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Papillary Thyroid Cancer
Sunday, 01 March 2009 12:18


What is thyroid papillary carcinoma?  What should I expect?


Papillary carcinoma accounts for 70% of all thyroid cancers.  This is the most common type of thyroid cancer as well as the least dangerous type of thyroid cancer.   It is slow growing and spreads slowly.  It is also the most treatable and has the best prognosis.  If you had to get cancer this is the cancer to get!


Overall death rate from papillary carcinoma is less than 10%.  The final prognosis depends on the age of the patient, size of the cancer and if there has been any invasion in surrounding tissue or lymph nodes.   Prognosis is better in younger patients with a tumor size of less than 2 cm without metastases.  However, even if the thyroid cancer is less then 4cm the prognosis is still excellent.  In older patients or patients that have had metastases and/or lymph node invasion recurrence rate and death rate is slightly higher.   


Papillary carcinoma usually presents between 30-40 years of age.1   It is more common in women than in men in a 2:1 ratio.  Within the last decade the ratio has been increasing to almost 3:1.  Papillary carcinoma has a strong tendency to spread within the thyroid gland, invade local tissue and to the lymphatic system.  About 10% of patients will have a metastasis of the cancer within the course of the patient’s life.  The most common area for thyroid cancer to spread is the lung, bone, or central nervous system.


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The treatment for papillary carcinoma typically involves thyroid surgery, iodine radiation therapy, daily thyroid hormone replacement therapy, and yearly ultrasound and blood thyroglobulin monitoring.  The initial treatment is the most challenging.  Follow-up tends to be routine.


If the fine needle aspiration pathology report is papillary carcinoma a total thyroid removal surgery is often recommended.  If pathology results are suspicious for papillary thyroid cancer typically half of the thyroid is removed and analyzed.  If no cancer is found, excellent!  You can go on with the rest of your life with confidence that you do not have thyroid cancer.  However, if papillary cancer is found then a second surgery must be done to completely remove the thyroid.   There is also an option to have the nodule tested by pathology while one is still in the operating room.  If this is the case then one may only have to have one surgery.  Your doctor will discuss the options available.



If your doctor reports that after surgery more thyroid cancer was found on both sides of your thyroid gland (multifocal disease), don’t worry.  Studies have shown has many as 80% of patients have multifocal disease.2   This has little influence on the prognosis of the disease.


There are four main criteria that are considered for prognosis:


1.  Patient’s age - the older one is the worse the prognosis (great then 45 years old)

2.  Cancer size - the larger the cancer the worse the prognosis (greater than 4cm)

3.  Grade of cancer - the higher the grade the worse the prognosis

4.  Extrathyroidal spread - the more the cancer the spread the worse the prognosis


Overall, papillary thyroid cancer has very low death rate regardless of treatment method.  One can be cured of papillary carcinoma with the treatments available today.  If you had to get cancer, this is the one to get!


Last Updated on Friday, 17 February 2012 11:28

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