Thyroid Cancer Symptoms and Types

If you’ve noticed a lump in your neck, changes in your voice or new trouble swallowing, you may wonder what’s going on. Some people begin their thyroid cancer journey because they feel like something just isn’t normal.

At Banner MD Anderson Cancer Center, we understand how stressful uncertainty can be. Our multidisciplinary team offers expert support, advanced imaging and a full thyroid program designed to guide you from symptoms to answers. 

Common signs of thyroid cancer

Thyroid cancer often grows slowly, especially in the most common types. Many people feel completely healthy in the early stages, while others may notice small changes before getting a diagnosis. 

Here are symptoms that may need closer attention:

• Neck lump or swelling: The most common sign is a lump or nodule in the front of the neck. The thyroid is a small gland just below your voice box (larynx). A growing nodule may feel like a small bump under the skin or show up as visible swelling. Some people only notice it when they swallow or look in the mirror. 
• Voice changes: Because the thyroid gland sits near the nerves that control the vocal cords, a tumor can affect your voice. Symptoms may include hoarseness, a raspy voice or vocal fatigue that doesn’t go away.
• Trouble swallowing: A larger nodule or tumor can make it feel like food or pills are getting stuck. You may also feel pressure when you swallow. 
• Breathing changes: In rare cases, the thyroid can press on the windpipe, causing shortness of breath or noisy breathing (stridor).
• Neck or throat pain: Some people feel pain in the neck, jaw or ear, although this is less common.
• Chronic cough: A cough that isn’t related to a cold, allergies or illness can be a sign of thyroid or lymph node involvement. 
• Enlarged lymph nodes: Swollen neck lymph nodes may mean that cancer cells have spread to nearby nodes. This is a common pattern in certain thyroid cancers. 

Many conditions, including thyroid nodules, thyroiditis or infections, can cause similar symptoms. But if something feels off, make an appointment with your primary care provider.

Learn more about testing and diagnosis.   

Types of thyroid cancer

There are several types of thyroid cancer. Not all thyroid cancers behave the same way. Some grow slowly with few or no symptoms, while others develop and spread more quickly. 

The three main types are:

• Differentiated
• Medullary 
• Anaplastic

Differentiated thyroid cancer

Differentiated thyroid cancers are the most common. They grow from thyroid cells that make thyroid hormones. Under a microscope, these cancers look a lot like normal thyroid tissue. Because of this, they often grow slowly and respond well to treatment.

The main types of differentiated thyroid cancers are papillary, follicular and oncocytic carcinoma. 

Papillary thyroid cancer

Papillary thyroid cancer is the most common type. It makes up about 85% of all thyroid cancers. It often:

• Grows slowly
• Begins as a single nodule
• Spreads first to nearby lymph nodes
• Causes few or no symptoms early on

Because it grows slowly, many people don’t realize anything is wrong until a routine test finds a thyroid nodule. Even when papillary cancer spreads to lymph nodes, treatment success rates are very high.

Follicular thyroid cancer 

Follicular cancer also tends to grow slowly, but it spreads differently from papillary cancer. Instead of moving to the lymph nodes, it is more likely to spread through the bloodstream to the lungs or bones if not treated.

Oncocytic carcinoma of the thyroid

Oncocytic carcinoma (formerly called Hurthle cell cancer) is rare. It can be more aggressive and less responsive to radioactive iodine therapy. These tumors are often larger when they are diagnosed.

Medullary thyroid cancer (MTC)

Medullary thyroid cancer starts in the thyroid’s C cells, which make the hormone calcitonin. Calcitonin helps control calcium levels in the blood. MTC may appear on its own or as part of a genetic condition. 

MTC can be harder to detect and treat. In some cases, it spreads to the lymph nodes, lungs or liver before a nodule is discovered. 

There are two forms of MTC: 

• Sporadic - not inherited (meaning it does not run in families)
• Familial - passed down through families 

Anaplastic thyroid cancer

Anaplastic thyroid cancer (also called undifferentiated carcinoma) is one of the rarest and fastest-growing types. It can spread quickly and is difficult to treat. It usually develops in older adults and needs urgent treatment. 

Less common thyroid cancers

Other rare cancers that can begin in the thyroid include:

• Thyroid lymphoma
• Thyroid sarcoma
• Squamous cell carcinoma (SCC) of the thyroid

How symptoms change as thyroid cancer grows

Thyroid cancer often develops in stages:

Early stage:

• Small nodule 
• No symptoms
• Normal thyroid function 

Intermediate stage:

• Visible neck lump
• Mild trouble swallowing
• Hoarseness or voice fatigue
• Swollen lymph nodes (common with papillary cancer)

Advanced stage:

• A larger mass pressing on the airway (trachea) or esophagus
• Difficulty breathing
• Significant hoarseness
• Neck pain
• Persistent cough

What should you do if you have symptoms?

If you’re concerned about symptoms, schedule an appointment with your health care provider or ask for a referral to our diagnostic team at Banner MD Anderson. 

Our team will perform:

• A physical exam of your thyroid and neck
• Thyroid ultrasound
• Fine-needle aspiration biopsy
• Blood tests related to thyroid cancer
• Additional imaging to check for spread

Our specialists can help determine whether your symptoms are caused by thyroid cancer, a benign (non-cancerous) thyroid condition or something else. 

Learn more about thyroid cancer

• Risk factors and prevention
• Tests and diagnosis
• Treatment and support services  

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