How is staging determined for thyroid cancer?

If the diagnosis is thyroid cancer, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to learn whether the cancer has spread and, if so, to what parts of the body.
Staging is based on the results of the physical exam, biopsy, and imaging tests, ultrasound, CT scan, MRI, chest x-ray, and/or nuclear medicine scans.
The TNM method is the most universally used staging method and applies to both papillary and follicular thyroid cancers.
- T indicates the size of the main (primary) tumor and whether it has grown into nearby areas.
- N describes the extent of spread to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections. Cells from thyroid cancers can travel to lymph nodes in the neck and chest areas.
- M indicates whether the cancer has spread (metastasized) to other organs of the body. If there is distant metastases, M = 1, if the cancer has not spread outside of the neck region, M = 0.

Based on these three categories, the cancer is assigned a Stage of 1, 2, 3 or 4. Stage 1 is the least advanced form of cancer with the best prognosis, and Stage 4 is the most advanced category.

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