Is Thyroid Cancer Really a Good Cancer?

Thyroid cancer, especially papillary thyroid cancer, has been called a “good cancer” for years because it is generally treatable and known for high survival rates. Recent research, healthcare professionals' experiences, and patient feedback, however, suggest that this term should no longer be used. Should thyroid cancer really be viewed as “good”? This article examines the realities behind this misconception and the challenges patients face.

What Is Papillary Thyroid Cancer?

Papillary thyroid cancer is the most common type of thyroid cancer, accounting for approximately 70-80% of all cases. According to the American Thyroid Association (ATA), it generally grows slowly and has an “overall excellent prognosis (disease outlook)” even when it spreads to lymph nodes. This favorable outlook leads many physicians to describe it as a “good cancer” or “the best of a bad situation”. However, this description may overlook patients' actual experiences.

Papillary Thyroid Cancer: The Pros and Cons of the “Good Cancer” Concept

Thyroid published a study in 2017 by Reese W. Randle and colleagues titled "Papillary Thyroid Cancer: The Good and Bad of the 'Good Cancer'" , which found that most patients with papillary thyroid cancer experience mixed emotions about the “good cancer” label. The study examined 31 patients who had experienced papillary thyroid cancer, and 94% (n=29) reported encountering the term during diagnosis.

Patients said they generally heard the “good cancer” concept from their doctors, the internet, friends, or general perceptions of other cancers. Although this optimistic approach initially made the diagnosis easier to accept, over time they felt that it minimized their own cancer experiences. Phrases such as “just thyroid cancer” or “an insignificant cancer” invalidate patients' concerns and downplay cancer's psychological burden. Participants emphasized that every type of cancer is serious and that the “good cancer” label did not fully reflect their actual struggle.

The results show that patients with papillary thyroid cancer struggle with this “good cancer” perception. Although doctors emphasize favorable outcomes to reassure their patients, this approach may unintentionally invalidate cancer's impact on their lives.

The Misleading Effect of the “Good Cancer” Label

Dr. Fiona Schulte, a psychologist at the University of Calgary in Canada, says many doctors use the term “good cancer” to reassure patients. However, she states that it minimizes the physical and psychological challenges patients face. “For most patients, treatment is only the beginning of a long and difficult journey”, she says. Although thyroid cancer can be treated successfully, surgery and other treatments may have serious long-term consequences. Many patients struggle to return to their lives after treatment and have to cope with lasting effects.

Patients' Experiences: Support or Minimization?

In a study of patients diagnosed with thyroid cancer at a young age, Dr. Miranda Fidler-Benaoudia from the University of Calgary found that most were uncomfortable with the term “good cancer.” Patients felt that it minimized their difficulties and the seriousness of their diagnosis. Less intensive treatment does not invalidate their emotional and physical struggles. Emma Stevens, who was diagnosed with thyroid cancer at 19, had a similar experience. She describes how misleading phrases such as “it is only thyroid cancer” or “this is an easy cancer” can be. Stevens highlights their negative effects on patients and works to encourage greater sensitivity.

The Life-Changing Effects of Thyroid Cancer

Papillary thyroid cancer is generally treated surgically. Some patients receive radioactive iodine (RAI) after surgery. However, these treatments may lead to long-term health problems. Dr. Caitlin P. McMullen from Moffitt Cancer Center notes that, in addition to removing all of the thyroid (total thyroidectomy) or part of it (lobectomy), lymph node removal may be necessary. After these operations, many patients require lifelong thyroid hormone replacement and regular blood tests and imaging.

McMullen points out that patients may face financial difficulties due to regular tests, medicines, and follow-up visits. Postoperative complications can also substantially affect quality of life. These include vocal cord paralysis, hypoparathyroidism, and adverse effects of RAI treatment. Patients may experience voice changes, difficulty swallowing, calcium imbalances, and dry mouth after treatment. Even when they are completely free of cancer, they must cope with these long-term effects.

A Critical Look at the “Good Cancer” Perception: Experiencing Thyroid Cancer at a Young Age

Published on September 18, 2024, in Supportive Care in Cancer , the study "No such thing as good cancer" shows how the experiences of people diagnosed with thyroid cancer at a young age expose the misleading nature of the “good cancer” label. The study found that 36 people diagnosed with thyroid cancer (83% women; median age at diagnosis: 37.1 years) experienced lifelong physical and emotional effects.

Participants said that describing thyroid cancer as “good” minimized their cancer experience and the seriousness of the diagnosis. In particular, they reported feeling lost in the healthcare system after diagnosis and being unable to access needed support services because of the “good cancer” label. The findings indicate that gaps in communication and information during cancer care may adversely affect treatment decisions and make adjustment after cancer more difficult.

Informing and Educating Patients

Experts emphasize that doctors need to be more careful when telling patients they have thyroid cancer. Research by Dr. Susan C. Pitt showed that a general fear of cancer combined with concern about recurrence causes psychological stress and reduced quality of life after a cancer diagnosis. Pitt notes that patients' perceptions of their diagnosis can affect treatment decisions and may sometimes lead to overtreatment.

Providing patients with accurate information will help them make more informed treatment decisions and reduce unnecessary fear and anxiety. Dr. Caitlin McMullen says that, rather than calling it a “good cancer,” providing detailed information and answering patients' questions may reassure them more.

Conclusion: There Is No Such Thing as a “Good Cancer”

Although thyroid cancer is known for successful treatments and high survival rates, it can have serious and lasting effects on patients' lives. The term “good cancer” overlooks these difficulties and minimizes patients' experiences. Experts recommend that doctors replace this term with a more empathetic and individualized approach. Cancer is always traumatic, and each type brings different challenges. What patients most need during this process is accurate information, support, and empathy.