Number stages for papillary and follicular thyroid cancer

The stage of a cancer tells you about its size and whether it has spread. Doctors use the number staging system and the TNM staging system for thyroid cancer.

The number staging system usually groups cancers into 4 groups, from stage 1 to stage 4. The higher the number the more the cancer has spread.

There are different types of thyroid cancer. The number staging system for papillary and follicular thyroid cancer is different to the staging system for other types of thyroid cancer. This page is about number staging for papillary and follicular thyroid cancer.

How many number stages are there?

Younger people with papillary and follicular thyroid cancers generally have a better outlook than older people. So the number staging system for papillary and follicular thyroid cancer is different for people under 55 years old compared to those over 55.

There are:

• 2 number stages for people under 55 years old
• 4 number stages for people over 55 years old

If you are under 55 years of age

Stage 1

Stage 1 means your cancer:

• is any size
• may or may not have spread to nearby lymph nodes
• hasn't spread to distant areas of the body.

In TNM staging, this is the same as any T, any N, M0.

Stage 2

Stage 2 means your cancer:

• is any size
• may or may not have spread to nearby lymph nodes
• has spread to other parts of your body, such as distant lymph nodes, the lungs or bone

In TNM staging this is the same as any T, any N, M1.

If you are over 55 years of age

Stage 1

Stage 1 means your cancer:

• is completely inside the thyroid but is no more than 4cm across
• hasn’t spread to the lymph nodes or other parts of the body

In TNM staging, this is the same as T1 or T2, N0, M0.

Stage 2

Stage 2 can mean different things.

It can mean your cancer:

• is completely inside your thyroid but is no more than 4 cm across
• has spread to the nearby lymph nodes but hasn't spread to other parts of your body

In TNM staging this is the same as T1 or T2, N1, M0.

Or it can mean your cancer:

• is more than 4cm or has started to grow outside the thyroid into surrounding muscle
• may or may not have spread to nearby lymph nodes but hasn't spread to other parts of your body

In TNM staging this is the same as T3, any N, M0.

Stage 3

Stage 3 means your cancer:

• has grown outside the thyroid into nearby soft tissue, such as the voice box (larynx), windpipe (trachea), food pipe (oesophagus) or the voice box nerve (recurrent laryngeal nerve)
• may or may not have spread to the nearby lymph nodes but hasn't spread to other parts of your body

In TNM staging this is the same as T4a, any N, M0.

Stage 4

Stage 4 is divided into 2 groups, 4A and 4B.

Stage 4A

Stage 4A means your cancer:

• has grown outside the thyroid into the area surrounding the bones of the spine or one of the main blood vessels
• may or may not have spread to the nearby lymph nodes, but it hasn't spread to other parts of your body

In TNM staging this is the same as T4b, any N, M0.

Stage 4B

Stage 4B means your cancer has spread to another part of your body, such as the lungs.

In TNM staging this is the same as any T, any N, M1.

Treatment for thyroid cancer

The stage of your thyroid cancer helps your doctor to decide which treatment you need. Treatment also depends on:

• your type of cancer (the type of cells the cancer started in)
• where the cancer is
• other health conditions that you have