Papillary and follicular thyroid cancers are the most common types of thyroid cancer. They both grow slowly, respond well to treatment, and can often be cured.
Your thyroid gland is a butterfly-shaped gland located across the front of your neck, and its main function is to create hormones that control your metabolism.
According to the Centers for Disease Control and Prevention (CDC), about
The four main types of thyroid cancer are:
- papillary
- follicular
- medullary
- anaplastic
Papillary and follicular thyroid cancer make up about
This article compares the similarities and differences between these two types of thyroid cancer.
Papillary and follicular thyroid cancer are classified as “differentiated” thyroid cancers, which means that the cancer cells resemble normal cells under a microscope. Differentiated cancers tend to spread slowly.
Follicular and papillary cancers are similar in that they both start in the follicular cells. Follicular cells are the main type of cell in your thyroid and produce and secrete the hormones thyroxine (T4) and triiodothyronine (T3).
Papillary thyroid cancer
Papillary cancer is the
Under a microscope, the
- enlarged
- oval shaped
- elongated
In most cases, the cancer is confined to one lobe of your thyroid but can spread to the lymph nodes.
Follicular thyroid cancer
Follicular cancer is significantly less common than papillary thyroid cancer, but it’s still the
Follicular thyroid cancer is generally made up of a solitary mass of cells enclosed in thick tissue. The cancer cells may spread to the surrounding tissue or blood vessels. Follicular cancer is usually defined by the takeover of these tissues without the features of papillary thyroid cancer.
| Papillary thyroid cancer | Follicular thyroid cancer | |
|---|---|---|
| Prevalence | about | about |
| Type of cells affected | follicular cells | follicular cells |
| Symptoms and characteristics | · hoarseness · shortness of breath · trouble swallowing · more likely to spread to lymph nodes | · hoarseness · shortness of breath · trouble swallowing · more likely to spread to distant areas · less likely to spread to lymph nodes |
| Unique risk factors | high iodine intake | low iodine intake |
| Primary treatment | surgical removal | surgical removal |
| Outlook | nearly |
Symptoms of follicular and papillary thyroid cancer are similar. Symptoms usually don’t appear until the tumor grows large enough to put pressure on other structures in your throat.
General symptoms of thyroid cancer include:
Follicular thyroid cancer usually develops as a solitary mass and is more likely to spread to distant parts of your body. The most common areas this kind of cancer spreads to are:
- bones
- lungs
- soft tissues
About
For papillary thyroid cancer, about
Thyroid cancer develops when genetic changes in your thyroid cells cause them to replicate beyond control. Doctors usually don’t know why this happens, but they’ve identified some risk factors.
The thyroid is particularly sensitive to radiation exposure because of its position on your neck. It’s thought that the risk of developing cancer remains elevated for more than
Risk factors for papillary cancer
- radiation therapy exposure, especially during childhood
- environmental radiation exposure
- inherited cancer syndromes, in about
5% of cases, such as:- Gardner’s syndrome
- Werner syndrome
- Carney complex type 1
Cowden syndrome
- regions with higher dietary iodine intake
- preexisting thyroid disease
- people who are overweight or have obesity
Risk factors for follicular cancer
Risk factors for follicular cancer are similar and include:
- inherited cancer syndromes such as:
- Carney complex type 1
Cowden syndrome
- regions with lower dietary iodine intake
- radiation exposure
- diabetes
- obesity
- Hashimoto’s thyroiditis
- estrogen therapy
Most thyroid cancers are treated with surgical removal of your thyroid gland. Surgery is the primary treatment for both papillary and follicular thyroid cancer.
If you have your thyroid removed, you’ll need to take thyroid pills to replace your body’s thyroid hormones. If radioactive iodine treatment is part of your thyroid removal therapy, taking hormone replacement pills may be delayed by
Treatment for follicular cancer
Follicular cancer is
- Radioiodine remnant ablation: the destruction of thyroid tissue with radioactive iodine
- Thyrotropin suppressing medication: medications that lower levels of your thyroid hormones by suppressing levels of a hormone called thyroid-stimulating hormone (TSH)
If your cancer has spread to distant body parts, you may also receive treatments such as:
Treatment for papillary cancer
A doctor may recommend the removal of your thyroid gland if you have papillary cancer, but they may recommend removing only one side of your thyroid if the tumor is small.
People with very small cancers may be treated with observation and routine ultrasounds rather than having immediate surgery.
You may receive radioiodine therapy
People who have papillary thyroid cancer have the
If the cancer spreads to distant tissues before it’s diagnosed, the relative 5-year survival rate
People with follicular thyroid cancer have a 5-year relative survival rate of about
Follicular and papillary thyroid cancer are the two most common types of thyroid cancer. Both cancers have high survival rates and can often be cured. Follicular cancer is more likely to spread to distant body parts such as your bones or lungs.
The difference between the two cancers is determined mainly by how cells appear under a microscope. Both cancers develop in cells that produce the hormones T3 and T4, which are called “follicular cells.”
Getting a cancer diagnosis is never easy, but getting a thyroid cancer diagnosis in the early stages gives you the best chance of having a good outlook and catching the cancer before it spreads to distant body parts.
