Understanding The New TNM Staging System for Thyroid Cancer

While thyroid cancer isn’t common in America, its incidence is on the rise, perhaps due to more effective screening procedures. It’s also a cancer that usually responds well to treatment. In 2018, new definitions for thyroid cancer stages took effect to more accurately reflect the experience of clinicians across the country. Generally, stages of cancers define themselves by how far the disease has spread.

Cancer stages

There are five stages of cancer, though only some cancers use the Stage 0 classification. These stages are:

The TNM system

Thyroid cancer stages are usually defined using the TNM system of the American Joint Committee on Cancer. The system considers three key points. Each letter has a further value assigned to it, with higher numbers indicating a more advanced level of cancer. The combination of these values determines the progress, or stage, of the overall thyroid cancer. The letters in TNM represent:

Each of these letters has a range of values to indicate the state of advancement for that component. T has 10 qualifiers, N has five, and M has three. The combination of these qualifiers plus the type of tumor, and sometimes the age of the patient, guide the stage definition of thyroid cancer.

Types of thyroid cancer

Thyroid cancers first fall into differentiated or undifferentiated types. Papillary and follicular forms comprise the differentiated thyroid cancers. These are more common and usually carry a good prognosis.

Anaplastic thyroid cancer is synonymous with undifferentiated thyroid cancer. It’s rare and always classed as stage IV. Medullary thyroid cancer falls outside of differentiated and undifferentiated definitions, originating in thyroid C cells.

Clinical versus pathologic stages

When a patient has had surgery that examines tissue surrounding the tumor, observations of the tumor are used to rank the TNM values of the thyroid cancer. Ranking a cancer’s progress through surgery creates a pathologic stage for the tumor. When surgical observation isn’t possible or hasn’t been done, a clinical stage value is estimated and might not be as accurate as pathologic staging.

Staging any cancer can be complex, and it’s certainly the case with thyroid cancers. The new 2018 TNM guidelines may place some patients at a lower stage than previously, but it may not represent a form of the cancer that’s less serious or less aggressive. Any case of thyroid cancer needs close monitoring, even if it’s differentiated and given a low stage number.

The ear, nose, and throat specialists at Lawrence Otolaryngology Associates are thyroid experts, ideal partners through diagnosis and treatment of thyroid cancer. Contact the most convenient office by phone if you or a loved one is dealing with this disease.

You Might Also Enjoy...

Understanding Parathyroid Disorders

When you have problems with the amount of calcium in your bloodstream, a doctor typically looks at the activity of four pea-sized glands behind your thyroid, the parathyroid glands. These glands regulate the level of calcium in your system.

What Causes Tongue Tie?

Medically known as ankyloglossia, tongue tie is a condition present in some children at birth that may cause problems with feeding and, later, speech development. It’s usually easily corrected once it’s discovered.

3 Reasons You Shouldn't Ignore Snoring

Snoring is more than just a funny sound you make while you sleep. It can be the cause behind sleep disorders for you and those around you, as well as a symptom of a potentially serious health issue called obstructive sleep apnea.

What's Involved in Voice Therapy?

When your voice no longer sounds like you and doesn’t seem to return to normal, you have a voice disorder, and therapy may be part of your treatment. Voice therapy is a highly customized treatment to help improve or eliminate vocal problems.

Lifestyle Adjustments for Vertigo

Vertigo is a symptom of many conditions, causing dizziness and nausea. When it’s severe, it can make daily living difficult as well as increasing your risk of falls or accidents. In some cases, you can make lifestyle changes to ease the problem.

Corrective Voice Therapy: What to Expect

Having a hoarse voice is a common problem, one that’s usually temporary and due to overuse. However, it can be a chronic issue for some, and one treatment option is corrective voice therapy. Here’s what you can expect.