Follicular Thyroid Cancer Staging

The staging process for follicular thyroid cancer – along with many other types of cancer – follows the American Joint Committee on Cancer (AJCC) TNM system, which considers the tumor’s size, lymph node involvement and spread throughout the body (metastasis). Stages range from 1 through 4, with stage 4 being the most advanced. Unlike some cancers, however, the patient’s age at the time of diagnosis also plays a key role in follicular thyroid cancer staging.  

Age and follicular thyroid cancer

Individuals who are diagnosed with follicular thyroid cancer at a young age are more likely to achieve a positive outcome than their older counterparts. Taking this into account, the TNM system consider patients who are diagnosed at age 54 or younger to have stage 1 thyroid cancer if the cancer is confined to the thyroid and nearby areas. If the cancer has traveled to distant sites, it is labeled as stage 2. 

In general, physicians use the following criteria to stage follicular thyroid cancer in patients who are 55 and older:

• Stage 1 – The cancer is confined to the thyroid or the tumor is smaller than 2 centimeters across.
• Stage 2 – The cancer has spread to nearby lymph nodes but has not traveled to distant areas, or the tumor is larger than 4 centimeters across and has grown into the strap muscles surrounding the thyroid.
• Stage 3 – The cancer has spread beyond the thyroid to nearby structures in the neck, such as the larynx or esophagus.
• Stage 4a – The cancer has traveled extensively beyond the thyroid and into the spine or major blood vessels.
• Stage 4b – The cancer has spread to distant organs, bones or other vital structures.

"I just knew Moffitt's reputation, and I knew that when you had cancer that's where you want to go."

Sarah, Thyroid Cancer Survivor

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Staging follicular thyroid cancer and determining a prognosis is a detailed process that involves more considerations than just those listed above. Other factors, such as the patient’s overall health and the specific location of the cancer, can also impact the outlook and treatment options. 

Moffitt Cancer Center offers streamlined diagnostics and diverse treatment options to patients with follicular thyroid cancer, as well as virtual visits for patients in Florida. Request an appointment with or without a referral by completing a new patient registration form online or calling 1-888-663-3488.