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Can You Survive Stage 4 Thyroid Cancer

What Kind Of Treatment Will I Need

Frequently Searched Questions | Thyroid Cancer

There are many ways to treat thyroid cancer but surgery is the main treatment. The treatment plan thats best for you will depend on:

  • The stage of the cancer
  • The chance that a type of treatment will cure the cancer or help in some way
  • Your age
  • Other health problems you have
  • Your feelings about the treatment and the side effects that come with it

Depending on the type and stage of your thyroid cancer, you may need more than 1 type of treatment.

Tests That May Be Done

Blood tests: Blood tests alone cant tell if a thyroid lump is cancer. But they can help show if the thyroid is working the way it should.

Ultrasound: For this test, a small wand is moved over the skin in front of your neck. It gives off sound waves and picks up the echoes as they bounce off the thyroid gland. The echoes are made into a picture on a computer screen. How a lump looks on ultrasound can sometimes help tell if its cancer, but ultrasound cant tell for sure.

Radioiodine scan: For this test, a low dose of radioactive iodine is swallowed or put into a vein. Over time, the iodine is absorbed by the thyroid gland. A special camera is then used to see the radioactivity. Nodules that have less iodine than the rest of the thyroid can sometimes be cancer.

CT or CAT scan: Its a special kind of x-ray that takes detailed pictures of the thyroid and can show if the cancer has spread.

MRI scan: This test uses radio waves and strong magnets instead of x-rays to take pictures. MRI scans can be used to look for cancer in the thyroid, or cancer that has spread.

PET scan: In this test, you are given a special type of sugar that can be seen inside your body with a camera. If there is cancer, this sugar shows up as hot spots where the cancer is found. This test can be very useful if your thyroid cancer is one that doesnt take up radioactive iodine.

Thyroid biopsy

If the diagnosis is not clear after an FNA biopsy, you might need another kind of biopsy to get more cells to test.

General Information About Thyroid Cancer

Thyroid cancer is a disease in which malignant cells form in the tissues of the thyroid gland.

The thyroid is a gland at the base of the throat near the trachea . It is shaped like a butterfly, with a right lobe and a left lobe. The isthmus, a thin piece of tissue, connects the two lobes. A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin.

The thyroid uses iodine, a mineral found in some foods and in iodized salt, to help make several hormones. Thyroid hormones do the following:

  • Control heart rate, body temperature, and how quickly food is changed into energy .
  • Control the amount of calcium in the blood.

There are four main types of thyroid cancer:

  • Papillary thyroid cancer: The most common type of thyroid cancer.
  • Follicular thyroid cancer. Hürthle cellcarcinoma is a form of follicular thyroid cancer and is treated the same way.
  • Medullary thyroid cancer.

See the PDQ summary on Unusual Cancers of Childhood for information about childhood thyroid cancer.

Age, gender, and exposure to radiation can affect the risk of thyroid cancer.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for thyroid cancer include the following:

Signs of thyroid cancer include a swelling or lump in the neck.

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How Is Thyroid Cancer Diagnosed

If you have an enlarged thyroid nodule or other signs of thyroid cancer, your healthcare provider may order one or more of these tests:

  • Blood tests: A thyroid blood test checks hormone levels and gauges whether your thyroid is functioning properly.
  • Biopsy: During a fine-needle aspiration biopsy, your healthcare provider removes cells from your thyroid to test for cancer cells. A sentinel node biopsy can determine if cancer cells have spread to lymph nodes. Your provider may use ultrasound technology to guide these biopsy procedures.
  • Radioiodine scan: This test can detect thyroid cancer and determine if cancer has spread. You swallow a pill containing a safe amount of radioactive iodine . Over a few hours, the thyroid gland absorbs the iodine. Your healthcare provider uses a special device to measure the amount of radiation in the gland. Areas with less radioactivity need more testing to confirm the presence of cancer.
  • Imaging scans:Magnetic resonance imaging , computed tomography and positron emission tomography scans can detect thyroid cancer and cancer spread.

Multivariable Cox Proportional Hazards Model

Thyroid Cancer Stage 4 Survival Rate

Predictors of 5-year DSS included advanced disease and larger tumor size . There was no association between 5-year DSS and gender, number of co-morbidities, race, type of surgery performed, insurance coverage, or hospital volume. The administration of radioactive iodine was protective . The hazard ratio for death from PTC at 5 years was 38 times higher in patients 60 years, compared to patients < 45 years of age . Harrells c-statistic was 0.9452.

Table 2 Multivariable Cox-proportional hazards analysis of predictors of 5-year disease-specific survival

Predictors of 10-year DSS included advanced disease and larger tumor size . There was no association between 10-year DSS and hospital volume, race, co-morbidities, insurance, surgery performed, or gender. The administrative of RAI was protective, with hazard ratio of 0.60. The hazard ratio for death from PTC at 10 years after diagnosis was nearly 30 times higher in patients 60 years, compared to patients < 45 years of age . Harrells c-statistic was 0.9328.

Table 3 Multivariable Cox-proportional hazards analysis of predictors of 10- year disease-specific survivalTable 4 Multivariable Cox-proportional hazards analysis of predictors of 5- year disease-free survivalTable 5 Multivariable Cox-proportional hazards analysis of predictors of 10- year disease-free survival

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Metastatic Or Recurrent Papillary Or Follicular Thyroid Cancer

Treatment is usually a combination of treatment techniques including surgery to remove cancer and radioactive iodine treatment. Surgery for typically consists of removing the entire thyroid if it has not already been performed.

Radioactive Iodine Treatment Research indicates that treatment with radioactive iodine improves survival for patients with thyroid cancer that has spread to nearby lymph nodes or to distant locations in the body.1,2

Metastatic disease that is radiation resistant is treated with systemic chemotherapy medications called multi-kinase inhibitors and precision cancer medicines.

How Does The Doctor Know I Have Thyroid Cancer

Most thyroid cancers are found when patients see a doctor because of new neck lumps . Sometimes doctors find neck lumps during a physical exam. Yet other times thyroid cancer may be found during an ultrasound test for other health problems.

If signs are pointing to thyroid cancer, more tests will be done.

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Keeping Health Insurance And Copies Of Your Medical Records

Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know about your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

What Is The Thyroid Gland

My cancer story stage 4 thyroid cancer

Your thyroid gland is one of many glands that make up your endocrine system. Endocrine glands release hormones that control different bodily functions.

The pituitary gland in your brain controls your thyroid gland and other endocrine glands. It releases thyroid-stimulating hormone . As the name suggests, TSH stimulates your thyroid gland to produce thyroid hormone.

Your thyroid needs iodine, a mineral, to make these hormones. Iodine-rich foods include cod, tuna, dairy products, whole-grain bread and iodized salt.

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Stage 4 Thyroid Cancer Life Expectancy

  • Stage 1: If the tumor is less than 2 cm, the prognosis is good at this stage and has not yet developed beyond the thyroid gland. According to a study, at this stage the person diagnosed 100% is still alive after 10 years.
  • Stage 2: In Stage 2, the tumor is larger than 2 cm, but is still located in the thyroid gland, or has spread to other tissues outside the thyroid gland, but not to the lymph nodes. At this stage, about 93% of the people are still alive after 10 years.
  • Stage 3rd: The tumor has spread to the lymph node or ballot box near the thyroid gland at Stage 3 people diagnosed with medullary thyroid carcinoma in phase 3rd, and still survive for 10 years after about 71%.
  • Phase IV: At this stage, the tumor has spread to the tissues of the neck, trachea, esophagus, throat, or body parts of the skin, such as the lungs or bones. The outlook for the decade has declined significantly: only 21% of the people at this stage are still alive after 10 years.

Stage 4 thyroid cancer life expectancy

Anaplastic Thyroid Cancer Quick Facts:

  • Needle biopsy of a lump in your thyroid or a mass in your neck can tell you that you have anaplastic thyroid cancer!!!
  • Peak onset above 65 years of age
  • Males effected more commonly than females
  • One of the most aggressive and lethal cancers known to mankind
  • Represents only about 1% of all thyroid cancers
  • May be related to radiation or x-ray exposure
  • Spread to lymph nodes of the neck in over 90% of cases
  • Extension of the anaplastic thyroid cancer into adjacent tissue is common
  • Distant spread to lung, bones, and liver commonly occurs even with initial diagnosis
  • Rarely found in younger patients
  • Long term survival only found in patients without evidence of distant metastasis and ability to completely surgically remove all neck disease

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Influence Of The Extent Of Metastatic Disease

To further categorize the effects of the extent of metastatic disease on life expectancy, we categorized patients at least 45 yr old according to the number of metastases as well as according to the involved organ systems. The results of this analysis are given in . It can be seen that patients with few metastases seem to do somewhat better than those with more metastases, and those with lung metastases only seem to do better than those with metastases to the bone or other organs. Unfortunately, the small group size of each of the subgroups leads to a wide margin of error, so that the differences between the groups do not reach statistical significance.

Stage Iv Papillary And Follicular Thyroid Cancer

Thyroid cancers

Treatment of stage IV papillary and follicular thyroid cancer that has spread only to the lymph nodes can often be cured. When cancer has spread to other places in the body, such as the lungs and bone, treatment usually does not cure the cancer, but can relieve symptoms and improve the quality of life. Treatment may include the following:

  • Radioactive iodinetherapy.
  • Surgery to remove cancer from areas where it has spread.
  • Hormone therapy.
  • A clinical trial of chemotherapy.
  • A clinical trial of a targeted therapy.

Check for U.S. clinical trials from NCI’s list of cancer clinical trials that are now accepting patients with stage IV papillary thyroid cancer and stage IV follicular thyroid cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

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Can The Cancer Stage Change

Once diagnosed, a cancers stage never changes. Even if the patient improves or gets worse, their cancer is the same as when diagnosed.

Once diagnosed with stage 4 cancer, you will always have stage 4 cancer. That doesnt mean that you cannot sustain a long period of disease-free survival.

Part of the reason for this is statisticalstages help scientists track and reevaluate survival statistics and treatment protocols. But they also let doctors track the efficacy of treatments for your stage.

Doctors use cancer stages to compare patients with similar diagnoses, to more easily study the effectiveness of treatments, to track a persons cancer progression, and as a way to estimate survival rates for specific cancers.

Part of the confusion regarding staging status arises from the fact the disease is sometimes re-staged. Re-staging determines if there has been a progression or remission of the disease.

If cancer is re-staged or recurs , doctors keep the initial staging diagnosis and add a new stage to the patients diagnosis. New staging diagnoses get differentiated with letterslike c for clinical, p for pathological , or y for after treatment.

For instance, stage 2 breast cancer that suddenly spreads to the lungs is stage 2 breast cancer with lung metastases rather than stage 4 breast cancer. Similarly, if stage 4 breast cancer meets the definition of remission after treatment, they describe it as stage 4 breast cancer with no evidence of disease.

What Is Thyroid Cancer

Thyroid cancer is a type of cancer that starts in the thyroid gland. It happens when cells in the thyroid grow out of control and crowd out normal cells.

Thyroid cancer cells can spread to other parts of the body such as the lungs and the bone and grow there. When cancer cells do this, its called metastasis. But the type of cancer is based on the type of cells it started from.

So even if thyroid cancer spreads to the lung , its still called thyroid cancer, not called lung cancer.

The thyroid

Ask your doctor to use this picture to show you where your cancer is.

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Medullary Thyroid Cancer Is Sometimes Caused By A Change In A Gene That Is Passed From Parent To Child

The genes in cells carry hereditary information from parent to child. A certain change in the RET gene that is passed from parent to child may cause medullary thyroid cancer.

There is a genetic test that is used to check for the changed gene. The patient is tested first to see if he or she has the changed gene. If the patient has it, other family members may also be tested to find out if they are at increased risk for medullary thyroid cancer. Family members, including young children, who have the changed gene may have a thyroidectomy . This can decrease the chance of developing medullary thyroid cancer.

Strategies To Improve Treatment

Thyroid Cancer Journey Video 4

Iodine Resensitization: Radioactive iodine is widely used in the treatment of advanced follicular cell-derived thyroid cancers, but patients may become develop radiation resistant disease. This occurs because of down regulation of the sodium-iodide symporter gene .

Researchers have figured out how to turn or enhance redifferentiation of NIS so that: the cancer cells can be treated with radioiodine again. Retinoids, Selumetinib and Dabrafenib have been shown to restore RAI uptake in advanced patients.10-12

References:

  • Podnos YD, Smith D, Wagman LD, Ellenhorn JD. Radioactive iodine offers survival improvement in patients with follicular carcinoma of the thyroid. Surgery. 2005 128:1072-6.
  • Rosenbluth BD, Serrano V, Happersett L, et al. Intensity-modulated radiation therapy for the treatment of nonanaplastic thyroid cancer. International Journal of Radiation Oncology Biology Physics. 2005 63:1419-26.
  • De Besi P, Busnardo B, Toso S, et al. Combined chemotherapy with bleomycin, adriamycin, and platinum in advanced thyroid cancer. Journal of Endocrinology Investigation. 1991 14:475-80.
  • Pak H, Gourgiotis L, Chang WI, et al. Role of metastasectomy in the management of thyroid carcinoma: the NIH experience. Journal of Surgical Oncology. 2003 82:10-8.
  • Schlumberger M, Makoto T, Wirth L, et al. The New England Journal of Medicine 372:621-630 February 12, 2015.
  • FDA approves Nexavar to treat type of thyroid cancer. . U.S. Food and Drug Administration website. Available at:
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    Thyroid Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Thyroid Gland

    The thyroid is a gland at the base of the throat near the trachea . It is shaped like a butterfly, with a right lobe and a left lobe. The isthmus, a thin piece of tissue, connects the two lobes. A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin.

    The thyroid uses iodine, a mineral found in some foods and in iodized salt, to help make several hormones. Thyroid hormones do the following:

    • Control heart rate, body temperature, and how quickly food is changed into energy .
    • Control the amount of calcium in the blood.

    How Does It Spread

    If a cancerous tumor is discovered in one of your kidneys, the usual treatment is to surgically remove part or all of the affected kidney.

    If the tumor is not removed, its more likely that the cancer will spread to either your lymph nodes or other organs. The spread of cancer is called metastasis.

    In the case of RCC, the tumor can invade a large vein leading out of the kidney. It can also spread to the lymph system and other organs. The lungs are especially vulnerable.

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    What Is A 5

    A relative survival rate compares people with the same type and stage of thyroid cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of thyroid cancer is 90%, it means that people who have that cancer are, on average, about 90% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.

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