Like with other cancers it has been found that staging of thyroid cancer into four categories is useful for predicting survival and treatment options. However, it may not be as useful as with other cancers, as the prognosis of thyroid cancer is dictated not only by tumor size, but also by the histological tumor classification as mentioned above.
Staging of thyroid cancer
Stage Extension of tumor
I : tumor 1 cm or less in diameter
II : more than 1 cm, but less than 4 cm
III : more than 4 cm
IV : tumor extends beyond thyroid gland
Different outcome with a smaller mass versus a larger one
However, it is also true that a local tumor with very little mass has a much better prognosis than a tumor with a larger mass; also, an invading thyroid tumor into the surrounding tissues will have a worse long-term outcome (Ref. 2). Without proper staging to indicate how far the cancer has spread, the physician would not be able to advice which therapy gives the best long-term result in a particular case. If a physician assumes that the thyroid tumor is only local, but in reality it has spread, the local cancer therapy would fail miserably. It is therefore important to be as thorough as we can with our present diagnostic knowledge to get proper staging as this allows the physician to recommend a therapy, which will improve long-term survival for a particular thyroid cancer patient.
Staging of thyroid cancer
There may be other tests required such as MRI scanning, CT scanning or bone scans as well as various blood tests. At the end of this testing period the doctor usually schedules an appointment where all of the findings are discussed with the family. In my opinion it is important that the whole family be involved, as some of the cancer therapies are rather invasive. It is also good to have several witnesses who hear the whole comprehensive treatment plan. Their support is invaluable and will ensure that the patient will follow through with the entire treatment program.
Prognosis of thyroid cancer
A patient can feel overwhelmed and upset by the multitude of details surrounding his treatment schedule. Fortunately, for the majority of thyroid cancers the prognosis is good. Only the poorly differentiated cancers and the older patients with thyroid cancer, where the immune system tends to be weak, have a poorer outcome.
Do not be afraid to ask the physician questions. You as the patient have the legal right to be fully informed.
References
1. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Thyroid tumors.
2. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B. LippincottCo.,Philadelphia, 1993.Thyroid tumors.
3. CC Cheung et al. J Clin Endocrinol Metab 2001 May;86(5):2187-2190.
4. F Dede et al. Clin Nucl Med 2001 May;26(5):396-399.
5. S Hermann et al. Int J Cancer 2001 Jun 15;92(6):805-811.
6. I Sturm et al. J Clin Oncol 1999 May;17(5):1364-1374.
7. VL Greenberg et al. Thyroid 2001 Apr;11(4):315-325.
8. K Ohta et al. J Clin Endocrinol Metab 2001May;86(5):2170-2177.
9. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
10. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc
