Papillary thyroid cancer (PTC) is a type of thyroid cancer. The first sign is usually a lump in the front of the neck, while later symptoms may include vocal changes and problems with swallowing. It is the slowest-growing thyroid cancer and the easiest to treat.

PTC is the growth of separate malignant tumors on the thyroid gland. This cancer typically stays in one lobe of the thyroid gland.

PTC is the most common type of thyroid cancer, accounting for up to 85% of all thyroid cancer diagnoses. It is more common in females and people aged 25–65 years.

However, it is slow-growing, and most people with PTC continue to have a positive quality of life.

Here, learn more about what PTC is, the signs and symptoms, and when to seek advice from a doctor.

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Image credit: Jason Hoffman

A person with PTC typically will not experience symptoms in the early stages, and blood tests may not show anything unusual.

When symptoms appear, the individual will typically notice a painless lump at the front of their neck that will not move with touch.

If PTC progresses, a person may experience further symptoms, though this is rare.

If further symptoms develop, they may include:

PTC develops slowly — other than a visible lump on the neck, the disease’s symptoms can take time to develop or may never appear.

Only around 20% of people with PTC experience vocal hoarseness or difficulty swallowing. This can occur when the disease spreads to the nerves that control the vocal cords.

Anyone who notices a new and persistent lump, or swelling, at the base of their neck below the Adam’s apple should seek advice from a medical professional.

This is especially important if they also experience:

  • neck pain
  • new and unexplained vocal changes
  • a tickle in the throat that does not stop
  • a history of radiation exposure
  • a family history of PTC

Complications can occur if PTC continues to develop and a person does not receive treatment.

They include:

  • Extrathyroidal extension: This occurs when the mass of cancer cells extends out of the thyroid gland and begins to protrude onto the neck muscles, larynx, trachea, or esophagus.
  • Recurrence: Even with the high success rates of thyroid cancer treatment, there is a risk of recurrence. The cancer may return to the thyroid gland.
  • Dysphagia: A person may have difficulty swallowing if the tumor presses on the esophagus.
  • Dyspnea: In rare cases, shortness of breath or feelings of suffocation can occur in the later stages if a tumor presses on the trachea. In this case, cancer will likely have spread to lymph nodes.

There are many treatment options for PTC, depending on the cancer stage at the time of diagnosis. A doctor may recommend each option alone or alongside another treatment.

The main treatment options include the below.

Surgery

A doctor may recommend surgical procedures, such as a thyroid lobectomy, in some cases. Here, a surgeon will remove a part or all of the thyroid gland.

Radioiodine therapy

A healthcare professional may recommend this procedure when the cancer has spread beyond the thyroid, which doctors call extrathyroidal extension. This therapy will permanently stop thyroid tissue from functioning and prevent further cancer growth in the thyroid gland.

Thyroid hormone treatment

People who have surgery to remove their thyroid gland will need hormonal replacement medications to replicate the function of their absent thyroid. Thyroid-stimulating hormone can encourage the growth of remaining cancer cells, but suitable dosages can reduce this risk.

Chemotherapy

If other treatments are ineffective, chemotherapy may be necessary.

Below are the answers to some commonly asked questions about PTC.

What are the early warning signs of thyroid cancer?

The early stages of thyroid cancers do not typically show symptoms. The first sign is usually a visible lump in the front lower region of the neck that does not move through touch. A person may first notice this if their collar becomes tight for no apparent reason. It may also appear as a general swelling of the neck.

Is PTC serious?

Most PTCs are small and respond effectively to treatment, even if the cancer cells spread to lymph nodes or soft tissues within the neck.

A person’s doctor will need to establish the stage of PTC at the time of diagnosis. The lower the stage, the less the cancer has spread. In stage 1, PTC has not spread to other parts of the body. Determining the stage will help plan the most effective treatment.

The staging process is different for people aged over 55 years. For those aged 55 or under, doctors classify even metastatic PTC as stage 2 because the survival rate is so high.

How quickly does PTC grow?

PTC is typically a slow-growing form of cancer that can still spread to the lymph nodes. However, this slow growth makes treating PTC easier than other types of the disease. Other types of thyroid cancer, such as anaplastic thyroid cancer, develop faster and are harder to treat.

Learn more here

PTC is one type of thyroid cancer. What are the other types?

PTC is a slow-growing cancer that sometimes causes no symptoms in the early stages. The first sign is often a lump or swelling in the neck area.

In time, PTC may progress and cause vocal changes and problems with swallowing.

PTC responds well to treatment, and most people continue to have a positive quality of life after treatment.