Most thyroid cancers have low malignancy, slow growth and distant metastasis, and have a very high long-term survival rate as long as they are detected and treated early and reviewed aggressively.
Long-term survival is not a dream for 90% of thyroid cancer patients
There are four broad pathological types of thyroid cancer: papillary, follicular, medullary, and undifferentiated cancers. More than 90% of patients fall into the first two types, also known as “differentiated thyroid cancer,” and most of them can be cured with surgery or survive for a long time with a 10-year survival rate of more than 90%. Therefore, for most thyroid cancer patients, “how long to live” is not an issue of concern.
In addition to the type of pathology, survival depends on age at onset, size of the tumor, extent of invasion of surrounding tissue, and whether it has metastasized. This is illustrated by the example of differentiated thyroid cancer.
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Age at the time of cancer is an important factor in life expectancy. Generally the older you are, the lower your long-term survival rate. patients over the age of 55 are worse off than those under 55.
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- Tumor size
The study showed that the 5- and 10-year survival rates were 96.7% and 89.9%, respectively, for patients with tumors ≤4 cm in diameter, compared with 88.7% and 68.4%, respectively, for patients >4 cm. This shows that the size of the tumor may be a factor in survival.
- Distant metastases
The presence of distant (lung, bone, brain) metastases is a bad sign. One study suggested that the 5- and 10-year survival rates were 95.3% and 88.9%, respectively, for patients without distant metastases, and decreased to 74.9% and 53.1%, respectively, for those with distant metastases.
In addition, the surgical approach, margin condition, and lymph node metastasis may also affect survival.
In summary, long-term, high-quality survival is possible for more than 90% of patients with thyroid cancer with aggressive treatment and close follow-up.
Medullary carcinoma: long-term survival for most patients
Medullary carcinoma is a relatively rare type of thyroid cancer that is poorly differentiated and accounts for about 5% to 10% of thyroid cancers. The outcome for patients is less optimistic than for differentiated thyroid cancer, but better than for undifferentiated cancer. The survival rates at 5, 10, and 15 years were 85.4%, 77.4%, and 73.1%, respectively, from previous cases of medullary carcinoma treated at the Cancer Hospital of Fudan University, where the author works.
Undifferentiated carcinoma: Toward aggressive treatment
Undifferentiated thyroid cancer, the least common type of thyroid cancer, is highly malignant, accounting for 1% to 7.5% of thyroid cancers and has the worst outcome. The average survival is only 3 to 6 months, with 1- and 2-year survival rates of about 5% to 15% and 0% to 17%.
Despite this, there are still many patients who live 3 to 5 years or more. Therefore, statistics from large populations are not representative of individuals, so don’t be discouraged to cooperate with your doctor and fight your cancer tooth and nail.
Co-written by Dr. Hongyi Jiang, Cancer Hospital, Fudan University