Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Diagnosing Thyroid Cancer

Diagnosing Thyroid Cancer

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Symptoms of Thyroid Cancer
Symptoms vary depending on the type of thyroid cancer, but may include one or more of the following:

  • A painless lump in the front of the neck
  • Hoarseness or voice changes
  • Swollen lymph nodes in the neck
  • Trouble swallowing or breathing
  • Pain in the throat or neck that does not go away
  • A constant cough that is not due to a cold

If you’re experiencing any of these symptoms, contact your physician right away so that the cause can be diagnosed and treated promptly. Keep in mind that these symptoms may be caused by conditions other than thyroid cancer, such as an infection or a goiter (swollen thyroid gland).

Diagnostic Tests for Thyroid Cancer
During a physical exam, your doctor will feel your thyroid and neck for lumps or swelling. If thyroid cancer is suspected, he or she may recommend one or more of the following tests:

  • Blood Tests: Blood tests can help determine if your thyroid is working properly and detect tumor markers—substances in your body that are found at higher than normal levels in some people with cancer.
  • Ultrasound: This test uses sound waves to produce images of your thyroid so your doctor can view its size, any nodules present, their size and shape, and whether they are solid (more likely to be cancerous) or fluid-filled. Ultrasound testing can also be used to guide needle placement during a biopsy.
  • Biopsy: A biopsy is the only definitive way to diagnose thyroid cancer. Using a very thin needle, your physician removes cells from your thyroid nodule(s) for examination under a microscope. The test, called a fine needle aspiration, is usually performed under ultrasound guidance by radiology or in the doctor’s office. In some cases, the whole nodule is removed during surgery for analysis (surgical biopsy).
  • Thyroid Scan and/or PET Scan: Small amounts of radioactive substances are put into your body and viewed to see where they go, to help determine if a thyroid nodule contains cancer cells. Radioactive iodine (RAI) is used because thyroid cells are the only cells in the body that absorb iodine. Abnormal thyroid cells take up less iodine than normal tissue.
  • MRI, CT Scan or Chest X-ray: Other imaging tests may be used to create more detailed images to look for cancer in the thyroid and determine if it has metastasized, or spread.


Staging Thyroid Cancer
If thyroid cancer is diagnosed, the next step is to determine the extent, or stage, of the disease so your physician can devise the best course of treatment.

Thyroid cancer spreads most often to the lymph nodes, lungs and bones. Staging may involve additional testing, such as an ultrasound, CT scan, MRI, chest X-ray and/or whole body scan.

Unlike most cancers, thyroid cancer is staged based on the type of thyroid cancer you have and your age. Each of the four types—papillary, follicular, medullary and anaplastic—has its own staging process, with stages ranging from 1 to 4, with 4 being the most severe. All anaplastic thyroid cancers are considered Stage 4, reflecting the severity of this form of the disease.

Your oncologist will explain how he or she classified your tumor, how the stage affects treatment options, and your prognosis.

Learn more about thyroid cancer:


For more information about thyroid cancer treatment at the Methodist Cancer Center or to make an appointment, call us at 713-790-2700.