Can Thyroid Cancer Spread? What Are the Symptoms If It Does?

Thyroid cancer is one of the most common cancers in Turkey, particularly among women. It generally has a favorable course when diagnosed early and managed with effective treatment. In rare cases, however, it can spread, affecting quality of life and treatment. This article explains where thyroid cancer can spread in the body and the symptoms that may result.

Symptoms of thyroid cancer metastasis (spread) may vary depending on where in the body the cancer has spread. Thyroid cancer commonly spreads to nearby lymph nodes, the lungs, bones, brain, and liver.

The most important determinant of the likelihood of metastasis is the thyroid cancer subtype. The different types are described in detail below.

Early diagnosis and personalized treatment plans are crucial to improving outcomes in all types of thyroid cancer.

Advances in targeted therapies and genetic testing offer new hope for patients with more advanced thyroid cancer.

This article examines what you need to know about metastatic thyroid cancer.

Symptoms of Metastatic Thyroid Cancer

Spread of thyroid cancer beyond the neck is uncommon, occurring in 1.2% to 13% of people with thyroid cancer.

The spread of thyroid cancer may cause various symptoms and complaints, depending on which part of the body is affected.

Thyroid cancer tends to spread first to lymph nodes in the neck, the lungs, and bones.

General symptoms of spread include:

• Unexplained weight loss
• Fatigue or weakness
• Pain
• Shortness of breath

Metastasis to Lymph Nodes

When thyroid cancer spreads to lymph nodes—often the first site of spread, particularly for papillary and medullary types—it may cause noticeable changes.

One possible symptom is swollen lymph nodes in the neck. A person may feel lumps when checking the neck by hand. These swellings may not be painful.

Spread of thyroid cancer to lymph nodes may sometimes cause difficulty swallowing or breathing if it puts pressure on the esophagus or windpipe.

Metastasis to the Lungs

Lung metastases may cause the following respiratory symptoms:

• A persistent cough
• Shortness of breath
• Hemoptysis (coughing up blood)
• Chest pain
• Weight loss
• Loss of appetite
• Fluid buildup in the lungs

Metastasis to the Bones

Thyroid cancer can spread to any bone but most commonly affects the spine, pelvis, and ribs.

Symptoms of bone metastasis include:

• Pain in the affected bone that may become more severe or persistent over time
• An increased risk of fractures, even with minor injuries
• Restricted movement due to pain or bone weakness

Metastasis to the Brain

Symptoms of brain metastasis vary depending on which part of the brain is affected.

Common symptoms include:

• Headaches
• Seizures
• Nausea or vomiting
• Drowsiness
• Mood changes
• Problems with hearing, swallowing, or vision
• Changes in mental status, such as confusion or memory problems
• Difficulty speaking
• Weakness or numbness in parts of the body

Metastasis to the Liver

Liver metastasis from thyroid cancer is rare but may occur with more aggressive forms of thyroid cancer.

Symptoms include:

• Abdominal pain or discomfort, particularly in the upper right side
• Jaundice (yellowing of the skin and eyes)
• Fatigue
• Unexplained weight loss

These symptoms result from the presence of cancer cells making it harder for the liver to perform its normal functions.

Patterns of Spread by Thyroid Cancer Subtype

Papillary Thyroid Cancer

Papillary thyroid cancer is the mildest or least aggressive subtype, and its likelihood of metastasis is very low. When it spreads, it usually affects lymph nodes first.

The American Cancer Society (ACS) gives the following 5-year relative survival rates for papillary thyroid cancer:

Follicular Thyroid Cancer

Follicular thyroid cancer is more likely to spread to distant organs, particularly the lungs and bones, than to lymph nodes. This spread may make treatment more difficult.

The 5-year relative survival rates for follicular cancer are:

Medullary Thyroid Cancer

A person diagnosed with medullary thyroid cancer (MTC) may have no symptoms for a long time if the tumor is small. However, if the tumor obstructs the vocal cords, it may cause hoarseness. Obstruction of the windpipe may cause difficulty breathing.

MTC may spread to the bones, lungs, liver, brain, and other organs.

The ACS gives the following survival rates for MTC:

Anaplastic Thyroid Cancer

Anaplastic thyroid cancer is a rare and aggressive form, accounting for only a small proportion of thyroid cancers (2% to 3%). It can spread rapidly within the neck and to other parts of the body.

Because of its aggressive nature, symptoms may progress rapidly, and the cancer may be resistant to conventional thyroid cancer treatments.

The outlook for anaplastic thyroid cancer is less favorable than for other types:

Frequently Asked Questions

How long can thyroid cancer remain without symptoms?

How long thyroid cancer can remain symptom-free depends on its type and growth rate. Papillary thyroid cancer, the most common type, generally grows very slowly and may remain asymptomatic for a long time. Other types, such as anaplastic thyroid cancer, are much more aggressive and may cause symptoms quickly. However, according to the ACS, healthcare professionals can now detect thyroid cancers much earlier than in previous years and identify many cases at an early stage.

Where does thyroid cancer spread first?

The first site of spread may vary by type. Papillary thyroid cancer, for example, generally spreads first to nearby lymph nodes. Anaplastic thyroid cancer spreads within the neck and then to distant parts of the body. Follicular thyroid cancer spreads to the lungs and bones.

How long does it take thyroid cancer to spread?

The time needed for thyroid cancer to spread varies substantially by type. Papillary and follicular thyroid cancers may take years to spread, particularly to distant organs. The spread of medullary thyroid cancer is more variable and can sometimes be relatively rapid. Anaplastic thyroid cancer is known for its usually rapid progression and spread to distant organs.

Summary

Symptoms of thyroid cancer spread may vary depending on where in the body the cancer has spread. General symptoms include fatigue, shortness of breath, unexplained weight loss, and pain. The pattern varies by cancer type, but thyroid cancer may commonly spread to nearby lymph nodes, the brain, lungs, liver, and bones.