Can you die from thyroid cancer?
It has a very high cure rate. It can cause death but it usually doesn’t. The thyroid nodule is discovered either by the patient himself, accidentally, or by the physician on an imaging study such as ultrasound of carotid, arteries in the neck. Some of these nodules also are benign.
The risk of thyroid cancer increases with age, although it can be diagnosed in children under the age of 5. It is increased when a person has had any kind of exposure to radiation of the neck. Sometimes, the history suggests that radiation was used to treat acne or enlarged tonsils or a sinus gland and sometimes it was used therapeutically for something like Hodgkin’s disease.
The TNM system of the International Union Against Cancer and the American Joint Committee on Cancer is used for staging thyroid cancer. The cause-specific mortality rate in PTC and FTC were: Stage 1, 1.7%; Stage 2, 15.8%; Stage 3, 30%; and Stage 4, 60.9%, with an overall mortality rate of 8.4%. In other words, more than 90% of patients survive longer than 10–20 years, making it one of the most curable cancers. The high rate of survival reflects the concentrated pool of patients (> 80%) in Stages 1 and 2. Other risk-stratification systems such as the AMES (patient age, metastases, extrathyroid invasion, and tumour size) and MACIS (metastases, age, completeness of resection, local invasion, and size) have classified patients into high- or low-risk for cancer recurrence and death in order to guide treatment strategies. The cause-specific causes of death in thyroid cancer are local invasion in a third of cases, distant metastases in a third, and both local and metastatic disease in the remaining third of cases.
Papillary and follicular cancers occur in more than 95% of thyroid cancers, and much of the discussion is applicable to this group of cancers. The combination of total thyroidectomy, followed by RAI therapy, and thyroid hormone replacement therapy to suppress TSH, works effectively in most cases to achieve a high and prolonged survival rate. New diagnostic approaches such as rhTSH and PET have recently emerged to add to the growing multidisciplinary field in the management of this disease.
References
Loh KC, Greenspan FS, Gee L, Miller TR, Yeo PPB. Pathological tumor-node-metastasis (pTNM) staging for papillary and follicular thyroid carcinomas: a retrospective analysis of 700 patients. J Clin
Endocrinol Metab 1997; 82:3553-62.
Sadler GP, Clark OH. Total thyroidectomy. In: Clark OH, Noguchi S, eds. Thyroid Cancer; Diagnosis and Treatment. St. Louis, MO: Quality Medical Publishing, 2000.
Kitamura Y, Shimizu K, Nagahama M, et al. Immediate causes of death in thyroid carcinoma: clinicopathological analysis of 161 fatal cases. J Clin Endocrinol Metab 1999; 84:4043-9.