If there is no distant metastasis, surgery is definitely the first choice, and after surgery, some endocrine therapy will be done to follow up the comprehensive treatment. In general, surgery is still the preferred treatment method. Clinically speaking, for patients who can undergo surgery and those who have the conditions to do so, surgery should be the primary treatment. There are many palliative treatment methods, and sometimes they may be misleadingly advertised as the main treatment of choice for thyroid cancer. What are the types of thyroid cancer? In terms of clinical categories, thyroid cancer is divided into differentiated thyroid cancer and hypofractionated thyroid cancer. Differentiated thyroid cancer includes papillary carcinoma and follicular carcinoma. Papillary carcinoma accounts for more than 90% of all thyroid cancers and has a better prognosis. Follicular carcinoma has a relatively poor prognosis. These two types of thyroid cancer are better differentiated types. Undifferentiated thyroid cancer includes medullary carcinoma and undifferentiated carcinoma, both of which are relatively poor. Is there any case of papillary thyroid cancer with poor prognosis? There are relatively few patients with papillary carcinoma who have a poor prognosis after treatment. Generally, the poor prognosis is mainly due to the fact that some patients come to the clinic late and lose the chance of surgery or have lung or bone metastasis at an early stage, which locally infiltrates the trachea and esophagus and is difficult to remove and the metastases are not well controlled. Overall, if detected and treated properly, papillary carcinoma can be treated with good results. There are ten subtypes of papillary carcinoma, including diffuse sclerosing type and high columnar type, which have relatively poor prognosis and higher invasive and metastatic rate. Some people may ask why lymph node metastasis occurs in papillary carcinoma, even though some of the tumors are smaller. It is because there are some differences in subtypes and genetic aspects. What are the contraindications and indications for surgery? Some people are not suitable for surgery because their heart and lungs cannot tolerate it, they are very old, and they have metastasis. On the contrary, if the physiological aspects are good and there is no obvious metastasis, we will do surgery, and even if some patients have good physiological functions, even if distant metastases appear, we can still strive for surgery to cut off the local metastases and then continue with endocrine therapy. It is also possible to treat distant metastases of papillary carcinoma, and it is not absolutely impossible to do surgery when there are metastases. The main problem is to analyze what type of tumor is and what is the physiological condition of the main organs of human body, and to make a comprehensive judgment whether to do or not to do surgery, and whether to get the benefit or not to get the benefit. Surgery is not the purpose, but the purpose is that the patient can get benefits through surgery. If the thyroid disease is benign and there are no symptoms of pressure and no cosmetic changes, then it is not done. In malignant thyroid disease it is not about the size of the nodule, if we can fight to do it we have to fight to do it.