Symptoms of Thyroid Cancer
Thyroid cancer often presents with no symptoms in the early stages, but as it progresses, patients may develop a neck mass, vocal cord paralysis, dysphagia, or dyspnea, particularly in aggressive forms like anaplastic thyroid cancer. 1
Common Presenting Symptoms
Physical Findings
- Palpable thyroid nodule or neck mass (most common initial finding)
- Cervical lymphadenopathy (present in 40% of anaplastic thyroid cancer cases) 1
- Hard, fixed mass invading surrounding neck structures (characteristic of anaplastic thyroid cancer)
- Vocal cord paralysis (occurs in approximately 30% of anaplastic thyroid cancer patients) 1
Compressive Symptoms
- Dysphagia (difficulty swallowing)
- Dyspnea (shortness of breath)
- Hoarseness or voice changes
- Cough
- Neck pain or discomfort
- Sensation of a lump in the throat
Systemic Symptoms
- Weight loss (more common in aggressive forms)
- Fatigue
- Hemoptysis (in cases with airway invasion) 1
Symptoms by Thyroid Cancer Type
Differentiated Thyroid Cancer (Papillary and Follicular)
- Often asymptomatic and discovered incidentally during imaging studies 2
- May present with a painless, slow-growing neck mass
- Lymph node involvement may be the first sign in some papillary thyroid cancers
Medullary Thyroid Cancer
- Neck mass
- May have associated symptoms of hormone production (diarrhea, flushing)
- Can be part of genetic syndromes with other manifestations
Anaplastic Thyroid Cancer
- Rapidly enlarging neck mass
- More aggressive compressive symptoms including:
- Severe dyspnea (often requiring urgent intervention)
- Dysphagia
- Vocal cord paralysis (30% of patients) 1
- Neck pain
- Distant metastases at presentation in approximately 50% of patients 1
- Symptoms of metastatic disease (lung, bone, liver, brain)
Thyroid Dysfunction Symptoms
Some thyroid cancers may cause thyroid dysfunction, resulting in:
Hypothyroidism
- Fatigue
- Weight gain
- Hair loss
- Cold intolerance
- Constipation
- Depression 1
Thyrotoxicosis (less common)
- Weight loss
- Palpitations
- Heat intolerance
- Tremors
- Anxiety
- Diarrhea 1
Red Flag Symptoms
- Rapidly growing neck mass
- Voice changes or hoarseness
- Difficulty breathing or swallowing
- Fixed, hard nodule
- Cervical lymphadenopathy
- Hemoptysis 1
Important Considerations
- Many thyroid cancers remain asymptomatic until advanced stages
- The mortality rate remains relatively low despite increasing incidence, particularly for differentiated thyroid cancers 2
- Symptoms may persist long-term after treatment, affecting quality of life 3
- Anaplastic thyroid cancer is particularly aggressive with a median survival of only about 5 months from diagnosis 1
Early recognition of suspicious symptoms is crucial, as prompt diagnosis and appropriate treatment significantly improve prognosis and reduce mortality, especially for differentiated thyroid cancers which have a 99% 20-year survival rate when detected early 4.