Thyroid Cancer Diagnosis Stages

Once cancer has been detected in a patient, doctors begin the process of staging the disease. They use an assortment of diagnostic tests — including physical exams, biopsies and imaging tests — to determine the location and size of the tumor, to see if and where the cancer has spread and to determine how the cancer is affecting other bodily functions.

The information gathered from these tests helps the doctor develop a thyroid cancer treatment plan. After a diagnosis, staging a cancer — final stages or early stages — helps doctors determine a patient’s prognosis.

Cancer stages run from I to IV, with I indicating the most minimal level of cancer and the best survival rate. Most patients dealing with cancer of thyroid glands have a very promising prognosis.

How Are Thyroid Cancer Stages Determined?

When determining cancer stages of the thyroid gland, doctors evaluate the kind of thyroid cancer and the patient’s age. With differentiated papillary and follicular thyroid cancers in particular, stages differ depending on the age of the patient. For example, papillary thyroid patients who are younger than 45 may be classified with a Stage I cancer if it hasn’t spread beyond the neck or lymph nodes. For patients older than 45, Stage I is only designated if the cancer hasn’t spread outside the thyroid at all.

In addition, for papillary cancer only, stages of the disease aren’t adversely affected by finding cancer in lymph nodes in the neck. Cancers of thyroid glands that aren’t differentiated (medullary and anaplastic) are more difficult to quantify and stage.

The TNM System for Classifying Cancer Stages

Introduced in 1987 by the International Union Against Cancer and adopted by the American Joint Commission on Cancer, TNM is the most widely used method to determine thyroid cancer stages. It analyzes three factors:

  • T – Tumor size and location: Doctors often subdivide this category according to tumor size and to note individual or multiple tumors.
  • N – Lymph Node Involvement: Doctors look for signs of cancer in lymph nodes in the neck.
  • M – Metastasis: Doctors check to see if the cancer has spread, or metastasized, to other parts of the body.

Doctors use diagnostic tests to assign a number value for each of these categories, and designate the cancer as a Stage I through IV.

The MAICS Method of Thyroid Cancer Staging

Developed at the Mayo Clinic, the MAICS method is an extremely reliable method for gauging the prognosis of papillary cancer patients. It takes into account the following factors:

  • M – Metastasis: Has the cancer spread outside the neck?
  • A – Age: How old is the patient? Thyroid cancer is rarely fatal for younger patients.
  • I – Invasion: Has the cancer has moved into the other areas of the neck?
  • C – Completeness: Did surgery remove the entire tumor?
  • S – Size: How big was the tumor?

Doctors add together the values for each factor to get a total MAICS score, which predicts the probability of the patient living 20 years after the tumor discovery.

Resources

American Cancer Society Staff. (2009). How is thyroid cancer staged? Retrieved March 19, 2010, from the American Cancer Society Web site: http://www.cancer.org/docroot/cri/content/cri_2_4_3x_how_is_thyroid_cancer_staged_43.asp.

Thyroid Center Staff. (n.d.). Thyroid cancer prognosis staging. Retrieved March 21, 2010, from the Columbia University Medical Center Web site: http://www.cumc.columbia.edu/dept/thyroid/staging.html.

National Cancer Institute Staff. (n.d.). Thyroid cancer types, stages and treatment overview. Retrieved March 21, 2010, from the Thyroid Cancer Survivors’ Association, Inc. Web site: http://www.thyca.org/types.htm#6_STAGEEXPLANATION.

Cancer.net Staff. (2009). Thyroid cancer. Retrieved March 21, 2010, from the Cancer.net Web site: http://www.cancer.net/patient/Cancer Types/Thyroid Cancer?sectionTitle= Staging With Illustrations.