Thyroid Cancer
Thyroid cancer is uncommon, about 4,000 Australians a year, and most types are very treatable: about 97 in 100 people are alive 5 years later. Most thyroid lumps are not cancer at all.
Thyroid nodules are like emails marked ‘urgent’: very common, and most of them aren’t.
See your GP soon for a lump in the neck that’s new or growing, a hoarse voice lasting more than 3 weeks, trouble swallowing, or swollen glands in the neck that don’t settle.
The numbers
- About 4,000 new cases a year in Australia, about 7 in 10 in women
- About 97% are alive 5 years after diagnosis
- Thyroid nodules are very common: about half of people over 60 have one on ultrasound. Over 9 in 10 are harmless
- Cases rose for years mainly because scans pick up tiny, slow cancers that may never have caused harm
Types
- Papillary: the most common. Slow-growing, usually curable
- Follicular: also usually very treatable
- Medullary: rarer. Sometimes runs in families (ask about gene testing)
- Anaplastic: rare and aggressive, mostly in older people
Tests
- A TSH blood test to check how the thyroid is working
- A neck ultrasound: the shape and features of a nodule decide whether it needs testing
- A fine-needle biopsy takes cells from suspicious nodules. Small, low-risk-looking nodules are often just watched
Sometimes the best treatment for a tiny thyroid cancer is a calendar reminder for the next ultrasound. Doing less can be the right call.
Treatment
- Surgery to remove half or all of the thyroid is the main treatment
- Radioactive iodine after surgery for some, to mop up remaining thyroid cells
- After removing the whole thyroid you take thyroxine tablets every day for life
- Active surveillance (regular ultrasounds) is an option for some very small papillary cancers
- Regular blood tests (thyroglobulin) and ultrasounds check it hasn’t come back
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Iodine or ‘thyroid support’ supplements to shrink nodulesThey don’t treat thyroid cancer and can upset thyroid levels.
- Full-body scans to ‘check for cancer’They find lots of harmless thyroid nodules and lead to tests you didn’t need.
Common questions
Is a thyroid nodule cancer?
Usually not. More than 9 in 10 thyroid nodules are harmless. An ultrasound decides which few need a needle test.
Is thyroid cancer curable?
Most types are very treatable: about 97% of Australians are alive 5 years after diagnosis. Anaplastic thyroid cancer is the rare exception.
Will I need thyroid tablets after surgery?
If the whole thyroid is removed, yes: one thyroxine tablet a day for life, with regular blood tests. After half is removed, many people don’t need them.
Helpful resources
- Cancer Council 13 11 20Information and support line for anyone affected by cancer. Free.
Evidence and more information
maladywise.com/thyroid-cancer/