Cancer types · Other solid tumours
Thyroid Cancer
Most thyroid cancers are differentiated (papillary or follicular) and many have a favourable outlook. Medullary and anaplastic thyroid cancers are less common and behave differently.
Molecular testing becomes important in advanced or treatment-resistant disease and in medullary thyroid cancer, where inherited RET variants are an important consideration.
Clinical and molecular questions that often arise
- Which type of thyroid cancer is it?
- For advanced or radioiodine-refractory disease, has molecular testing been done?
- For medullary thyroid cancer, has germline RET testing been offered?
- What do calcitonin and CEA show in medullary disease?
Information that may be part of an individual assessment
- Ultrasound and fine-needle aspiration.
- Histopathology after surgery.
- Thyroglobulin, or calcitonin and CEA for medullary cancer.
- Molecular testing in advanced disease.
Which investigations are appropriate is decided by the treating team for each person.
Molecular profiling and biomarker interpretation
Depending on the setting, molecular and biomarker questions in thyroid cancer may involve:
- BRAF V600E
- RET fusions (papillary) and RET mutations (medullary)
- NTRK and ALK fusions
- RAS mutations
- TERT promoter mutations
Biomarkers, panels and available tests vary by subtype, disease setting, assay and guideline version. A detected alteration is not automatically actionable.
How KPCIRC pathways may apply
POAS
POAS may help interpret a report in advanced thyroid cancer, separating alterations with thyroid-specific evidence from those without.
Molecular Tumour Board
MTB discussion may help where surgery, radioiodine, endocrinology and systemic treatment all need to be considered.
Second opinion and progression review
A second opinion may help clarify the extent of surgery or follow-up. Progression review may help when markers rise or imaging changes.
Hereditary risk and screening
Medullary thyroid cancer can be part of multiple endocrine neoplasia type 2 (MEN2), caused by inherited RET variants. Guidelines generally recommend germline RET testing for everyone with medullary thyroid cancer, because the result can matter for relatives.
How to access the relevant pathway
Patients and families
- Talk to your treating oncologist about whether an additional review may help.
- Request a consultation and tell us which question you want answered.
- Share records only when asked, through the secure route.
Referring doctors
- Define the clinical question and the pathway: POAS, MTB, second opinion or progression review.
- Start a case enquiry without patient identifiers.
- Scope, fees and timing are confirmed before any review proceeds.
Questions and limitations
Is thyroid cancer usually inherited?
Most are not. Medullary thyroid cancer is the main exception, where an inherited RET variant is found in a proportion of people.
What does radioiodine-refractory mean?
It describes disease that no longer takes up radioactive iodine, which changes which treatment questions are discussed.
Does this page apply to my situation?
This page is educational. It explains common questions but cannot account for individual circumstances. Your treating clinician is best placed to interpret your reports and plan your care.
Educational content reviewed against the KPCIRC service scope. It is not a diagnosis, a treatment recommendation or a statement that a specialist or service is available for this cancer type.