Papillary thyroid cancer is the most common type of thyroid cancer. It usually has an excellent prognosis and treatment, most commonly surgery, and is often successful.
Papillary thyroid cancer begins in the follicular cells in your thyroid that produce thyroglobulin (a protein). It’s the most common type of thyroid cancer.
Your thyroid is a small, butterfly-shaped gland located at the front of your neck under your skin. It’s a part of your endocrine system and controls many of your body’s important functions by producing and releasing (secreting) certain hormones.
PTC tends to grow very slowly and usually develops in only one lobe of your thyroid gland.
There are several subtypes of papillary thyroid cancers. Of these, the follicular subtype (also called mixed papillary-follicular variant) is the most common. Other subtypes of papillary cancer aren’t as common and tend to grow and spread more quickly. They include:
Papillary thyroid cancer is also called papillary thyroid carcinoma.
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Papillary thyroid cancer can affect anyone, but it most commonly occurs in middle-aged adults. Women and people assigned female at birth (AFAB) are more likely to develop PTC than men and people assigned male at birth (AMAB).
Although PTC is rare in children, it’s still the most common pediatric thyroid cancer.
Thyroid cancer is fairly common, and papillary thyroid cancer is the most common type. It accounts for 80% to 85% of all thyroid cancer cases.
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While all cancer types are serious in that they require medical treatment and have the potential to spread to other parts of your body (metastasize), papillary thyroid cancer has the best overall prognosis of all thyroid cancer types.
PTC can often be treated successfully and is rarely fatal.
Papillary thyroid cancer is most likely to spread (metastasize) to the lymph nodes in your neck first. Lymph nodes are small bean-shaped structures that are part of your body’s lymphatic system and immune system.
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Even though papillary thyroid cancer grows slowly, PTC often spreads to the lymph nodes in your neck.
About 30% of people have metastatic papillary thyroid cancer (that has spread to other parts of their body) at diagnosis.
The main sign of papillary thyroid cancer is a painless lump or nodule on your thyroid gland. PTC usually doesn’t cause any other symptoms.
In rare cases, you may experience pain in your neck, jaw or ear from PTC. If the nodule is large enough to compress your windpipe or esophagus, it may cause difficulty with breathing or swallowing.
Scientists still don’t know the exact cause of papillary thyroid cancer, but they have identified risk factors that increase your risk of developing PTC, including radiation exposure and certain genetic conditions.
The rates of papillary thyroid cancer are higher in people who have a history of exposure to significant ionizing radiation. This exposure could be due to:
A few genetic (inherited) conditions are associated with PTC, including:
Only 5% of all papillary thyroid cases are associated with these genetic conditions.
Papillary thyroid cancer usually presents as a lump or nodule on your thyroid gland. You may notice it, or your healthcare provider may discover it during a routine neck examination. Sometimes, the nodule is discovered incidentally (accidentally) by imaging tests you get for other medical reasons.
Your healthcare provider will likely order the following tests to help diagnose PTC:
Your healthcare provider may also recommend genetic counseling to see if you have a genetic condition that may have caused PTC and may cause other types of tumors.
Treatments for papillary thyroid cancer depend on the tumor size and whether the cancer has spread (metastasized).
Surgery is the most common treatment for PTC. Depending on the tumor’s size and location, your surgeon may remove part of your thyroid gland (lobectomy) or all of your gland (thyroidectomy). If you have cancer present in the lymph nodes of your neck, your surgeon may remove the affected lymph nodes at the time of the initial thyroid surgery or as a second procedure.
If you have a total thyroidectomy, you’ll need to take thyroid hormone replacement medication for the rest of your life.
Additional treatments for PTC include:
Permanent hypothyroidism (low thyroid hormone levels) is an expected side effect of thyroidectomy and radioiodine therapy. Because of this, you’ll need to take replacement thyroid hormone medication for the rest of your life if you undergo either or both of these treatments.
Possible complications of thyroid surgery include:
Potential side effects of radioactive iodine therapy include:
Most people with thyroid cancer have no known risk factors, so it’s not possible to prevent most cases of papillary thyroid cancer.
Radiation exposure, especially in childhood, is a known PTC risk factor. Because of this, healthcare providers no longer use radiation to treat less serious diseases. Imaging tests, such as X-rays and CT scans, also expose children to radiation, but at much lower doses. It’s not clear how much they might increase the risk of PTC.
If you have a family history of thyroid cancer, you may want to get genetic counseling to see if you have any inherited conditions that put you at a higher risk of developing PTC. If this is the case, your healthcare provider may recommend getting preventive (prophylactic) surgery to remove your thyroid gland before cancer develops.
Overall, the prognosis of papillary thyroid cancer is excellent, especially if you’re younger than 40 at diagnosis and have a small tumor. PTC can often be treated successfully and is rarely fatal, even if it has spread to lymph nodes in your neck.
Factors that may lead to a worse prognosis include:
The survival rate for papillary thyroid cancer is excellent. More than 90% of adults with PTC survive at least 10 to 20 years after treatment.
If you’ve been diagnosed with papillary thyroid cancer, you’ll need to see your healthcare team regularly to monitor your treatment progress. You’ll also need long-term monitoring every six to 12 months to look for cancer recurrence (when it comes back) for at least five years.
If you had your thyroid removed and/or had radioactive iodine therapy as part of treatment, you’ll need to take thyroid hormone medication for the rest of your life. Your healthcare provider will want to monitor your thyroid hormone levels throughout your life to make sure your medication dosage is working for you.
A note from Cleveland Clinic
Receiving a cancer diagnosis is unsettling, regardless of the type. The good news is that papillary thyroid cancer (PTC) often has an excellent prognosis. Your healthcare team will work with you to determine the best treatment plan for you.
Last reviewed on 06/28/2022.
Learn more about the Health Library and our editorial process.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy