Papillary and Follicular Thyroid Cancer

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Papillary and Follicular Thyroid Cancer?

Papillary thyroid cancer (PTC, 80-85% of thyroid cancers) and follicular thyroid cancer (FTC, 10-15%) are differentiated thyroid cancers arising from follicular cells that produce thyroid hormones. PTC grows slowly, often spreading to lymph nodes, while FTC is more likely to metastasize to distant sites (lungs, bones) via blood. Both are well-differentiated, with variants like tall cell (aggressive PTC) or Hürthle cell (FTC subtype). In 2025, thyroid cancer has ~44,000 US cases, with PTC/FTC comprising 90%, affecting women 3:1, median age 50.

Symptoms

Early symptoms are rare, but include a neck lump (thyroid nodule), difficulty swallowing, hoarseness, neck pain, swollen lymph nodes, and cough. Advanced PTC causes voice changes from nerve invasion, while FTC may present with bone pain or fractures from metastases. Hyperthyroidism (rare) or hypothyroidism from gland dysfunction can occur. Symptoms often mimic benign nodules.

Causes

Causes involve genetic mutations (BRAF V600E in 40-60% PTC, RAS in FTC), with risk factors like radiation exposure (childhood therapy), family history, iodine deficiency (for FTC), obesity, and female gender. PTC links to Hashimoto’s thyroiditis. In 2025, genomic studies show RET fusions in PTC and PAX8/PPARG in FTC.

Diagnosis

Diagnosis uses thyroid function tests, ultrasound for nodule assessment, fine-needle aspiration biopsy for cytology, and molecular testing (BRAF, RAS) for risk stratification. Imaging (CT, PET) evaluates spread. In 2025, AI ultrasound and NGS improve detection of high-risk features.

Treatment

Treatment includes surgery (lobectomy or total thyroidectomy with lymph node dissection for PTC), radioiodine therapy for remnant ablation and metastases, TSH suppression with levothyroxine, and targeted therapies (sorafenib, lenvatinib for advanced). In 2025, RET inhibitors (selpercatinib) treat RET-fusion cases.

Future Outlook

In 2025, 5-year survival is 98-100% for localized PTC/FTC, 78% for regional. Advances in targeted therapies extend advanced survival to 5 years in 50% of cases. By 2030, vaccines and AI could achieve near-100% cure for early disease.

Sources

The information is based on Cleveland Clinic’s “Follicular Thyroid Cancer: Symptoms, Diagnosis & Treatment” for FTC; WebMD’s “Thyroid Cancer: Symptoms, Causes, Diagnosis, Treatment” for overview; Healthline’s “Papillary vs. Follicular Thyroid Cancer: Comparison Overview” for comparison; MD Anderson’s “Thyroid Cancer – Types, Symptoms, Treatment, Staging & Diagnosis” for staging; American Thyroid Association’s “Thyroid Cancer” for subtypes; OncoDaily’s “Thyroid Cancer: Symptoms, Causes, Stages, Diagnosis and Treatment” for diagnosis; NCI’s “Thyroid Cancer Treatment” for treatment; Mayo Clinic’s “Thyroid cancer – Symptoms and causes” for symptoms.