Papillary and follicular thyroid cancer
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On this page
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What is papillary and follicular thyroid cancer?
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Symptoms of papillary and follicular thyroid cancer
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Causes of papillary and follicular thyroid cancer
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Diagnosis of papillary and follicular thyroid cancer
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Staging and grading of papillary and follicular thyroid cancer
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Treatment for papillary and follicular thyroid cancer
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After papillary and follicular thyroid cancer treatment
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How we can help
What is papillary and follicular thyroid cancer?
Thyroid cancer is not common. The thyroid is a small gland in the front of your neck, just below your voicebox (larynx) and near your windpipe (trachea).
The thyroid gland is part of the endocrine system. This system makes thyroid hormones that help control the way your body functions.
Around 4000 people in the UK are diagnosed with thyroid cancer each year. It is more common in women and people assigned female at birth.
There are different types of thyroid cancer. This information is about papillary and follicular thyroid cancer. We also have information about:
Papillary and follicular thyroid cancer together are called differentiated thyroid cancer (DTC). Differentiated means the thyroid cancer cells look like normal thyroid cells.
About 9 in 10 thyroid cancers (90%) are DTC. They are often treated in the same way. Most people with DTC can be cured.
Papillary
Follicular
Hurthle cell thyroid cancer
Hurthle cell thyroid cancer is a type of cancer that is similar to follicular thyroid cancer. It is treated in the same way.
The information here is about papillary and follicular thyroid cancer.
Related pages
Booklets and resources
Symptoms of papillary and follicular thyroid cancer
In most people, papillary and follicular thyroid cancer develops very slowly. The most common symptom is a painless lump in the neck, that usually slowly gets bigger. Most thyroid lumps are not cancerous (benign) but it is very important to get any lump checked whether it is painful or not.
There are other possible symptoms, such as a hoarse voice that has no obvious cause.
We have more information about the other symptoms of papillary and follicular cancer.
Related pages
Causes of papillary and follicular thyroid cancer
Doctors do not know the exact causes of thyroid cancer. But there are risk factors that can increase your chance of developing it. Having 1 or more risk factors does not mean you will get thyroid cancer.
Having an overactive or underactive thyroid (hyperthyroidism and hypothyroidism) does not increase the risk of developing thyroid cancer.
Some types of non-cancerous (benign) thyroid disease, such as thyroid goitres and nodules can slightly increase the risk of thyroid cancer. Other possible risk factors include having had radiotherapy to the head or neck area, usually in childhood.
We have more information about possible causes of thyroid cancer.
Diagnosis of papillary and follicular thyroid cancer
You usually start by visiting your GP. Your GP will examine the lump or swelling in your neck and ask about any other symptoms you might have. The GP will usually do some blood tests to check how well your thyroid is working.
A lump in the thyroid is sometimes called a nodule. Sometimes a thyroid lump shows up on a scan you may have having for another reason.
If they think that your symptoms could be caused by cancer, they will refer you to a specialist doctor. This is usually within 2 weeks.
At the hospital, the specialist doctor will ask you about your general health, any previous medical problems and your family history. They will also examine you. You may have some of the following tests:
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Blood tests
You usually have blood tests to:
- show how well your thyroid is working and to measure levels of thyroid hormones.
- check your general health, by monitoring how well organs like your kidneys and liver are working.
- measure levels of different blood cells in your blood.
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Ultrasound of your neck
An ultrasound scan uses sound waves to build up a picture of the inside of the neck and the thyroid gland. Your doctor will also check the lymph nodes in your neck to see if any of them are abnormal. The results of the ultrasound scan help the doctors decide if you need to have a fine needle aspiration.
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Fine needle aspiration (FNA)
A doctor gently passes a small needle into the lump or swelling in your neck. They take a small sample of cells and examine it under a microscope, to check for any abnormal cells. This is a type of biopsy.
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Core needle biopsy
Some people may need another type of biopsy called a core needle biopsy. You have a local anaesthetic to numb the area so you should not feel any pain. Your doctor uses a needle slightly bigger than used for the FNA to take a sample of tissue from the lump. They use an ultrasound scan to guide the needle to the right area.
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Surgery
Sometimes it may not be possible to tell the difference between a non-cancerous and a cancerous nodule by biopsy. Your doctor may advise you to have surgery to remove the side of the thyroid where the lump is to help make a diagnosis.
Tests on the cancer cells (molecular testing)
Your doctor may also arrange tests to look for certain gene changes (mutations) in the thyroid cancer cells. This is called molecular testing.
The results might help to diagnose thyroid cancer and affect the type of cancer drug treatment you have.
Further tests
After thyroid cancer is diagnosed you will have further tests, such as scans, to find out the size of the cancer and if it has spread.
We have more information about tests to diagnose thyroid cancer and the type of thyroid cancer you have.
Waiting for test results can be a difficult time. We have more information that can help.
Related pages
Staging and grading of papillary and follicular thyroid cancer
The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.
Knowing the stage and grade helps your doctors plan the best treatment for you.
Unlike most cancers, papillary and follicular thyroid cancers are also staged based on your age.
We have more information about staging of papillary and follicular thyroid cancer.
Treatment for papillary and follicular thyroid cancer
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
- the stage of the cancer
- the risk of it coming back
- the results of tests on the thyroid cancer cells
- your general health and your preferences.
Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions before you agree (consent) to have treatment.
Your cancer team may also give you advice about preparing for your treatment. This is sometimes called prehabilitation. It helps to improve your fitness and diet and to get you ready mentally before treatment.
Treatments include:
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Surgery
Surgery is usually the main treatment for thyroid cancer. Your surgeon may advise you to have all the thyroid removed (total thyroidectomy). Some people may have part of the thyroid removed (lobectomy or partial thyroidectomy). The surgeon may also remove the lymph nodes and tissue around the thyroid.
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Thyroid hormone therapy
After thyroid surgery, your doctor may advise you to take thyroxine (levothyroxine) tablets. It is given to replace the thyroid hormones you no longer make. It also reduces the risk of the cancer coming back after treatment.
We have more information about thyroid replacement therapy.
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Radioactive iodine
If you have all your thyroid removed your doctor may suggest you have radioactive iodine after your surgery. You usually have it as a capsule and may need to stay in hospital for a few days.
The thyroid cells absorb the radioactive iodine and get a high dose of radiation. This destroys any remaining thyroid cancer cells wherever they are in the body and also any normal thyroid cells.
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External beam radiotherapy
Radiotherapy uses high-energy rays to treat cancer. It works by destroying cancer cells in the area being treated.
Sometimes, external beam radiotherapy is used to treat follicular and papillary thyroid cancer. It might be given if surgery cannot remove all the cancer, or the cancer has come back or spread.
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Targeted therapies
Targeted therapies target something in or around the cancer cell that is helping it grow and survive. They might be used if the cancer has stopped responding to radioactive iodine or has spread to other parts of the body. We have more information about targeted therapy for thyroid cancer.
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Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is not usually used to treat follicular or papillary thyroid cancer. Your doctor may suggest it if the cancer comes back after other treatments.
You may have some treatments as part of a clinical trial.
We have more information about treating papillary or follicular thyroid cancer.
After papillary and follicular thyroid cancer treatment
Follow up after treatment for papillary and follicular thyroid cancer
You will have regular check-ups during and after your treatment. Follow-up appointments are a good time for you to talk to your cancer doctor or specialist nurse about any concerns you have.
Tell them as soon as possible if you have any problems with treatment side effects or notice new symptoms between appointments.
You will have regular blood tests which can help tell if there are any remaining thyroid cells. You may have other tests to find out if you need any more radioactive iodine treatment. Some people might need further scans.
We have more information about follow-up care after treatment.
Wellbeing and recovery
It can take time to recover after thyroid cancer treatment. Some days you may feel better than others.
A healthy lifestyle can help speed up your recovery. Even small lifestyle changes may improve your wellbeing and long term health.
Even if you already have a healthy lifestyle, you may choose to make some positive changes after treatment. We have more information on leading a healthy lifestyle after treatment.
More information and advice
We know cancer can affect you physically, emotionally and financially. We have information and advice about different ways cancer might impact you, such as help with:
Support after papillary and follicular thyroid cancer
People often have many different feelings when they finish papillary and follicular thyroid cancer treatment. You may feel relieved that treatment has ended, but worried about what will happen in the future.
It is important to know where to get support or information if you need it. People often need support even if it has been some time since they finished cancer treatment. But sometimes it is difficult to know who to ask for help.
To find support:
- ask your GP or someone from your cancer team for advice about support in your area
- find cancer support services near you
- call the Macmillan Support Line on 0808 808 00 00
- chat to our cancer information specialists online
- visit our Online Community thyroid cancer forum to talk to people who have been affected by thyroid cancer, share your experience, and ask questions.
The HOPE programme is a free 6 week self-management course designed to help you develop techniques and strategies when living with or after cancer.
Topics include goal setting, fatigue management, and wellbeing. You can sign up for the online HOPE programme. Or to find out more about face to face programmes in your area, email ServiceOpsSupport@macmillan.org.uk
Other organisations who offer information and support
There are also other organisations that can give you information and support. These include:
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our thyroid cancer information. If you would like more information about the sources we use, please contact us at
informationproductionteam@macmillan.org.uk
National Institute for Health and Care Excellent (NICE). [NG230]. Thyroid cancer: assessment and management. Published: 19 December 2022. Available from: www.nice.org.uk/guidance
Datta, R. British Medical Journal Best Practice Guidelines, Thyroid cancer. 2023. British Medical Journal. Available from: www.bestpractice.bmj.com/topics/en-gb/263
European Society Medical Oncology (ESMO): Thyroid cancer, Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up. 2019. Available from: www.annalsofoncology.org/article/S0923-7534(20)32555-2/fulltext
Date reviewed
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