Metastatic papillary thyroid cancer is when papillary thyroid cancer has spread to distant parts of your body, such as your bones or lungs.

Metastatic papillary thyroid cancer, also called metastatic papillary thyroid carcinoma, is more difficult to treat than cancer limited to the thyroid gland or surrounding tissue.

Surgery that removes part or all of the thyroid gland can successfully treat most people with early stage papillary thyroid cancer.

People with metastatic papillary cancer often need additional treatment, such as radiation therapy or targeted therapy.

Read on to learn more about metastatic papillary thyroid cancer, including how it’s treated and its outlook.

Papillary thyroid cancer is the most common type of thyroid cancer. It makes up about 80–85% of cases. It gets its name from the appearance of finger-like projections called papillae coming from cancer cells.

At the time of diagnosis, most people have the disease contained in the thyroid gland or surrounding tissue.

Only about 2.1% of cases in the United States diagnosed from 2011–2020 had metastatic disease at the time of diagnosis.

“Metastatic” cancers are those that spread from beyond the original organ to distant tissues through the blood or lymph systems. The new cancer locations are called metastases.

The most common locations of papillary thyroid cancer metastases are the:

  • lungs
  • bones, such as the:
    • sternum
    • pelvis
    • vertebrae
    • femur
    • ribs

Is metastatic papillary thyroid cancer curable?

Metastatic papillary thyroid cancer is more difficult to treat than papillary cancers that haven’t spread to distant locations. However, it has a better chance of cure than most other types of metastatic cancer.

People with metastatic papillary thyroid cancer live at least 5 years after their diagnosis about 75% as often as a person without thyroid cancer.

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Metastatic papillary thyroid cancer is also called stage 4 or stage IV papillary thyroid cancer.

“Stage 4” comes from the American Joint Committee of Cancer (AJCC)’s TNM system, which stages cancer based on three factors:

  • T: the size of the tumor
  • N: the number of nearby lymph nodes it has spread to
  • M: metastasis, whether the cancer has spread to distant organs

Papillary thyroid cancer by stage

Here’s a brief overview of how papillary thyroid cancer varies by stage using the AJCC’s TNM system:

  • Stage 1: The cancer is contained to the thyroid gland or surrounding lymph nodes in a person younger than 55 years.
  • Stage 2: The cancer has spread to nearby lymph nodes or distant tissues in a person younger than 55.
  • Stage 3: The cancer has grown extensively beyond the thyroid gland and spread to nearby lymph nodes in a person older than 55 but hasn’t spread to distant tissues.
  • Stage 4: This stage is only for people over 55 years old. In this stage, cancer has spread to distant tissues in or extensively beyond the thyroid gland toward the spine or major blood vessels.
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Your thyroid gland requires an essential mineral called iodine to create thyroid hormone. Whether papillary thyroid cancer cells uptake iodine influences how doctors treat the cancer.

Metastatic papillary thyroid cancers that uptake iodine are treated with:

Metastatic papillary thyroid cancers that don’t uptake iodine can be treated with:

Learn more about thyroid cancer treatment options.

Doctors often use a 5-year relative survival rate to measure the survival rate of a cancer. This statistic is a measure of how many people with a cancer are alive 5 years later compared with people without the cancer.

Here’s a look at the 5-year relative survival rate for papillary thyroid cancer in the United States from 2012–2018:

Stage5-year relative survival rate
localized (contained to thyroid)greater than 99.5%
regional (contained to nearby tissues)99%
distant (metastatic)74%
all stagesgreater than 99.5%

In a 2021 study, researchers found that people who received a diagnosis of metastatic thyroid cancer in the United States from 1975–2016 had poorer survival if the cancer had spread to multiple organs or the brain.

People younger than 40 years with thyroid cancer tend to have a better outlook.

Metastatic papillary thyroid cancer is more difficult to treat than cancer that hasn’t spread to distant parts of your body. However, it still has a better outlook than many other types of cancers.

Treatment for metastatic papillary thyroid cancer usually involves removing your thyroid gland. You may also receive additional treatments, such as radioactive thyroid therapy or targeted therapy.

Getting treatment as soon as possible may improve your outlook.