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Understanding Your Stage of Thyroid Cancer

Thyroid cancer acts differently in each person. Your doctor uses staging tests, such as imaging scans and biopsies, to determine how far it has spread. With the results of these studies, your doctor will assign your cancer a stage.

The stage of cancer is based on the size of a cancerous tumor at the time of diagnosis and whether or not the cancer has spread to lymph nodes or to other organs. The first place cancer is found in the body is called the primary site or primary tumor. Cancer that has spread to distant parts of the body is called metastatic.

With thyroid cancer, your doctor must remove your thyroid with surgery before he or she knows the cancer's stage. The stages of thyroid cancer differ, depending on the type of cancer you have. Here is a summary of the stages for different types of this cancer.

Understanding the Stages of Papillary and Follicular Types

  • Stage I. This stage depends on your age. If you are younger than 45, stage 1 includes a tumor or any size, that may or may not have spread to nearby lymph nodes, but has not spread to distant sites. If you are 45 or older, you have stage I cancer if the tumor is small (subdivided as less than or equal to 1 cm or greater than 1- 2 cm), is still within the thyroid, and has not spread to the nearby lymph nodes or to distant parts of the body.

  • Stage II. This stage also depends on your age. If you are younger than 45, stage 11 includes a tumor of any size that may or may not have spread to nearby lymph nodes, but has spread to distant sites. If you are 45 or older, the size of the tumor is between 2 and 4 centimeters, and the cancer has not spread to the nearby lymph nodes or to distant parts of the body, you have stage II cancer.

  • Stage III. This stage applies to people age 45 or older. You have stage III cancer if the tumor is bigger than 4 centimeters, or if the cancer has started to spread just outside the thyroid, but has not spread to lymph nodes or distant sites; or the tumor is any size and has spread to the lymph nodes around the thyroid, but not to distant sites.

  • Stage IVA. This stage applies to people age 45 or older. You have stage IVA if the tumor has grown beyond the thyroid gland into nearby structures of the neck, regardless of whether it has spread to the lymph nodes, but it has not spread to distant sites. Or you have stage IVA with a localized tumor that may have minimally grown just outside the thyroid tissue, with lymph node spread to the upper check or behind the throat, but has not spread to distant sites.

  • Stage IVB. This stage applies to people age 45 or older. You have stage IVB if the cancer has spread beyond nearby structures to the blood vessels in your neck or upper chest, or to tissue near your backbone. It may or may not have spread to the lymph nodes, but has not spread to distant sites.

  • Stage IVC. This stage applies to people age 45 or older. If the cancer has spread to distant sites, you have stage IVC, no matter how big the tumor is or if it has spread to the nearby lymph nodes.

Understanding the Stages of Medullary Type

Staging for medullary thyroid carcinoma in people of any age is the same as for papillary or follicular carcinoma in people older than age 45.

Understanding the Stages of Anaplastic Type

Anaplastic thyroid cancer is always stage IV, regardless of tumor size or whether or not it has spread to lymph nodes or distant sites.

  • Stage IVA. You have stage IVA if the tumor is of any size, but has spread to nearby structures. It may or may not have spread to nearby lymph nodes, but it has not spread to distant sites.

  • Stage IVB. You have stage IVB if the tumor has spread beyond nearby structures. It may or may not have spread to nearby lymph nodes, but it has not spread to distant sites.

  • Stage IVC. You have stage IVC if the cancer has spread to distant sites. The tumor may be any size and may or may not have spread to nearby lymph nodes.

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