The signs that thyroid cancer has spread can vary depending on where in the body it has traveled to. Thyroid cancers often spread to the nearby lymph nodes and the lungs, bone, brain, and liver.

For all types of thyroid cancer, early detection and personalized treatment plans are crucial for improving outcomes.

Advances in targeted therapies and genetic testing are providing new hope for people with thyroid cancer, even in more advanced stages of disease.

This article looks at what to know about metastatic thyroid cancer.

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It is rare for thyroid cancer to spread beyond the neck. This occurs in 1.2% to 13% of people with this type of cancer.

The spread of thyroid cancer can cause various signs and symptoms, depending on which area of the body it is affecting.

Thyroid cancer typically spreads to the lungs, bone, brain, and liver.

General signs of metastasis (spread) include:

Lymph nodes

When thyroid cancer spreads to the lymph nodes — which is often the first site of metastasis, particularly for the papillary and medullary types — it can cause noticeable changes.

One possible symptom is swollen lymph nodes in the neck. A person may feel lumps when touching the neck area. This swelling might not be painful.

The spread of thyroid cancer to lymph nodes can sometimes cause difficulties with swallowing or breathing if the enlarged nodes press against the esophagus or trachea.


Metastasis in the lungs can lead to respiratory symptoms such as:


Thyroid cancer can spread to any bone in the body but most commonly affects the spine, pelvis, and ribs.

Signs and symptoms of bone metastasis include:

  • pain in the affected bone, which can become more severe or persistent over time
  • an increased risk of fractures, even with minor injuries
  • reduced mobility due to pain or bone weakness


Symptoms of brain metastasis vary and depend on the affected part of the brain.

Common symptoms include:

  • headaches
  • seizures
  • nausea or vomiting
  • sleepiness
  • changes in emotions
  • problems with hearing, swallowing, or vision
  • changes in mental status, such as confusion or memory issues
  • difficulty speaking
  • weakness or numbness in parts of the body, which can indicate neurological impairment


Liver metastasis in thyroid cancer is less common but can happen, especially in more aggressive types of thyroid cancer.

Symptoms include:

  • abdominal pain or discomfort, particularly in the upper right side
  • jaundice (a yellowing of the skin and eyes)
  • fatigue
  • unexplained weight loss

These symptoms occur because the presence of cancer cells makes it difficult for the liver to perform its usual functions.

When papillary thyroid cancer spreads, it typically affects the lymph nodes first. Healthcare professionals consider this a less aggressive form of thyroid cancer, and it can spread slowly.


The American Cancer Society (ACS) outlines the following 5-year relative survival rates for papillary thyroid cancer:

StageSurvival rate
localmore than 99.5%

Follicular thyroid cancer is more likely to spread to distant organs than to the lymph nodes — particularly the lungs and bones.

This spread can make it more challenging to treat.


The 5-year relative survival rates for follicular cancer are as follows:

StageSurvival rate
localmore than 99.5%

A person can have medullary thyroid cancer (MTC) for a long time without symptoms due to the small size of the tumor. However, if the tumor blocks the vocal cords, it can cause a hoarse voice. And if it blocks the windpipe, it can cause difficulty breathing.

MTC can spread to bones as well as the lungs, liver, brain, and other organs.


The ACS outlines the following survival rates for MTC:

StageSurvival rate
localmore than 99.5%

Anaplastic thyroid cancer is a rare and aggressive form of thyroid cancer, accounting for 2% to 3% of cancerous thyroid tumors. It can spread rapidly into the neck and to other parts of the body, such as the bones, the lungs, and other organs.

Due to its aggressive nature, symptoms can progress quickly, and it may be resistant to traditional thyroid cancer treatments.


The outlook for anaplastic thyroid cancer is less favorable than for other types of thyroid cancer:

StageSurvival rate

How long can thyroid cancer go undetected or before symptoms show?

The length of time thyroid cancer can go undetected varies depending on factors such as the type of thyroid cancer and how quickly it grows.

For example, papillary thyroid cancer, the most common type, often grows very slowly and can remain asymptomatic for a long time. Other types, such as anaplastic thyroid cancer, are much more aggressive and cause symptoms quickly.

However, the ACS states that healthcare professionals can now detect most thyroid cancers much sooner than they could in previous years and can find many cases early.

Where is the first place thyroid cancer spreads?

The first place thyroid cancer spreads can depend on the type.

For example, papillary thyroid cancer often spreads to the nearby lymph nodes first. Anaplastic thyroid cancer spreads to the neck and then to distant parts of the body. Follicular thyroid cancer spreads to the lungs and bones.

How long does it take thyroid cancer to spread?

The time it takes for thyroid cancer to spread can vary significantly depending on the type of cancer.

Papillary and follicular thyroid cancers may spread slowly over several years, particularly in their movement to distant organs.

Medullary thyroid cancer’s spread can be more variable, sometimes occurring relatively quickly.

Anaplastic thyroid cancer is known for its rapid progression, often spreading quickly to distant organs.

The signs that thyroid cancer has spread can depend on what area of the body the cancer is affecting. General signs that thyroid cancer has spread to other parts of the body include fatigue, shortness of breath, unexplained weight loss, and pain.

Although this can vary by type, thyroid cancer often spreads to the nearby lymph nodes, the brain, the lungs, the liver, and the bones.