(A patient asked, “Can you tell me about survival expectations after thyroid cancer surgery? This is a question that patients want to know very much and is difficult for doctors to answer, but I hope you will answer it with great interest. Everyone knows that thyroid cancer is a “good cancer”, but people who do not have the disease cannot understand the feelings of patients with thyroid cancer. As a thyroid surgeon, I understand why the American Thyroid Cancer Patient’s Association published an article “Why Stop Saying Nail Cancer is Good Cancer”. It is not that the prognosis of thyroid cancer is not good, but that there is no such thing as “good” cancer. The patient’s emotions, the pressure of family and career, the anxiety of review, the follow-up treatment, etc., all these are beyond the understanding of outsiders, and only patients can deeply appreciate them. (In this article, I would like to convey to you the information that thyroid cancer has a relatively good prognosis, and more importantly, to build up your confidence to overcome the disease and build up your faith to live a strong life.) By prognosis, I mean predicting the outcome of the disease, i.e., predicting what will happen to the patient in the future, the possible life expectancy, whether the cancer will be cured or in remission, the occurrence of non-lethal tumor residuals, and the possibility of death based on the manifestations of the disease. In this article, we will only discuss the prognosis of patients with papillary carcinoma, which accounts for the largest proportion of nail cancers. We take for granted that cancer prognosis correlates with the early or late stage of cancer, in this case also the stage of papillary thyroid cancer. Thyroid cancer with stage I or II is considered a low-risk tumor that can have a good prognosis, but thyroid cancer with stage III or IV is usually considered to have a higher risk of residual cancer or recurrence after treatment. Survival rates for papillary thyroid cancer published in the American Cancer Society’s Cancer are: 10-year survival rates are 100% for stage I, 98% for stage II, 82% for stage III, and 38% for stage IV. It can be seen that for patients with stage I or II thyroid cancer, there are essentially no cases of death 10 years after surgery, and death is a small probability event. The Mayo Medical Center in the United States counted 1400 thyroid cancer patients and their survival rate at 25 years also reached 97% and the survival rate at 30 years was 75%-80%, which means that most patients are still alive 30 years after surgery. The above survival rates are for the population and are somewhat different for the individual. Because tumor staging only takes into account the patient’s age, tumor size or local invasion, lymph node metastases and distant metastases. But there may be many other prognosis-related factors, for example, different pathological subtypes of papillary thyroid cancer may also lead to different outcomes, including hypercellular variant, columnar cell variant and insular papillary thyroid cancer, which may have a poorer prognosis. In addition, the treatment modality also has an impact on the prognosis. Proper treatment can improve the patient’s prognosis, and there is a suitable treatment modality for each patient. For example, for an early stage microscopic carcinoma, glandular lobectomy may be sufficient, and even if the treatment modality is expanded or even radiation iodine treatment is performed, the prognosis will be the same for him. For example, some scholars have found that patients with Hashimoto’s thyroiditis have a better prognosis than those without. There may be many other prognostic factors for patients, and it may require doctors to observe patients for a long time before they can make more detailed and accurate judgments about the disease process and tumor behavior of patients and predict the disease outcome more accurately. In addition, the patient’s attitude towards life is very important. Maintaining an optimistic attitude and positive behavior will fill the patient’s heart with the value of survival, while being pessimistic and negative in dealing with people will make life much worse. Most of the patients can survive for decades, and it is far more meaningful to live in a limited time and let life shine than to muddle through every day thinking about how much longer they can live, and eventually to harvest a wonderful life.