Staging Of Thyroid Cancer

Like with other cancers it has been found that staging of the cancer into four categories is useful for predicting survival and treatment options. However, it may not be as useful as in other cancers, as the prognosis of thyroid cancer is dictated more by the cell type of the cancer as mentioned above. However, it is also true that a local tumor with very little mass has a much better prognosis than a tumor with a large mass and invading surrounding tissue (Ref. 2).

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Without proper staging to indicate how far the cancer has spread, the physician would not be able to advice which therapy gives the best long-term result in a particular case. If a physician assumes that the thyroid tumor is only local, but in reality it is spread, the local cancer therapy would fail miserably. 

Staging of thyroid cancer
StageExtent of thyroid cancer
Itumor 1 cm or less
IImore than 1 cm, but less than 4 cm
IIImore than 4 cm
IVtumor extends beyond thyroid gland

It is therefore important to be as thorough as we can with our present diagnostic knowledge to get proper staging as this allows the physician to recommend a therapy which will improve long-term survival for this particular patient with thyroid cancer.

There may be other tests required such as MRI scanning, CT scanning or bone scans as well as various blood tests. At the end of this testing period the doctor usually schedules an appointment where all of the findings are discussed with the family. In my opinion it is important that the whole family be involved, as some of the cancer therapies are rather invasive. It is also good to have several witnesses who hear the whole comprehensive treatment plan. Their support is invaluable and will ensure that the patient will follow through with the entire treatment program.

A patient can feel overwhelmed and upset by the multitude of details surrounding his treatment schedule. Fortunately, for the majority of thyroid cancers the prognosis is good. Only the poorly differentiated cancers and the older patients with thyroid cancer, where the immune system tends to be weak, have a poorer outcome.

Do not be afraid to ask the physician questions. It is the patient's right to be fully informed.



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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Thyroid tumors.

2. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B.  LippincottCo.,Philadelphia, 1993.Thyroid tumors.

3. CC Cheung et al. J Clin Endocrinol Metab 2001 May;86(5):2187-2190.

4. F Dede et al. Clin Nucl Med 2001 May;26(5):396-399.

5. S Hermann et al. Int J Cancer 2001 Jun 15;92(6):805-811.

6. I Sturm et al. J Clin Oncol 1999 May;17(5):1364-1374.

7. VL Greenberg et al. Thyroid 2001 Apr;11(4):315-325.

8. K Ohta et al. J Clin Endocrinol Metab 2001May;86(5):2170-2177.

9. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

10. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc

Last Modified: Jan. 2, 2009