This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on June 7, 2022.
The thyroid is a quarter-sized, butterfly-shaped gland that wraps around your trachea. It produces hormones that control your body’s temperature, heart rate and metabolism. Thyroid hormones also regulate how much calcium is present in your blood.
In its early stages, thyroid cancer may not show signs or symptoms. In many cases, thyroid cancer is discovered during a routine neck examination or during an imaging scan performed to diagnose another condition. Normally, you can’t feel your thyroid simply by touch. But when cancer is present, a lump may form as the tumor increases in size.
Thyroid cancer is more common if you’re:
Most often, thyroid cancer causes a lump and/or swelling of the neck, but it may also cause difficulty breathing or swallowing, as well as vocal hoarseness. Other symptoms include neck pain that may radiate up to your ears or a persistent cough not caused by illness. If you’re experiencing any symptoms, it’s important to reach out to your doctor for diagnosis.
The most common early sign of thyroid cancer is an unusual lump, nodule or swelling in the neck. If you notice a new or growing lump, you should see your doctor, who can run additional tests to identify the cause and determine if it is a tumor. Most nodules on the thyroid are usually benign, but it is important to have any unusual growths examined by a health care professional.
Other early warning signs of thyroid cancer include:
Other possible symptoms of thyroid cancer include:
Neck pain: In many cases, neck pain starts in the front. In some cases, the neck pain may extend all the way to the ears.
Voice changes: Experiencing hoarseness or other voice changes that do not go away could be a sign of thyroid cancer.
Breathing problems: Sometimes thyroid cancer patients say it feels like they are breathing through a straw. This breathing difficulty is often a symptom of the disease.
Trouble swallowing: A growth or nodule on the thyroid gland may interfere with swallowing.
Signs and symptoms of thyroid cancer recurrence may include:
Early thyroid cancer relapse symptoms may not be apparent, so regular screenings and follow-up appointments are strongly recommended. At the follow-up appointments, you may undergo a physical exam, blood tests or imaging tests, such as radioiodine scans or ultrasounds. These tests are designed to screen for cancer recurrence and other health concerns. Make sure to discuss with your doctor any symptoms you may be experiencing. The timing and frequency of recommended follow-up appointments depend on many factors, including the stage and size of the original tumor.
As for the recurrence rate, up to 30 percent of thyroid cancer patients may develop cancer recurrence. Of these patients, an estimated 80 percent develop thyroid cancer recurrence only in the neck area. The other 20 percent diagnosed with recurrent disease develop distant metastases, tumors that form in other areas of the body, such as the lungs, liver and bone. A number of treatment options are available for primary and recurrent thyroid cancer, but early detection is key.
If you experience signs of thyroid cancer, it’s important to consult with your doctor to get an accurate diagnosis.
First, your doctor may conduct a physical examination, manually palpating your neck and throat to check for abnormal growths or areas of swelling, including the thyroid and lymph nodes. Your doctor may also gather your personal and family medical history, ask about your symptoms and risk factors, including any inherited genetic mutations.
A blood test called a tumor marker test may be recommended to check for high levels of certain hormones, such as:
If cancer is suspected, one or more of the following diagnostic tests may be ordered:
Ultrasound. An ultrasound over the neck region may be done to locate any nodules that are present on your thyroid and determine whether they’re made up of solid or liquid material.
Chest X-ray: This basic imaging test may be done if your doctor suspects the cancer has metastasized to your lungs.
Magnetic resonance imaging (MRI) scan: Using magnets, an MRI scan creates highly detailed images of the thyroid and surrounding areas.
Computed tomography (CT) scan or positron emission tomography (PET) scan: A CT scan uses contrast dye (injected or swallowed) that helps your doctor pinpoint the size and location of your cancer, and whether it has metastasized to surrounding tissues. A PET scan is similar but uses an injection of radioactive sugar instead of contrast dye (both of which are mostly absorbed by cancerous tissues).
Biopsy: If suspicious tissue is present, a small sample may be taken to confirm a diagnosis of cancer. A biopsy may be taken via fine needle aspiration or through a surgical biopsy. During fine needle aspiration, a fine needle is inserted into a small, anesthetized area of skin to remove the sample. A surgical biopsy is done under general anesthesia to remove the nodule and/or a portion of the thyroid.
Molecular testing of the nodule sample: Using a tissue sample, this testing is done to identify the specific genetic makeup of your nodule or tumor, helping your doctor devise an appropriate treatment regimen.
Radionuclide scanning: During this test, you swallow or are injected with a small amount of radioactive iodine, a tracer that is absorbed by your thyroid cells. The tracer helps make these specific cells easier for your doctor to differentiate from other regions.
Vocal cord exam: Before surgery, a laryngoscopy may be performed in order to ensure your vocal cords are functioning properly. Your doctor will perform this examination of your larynx using a laryngoscope, a thin scope with a light and mirror.
