How Do You Treat Papillary Thyroid Cancer?

If it’s not treated, papillary thyroid cancer can spread to your lymph nodes and other areas of your body. Compared with many other types of cancer, papillary thyroid cancer is slow-growing and has a generally good outlook, even if it has already spread to your lymph nodes.

If your papillary thyroid cancer spreads to your lymph nodes — as it does in 30–40% of cases, treatment may extend beyond removal of your thyroid gland to include lymph node removal and systemic treatments such as radiation therapy.

Like other forms of cancer, thyroid cancers are most dangerous when they spread to distant areas of your body. Research suggests that in 1–4% of cases, the cancer spreads to distant areas of the body, which can reduce overall survival rates by 25–75%.

Some of the possible sites of spread (metastasis) of papillary thyroid cancer are:

• lymph nodes in the neck
• lungs
• bones
• liver and brain, in rare cases

Surgical removal of the thyroid gland (thyroidectomy) is the primary treatment for papillary thyroid cancer. This surgery can be done rather quickly with a low risk of complications.

It’s possible to live well without a thyroid gland by taking replacement thyroid hormones. Complete removal of your thyroid significantly reduces the chances that your cancer will return or spread after initial treatment.

Active surveillance is another treatment option.

Since papillary thyroid cancer spreads so slowly and can start in very small portions of thyroid tissue, your healthcare team might offer you the option to hold off on aggressive treatment and check the progress of your cancer with regular (usually yearly) ultrasounds.

While thyroid care experts recommended active surveillance nearly a decade ago, a recent survey of thyroid specialists found that a total thyroidectomy is still the preferred treatment in most cases.

Papillary thyroid cancer has the best outlook when treated quickly and effectively.

If you opt for complete thyroid removal as a form of treatment, you can have the surgery within 90–180 days after your initial diagnosis. Longer waiting periods for surgery are usually associated with higher risks of cancer recurrence and other complications.

You can resume most light activities the day after surgery. Voice changes and surgical wound healing could last for several weeks, and most people choose to take 1–2 weeks off from work to recover from this surgery.

A sore throat, pain at the surgical site, voice changes, and voice fatigue are the most common side effects after total thyroidectomy.

Even after your thyroid has been removed, you might undergo radioactive iodine treatments to further reduce the chances that your cancer will return or spread. These treatments can begin a couple days to several weeks after surgery and can cause side effects such as:

• neck tenderness
• neck swelling
• nausea
• vomiting
• salivary gland swelling
• dry mouth
• taste changes
• dry eyes
• fertility changes
• reduced immunity to infections

Papillary thyroid cancer is very treatable and can often be cured with surgery. But in about 20% of cases, cancer cells spread beyond the thyroid gland to cause a recurrence of cancer in another area of the body.

Survival rates vary based on where your cancer appears in a recurrence and where it spreads.

Overall, the life expectancy for people with papillary thyroid cancer is good.

For the most treatable forms of this cancer, the survival rate is 93% at 10 years. If cancer spreads to other areas, survival rates drop by 25–75%, with spread to multiple organs carrying the biggest risk.

For example, for people with papillary thyroid cancer that spreads to one organ, the 5-year survival rate is 77.6%. For people whose papillary thyroid cancer spreads to multiple areas, the 5-year survival rate is 15.3%.

Papillary thyroid cancer is very treatable and is often cured completely with surgery to remove the thyroid gland. Recurrence rates are about 20%, and survival rates drop when cancer spreads from the thyroid gland to more than one other area.

Your healthcare team can help you make treatment decisions based on your specific type and grade of cancer, as well as your treatment goals, overall health, and lifestyle.