Papillary thyroid gland cancer in NZ: A guide to symptoms, diagnosis, treatment, and prognosis

What is papillary thyroid cancer?

Papillary thyroid cancer (PTC) originates in the follicular cells in the thyroid, a small, butterfly-shaped gland at the base of the neck, which produces and stores hormones. PTC often presents as a small, painless lump or nodule in the thyroid, and may spread to nearby lymph nodes.

Who is most affected?  

Papillary thyroid cancer is most commonly diagnosed in adults under the age of 40. Women are more likely to develop the disease than men.

Types of papillary thyroid cancer    

There are several variants of papillary thyroid cancer. Common subtypes include the classical (conventional) and follicular variants. Other less common but more aggressive types include columnar cell, tall cell, diffuse sclerosing, solid, and hobnail variants.

Does papillary thyroid cancer spread?

Papillary thyroid cancer is generally slow-growing but can spread to other parts of the body, typically to the nearby lymph nodes in the neck, which is known as regional metastasis. In rare cases, PTC can spread to distant organs, such as the lungs and bones.

Risk factors for papillary thyroid carcinoma

Certain risk factors may increase the likelihood of developing papillary thyroid cancer.

• Radiation exposure: This can occur as a result of medical treatments for other conditions, such as external radiation therapy during childhood for cancer in the neck.
• Genetic conditions: Hereditary conditions such as familial adenomatous polyposis (FAP) and Cowden syndrome are linked with a higher risk of developing papillary thyroid cancer.

Symptoms of papillary thyroid cancer

Papillary thyroid cancer may present with few or no symptoms, which is why some cases are diagnosed incidentally, i.e., when the patient is being checked for other issues.

As the cancer grows, symptoms become more apparent and can include:

• A lump (nodule) in the neck
• Hoarseness or voice changes
• Difficulty swallowing (dysphagia)
• Difficulty breathing
• Swollen lymph nodes in the neck
• Persistent cough
• Neck pain.

Sometimes these symptoms are mistaken for less serious conditions, leading to delays in seeking medical advice. However, any type of cancer is best detected in its early stages if possible.

Diagnosing papillary thyroid cancer

Cancerous cells in the thyroid gland are detected via a series of tests and procedures. Here are the usual steps your health professional will follow in diagnosing papillary thyroid cancer:

• Physical examination: Feel for lumps in the neck; check for enlarged lymph nodes
• Blood tests: Measure hormone levels to determine if your thyroid is working properly and to monitor your treatment response
• Imaging tests: Perform an ultrasound of the thyroid gland and neck; CT, MRI, or PET scans
• Fine-needle aspiration biopsy (FNAB): Extract cells for examination, to determine whether a nodule may be cancerous
• Laryngoscopy: Check if the cancer is affecting your vocal cords.

Treatment options

The following options are used to treat or relieve the symptoms of papillary thyroid cancer.

Surgery

Papillary thyroid cancer is most commonly treated with surgery. The goal is to remove the tumour or nodule and any affected tissue to prevent the cancer from spreading. Two types of surgeries may be used:

• Thyroid lobectomy (or hemithyroidectomy): For smaller tumours, only the affected lobe of the thyroid is removed.
• Total thyroidectomy: This involves removing the entire thyroid gland, particularly for larger tumours, cancerous nodules affecting both lobes, or when cancer has spread to nearby lymph nodes.

Thyroid hormone therapy

Depending on the type of surgery, patients may be placed on thyroid hormone therapy afterwards. This serves two purposes: replacing thyroid hormones that the body can no longer produce after the thyroid gland is removed; and helping suppress TSH (thyroid-stimulating hormone) levels, which could otherwise stimulate the growth of any remaining cancer cells.

Radioactive iodine (RAI) therapy

Radioiodine or radioactive iodine therapy is used after surgery to destroy any remaining thyroid tissue or microscopic cancer cells. RAI therapy is typically used for larger tumours or when the cancer has spread to lymph nodes or other parts of the body.

Targeted therapy

For advanced cases of papillary thyroid cancer that do not respond to traditional treatments, targeted therapy may be used. These drugs target and attack specific gene and protein changes to block the growth of cancer cells.

Chemotherapy

In rare instances, chemotherapy may be considered for advanced cancers or in combination with other treatments.

External radiation therapy

External radiation therapy may also be used if the cancer has spread to other parts of the body and radioactive iodine therapy is ineffective.

Managing papillary thyroid gland cancer

Regular follow-ups and monitoring are important to check that the cancer has not returned and your thyroid medication is working as it should.  This may include:

• Blood tests: Regular blood tests to monitor thyroid hormone levels and thyroglobulin levels, as high thyroglobulin may indicate recurring or metastatic cancer
• Ultrasound: Periodic ultrasound scans to check for any new nodules or swollen lymph nodes  
• Radioactive iodine scans: In some cases, follow-up RAI scans may be used to ensure that no cancer cells remain in the body.

Early diagnosis and prompt treatment are key to achieving the best possible outcomes for any type of cancer. However, if you seek private healthcare in New Zealand, that treatment is expensive.

Comprehensive health insurance can provide valuable financial support, offering cost-effective access to timely specialist consultations, diagnostics, and treatments.

If you have critical illness insurance, check whether your specific case can qualify for a claim. You can use this lump sum benefit to pay for private healthcare costs.

RECOMMENDED READINGS

Health insurance for pre-existing conditions

Is health insurance worth it in New Zealand?

Long waiting lists in NZ's public health system: Causes and impacts on patients

Thyroid gland cancer: symptoms, causes, and treatment

Papillary thyroid cancer prognosis and survival rate

Prognosis

The prognosis for papillary thyroid cancer is often excellent, especially if you’re young and the tumour was small when detected. With appropriate thyroid surgery and, in some cases, follow-up treatments, most patients continue to live a normal, healthy lifestyle.

Survival rate

The survival rate for papillary thyroid cancer is among the highest of all cancers, providing a great deal of hope to those diagnosed. For patients whose cancer is localised, meaning it is contained within the thyroid gland, the five-year survival rate is close to 100%. Even in cases where the cancer has spread to nearby lymph nodes or tissues, survival rates remain very high, generally above 95%. If the cancer has metastasised (spread to distant parts of the body), the survival rate is over 70%.

Recurrence

Papillary thyroid cancer may recur even years after successful treatment. This could manifest in the remaining thyroid tissue (if any), nearby lymph nodes, or more distant sites, such as the lungs.

Be prepared and protected with Policywise

Policywise is a 100% free service which tells you which health, life, and disability insurance provider best fits your needs. We offer fast, comprehensive, and easy-to-understand comparisons of all leading providers, and a simple summary clearly recommending which insurer is best for your situation.

Not all insurance policies are the same. Policywise can help you sort out the duds, avoid the lemons, understand the fine print and exclusions, and get the right insurance for you and your family.

We make the important decision of where to buy your insurance super easy. We’ll answer your questions, provide experienced advice and quotes, and manage all the back and forth throughout the application process. Taking out your cover through us means you'll have our lifetime support and claims advocacy, and we'll help you negotiate a positive outcome at claim time. We can also take care of lodging any claims on your behalf and back you up if the going gets tough.

Check out the reviews on our homepage for how other New Zealanders have found our service, because now is the time to get your health or critical illness insurance sorted. Book a 5-minute callback with Policywise today; our service is fast and free.

^{Disclaimer: This article is for general information only. Nothing in this blog or on this website is intended as medical, dietary, or financial advice. Although we aim to update our content regularly, you are advised to consult a Policywise adviser, health professional, or an appropriate specialist before acting on any information herein. They can factor in your personal circumstances or preferences and help guide your decision-making process.}