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Follicular vs Papillary Thyroid Cancer: Complete Comparison

Thyroid cancer can be a frightening diagnosis, but not all types are equal. The two most common varieties, papillary and follicular, have key differences you should understand. While both arise from thyroid cells, they vary in growth patterns, spread, and even treatment methods.

Detecting those unique hallmarks is crucial for developing an optimal treatment plan. This guide will help you learn how papillary vs. follicular thyroid cancers contrast.

Main Differences Between Follicular and Papillary Thyroid Cancer

While both cancers affect the thyroid, there are notable distinctions:

  • Prevalence – Papillary thyroid cancer accounts for 80-85% of all thyroid cancer cases. Follicular thyroid cancer represents around 10-15% of cases.
  • Spread – Papillary thyroid cancer often spreads to nearby lymph nodes in the neck. Follicular thyroid cancer can spread through the blood to distant sites like the lungs and bones.
  • Growth Rate – Papillary thyroid cancer tends to grow slowly over many years. Follicular thyroid cancer can have a more rapid growth rate.

Symptoms of Follicular vs Papillary Thyroid Cancer

In the early stages, both papillary and follicular thyroid cancers usually don’t cause symptoms. As tumors enlarge, common signs include:

  • A lump or nodule in the front of the neck that is typically painless but may be visible or palpable.
  • Changes to the voice leading to hoarseness.
  • Difficulty swallowing.
  • Swollen lymph nodes in the neck.

Since the symptoms are very similar, diagnostic testing is required to confirm the type.

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Diagnosing Follicular and Papillary Thyroid Cancers

To diagnose follicular or papillary thyroid cancer, doctors typically use:

  • A physical exam is needed for lumps in the neck area.
  • Blood tests to check levels of thyroid hormones.
  • An ultrasound to identify any nodules or tumors in the thyroid.
  • A fine needle aspiration biopsy to extract cells from the lump for examination.
  • Molecular marker testing for more certainty about the cancer type.

The biopsy results can definitively distinguish between follicular and papillary thyroid cancers.

Risk Factors for Follicular vs Papillary Thyroid Cancer

Some known risk factors raise the odds of developing both papillary and follicular thyroid cancers:

  • Radiation exposure in childhood, like from cancer treatment.
  • Family history of thyroid cancer, especially in a close relative.
  • Inherited conditions such as familial adenomatous polyposis.
  • Being female – women have about 3 times higher risk than men.

Treatment Options for Follicular and Papillary Thyroid Cancers

Standard treatments for both papillary and follicular thyroid cancers include:

  • Radioactive iodine therapy destroys any remaining thyroid tissue after surgery.
  • Thyroid hormone medication to replace natural hormones.
  • External beam radiation in some situations.
  • Chemotherapy drugs for advanced cancers.

Standard thyroid cancer treatments, such as surgery, can cause side effects. These include voice alteration, fatigue, the appearance of scars, swallowing dysfunction, pain, and concern about weight gain. That’s why we recommend ablation or iodine therapy for treating thyroid disorders.

Prognosis and Survival Rates for Follicular vs Papillary

As noted earlier, papillary thyroid cancer generally has a better prognosis and higher survival rates than follicular thyroid cancer. The 5-year relative survival rates by stage are

Papillary Thyroid Cancer

  • Localized: >99.5%
  • Regional: 99%
  • Distant: 74%

Follicular Thyroid Cancer

  • Localized: >99.5%
  • Regional: 98%
  • Distant: 67%.

Effect of Cancer Stage on Treatment and Prognosis

When thyroid cancer is diagnosed at an early localized stage, treatment is more straightforward, and the prognosis is excellent, with a 5-year relative survival of >99.9% for localized papillary and follicular thyroid cancer

If the cancer spreads to the lymph nodes or distant organs, treatment becomes more complex, and survival rates are lower. But even at this stage, 5-year survival rate is

  • 74% for papillary thyroid cancer
  • 67% for follicular thyroid cancer

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Recurrence Rates for Follicular and Papillary Thyroid Cancer

Recurrence is possible with both cancer types, so ongoing monitoring is advised:

  • Follicular thyroid cancer: 13.6% recurrence rate
  • Papillary thyroid cancer: Varies from 1.6% to 22.7% depending on risk level

Younger patients have a higher risk of recurrence. Discuss your prognosis with your doctor.

Conclusion

In summary, papillary and follicular thyroid cancers have important differences in their prevalence, spread, prognosis, and treatment response. Being informed about your specific thyroid cancer type is vital for getting optimal care. Work closely with your medical team and connect with support groups during every phase of diagnosis, treatment, and follow-up care. While thyroid cancer poses challenges, the treatment outlook continues to improve.

References

Papillary Thyroid Carcinoma: An Autobiographical Case Report – PMC

Follicular Thyroid Cancer: Symptoms, Diagnosis & Treatment

Thyroid Cancer Survival Rates, by Type and Stage

Thyroid Cancer Recurrence: How Often Does It Come Back?

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