://emedicine.medscape.com/article/851968-overview

https://www.thyroid.org/thyroid-cancer/

https://www.thyroid.com.au/thyroid-cancer/thyroid-cancer-prognosis/

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