Kanser tiroid (thyroid cancer) is cancer that starts in the thyroid, the butterfly-shaped gland at the front of your lower neck. The most common sign is a painless lump in the neck that slowly gets bigger, but many thyroid cancers cause no symptoms. Most thyroid lumps are not cancer, and most thyroid cancers can be cured with treatment, especially when found early. In Malaysia, thyroid cancer is the 8th most common cancer in women, and about half of the women diagnosed between 2017 and 2021 were aged 20 to 49. This guide explains the signs (tanda kanser tiroid), the types, who is at risk, how it is tested, what the stages (tahap 1 hingga 4) mean, the treatments, and life after treatment.
Apa itu kanser tiroid (thyroid cancer)?
Your thyroid is a small gland at the base of your neck, just above your windpipe. It makes hormones that control how your body uses energy, and help control your body temperature, blood pressure and heart rate (Cleveland Clinic). Thyroid cancer forms when the DNA in a thyroid cell changes (mutates) (Cleveland Clinic).
Thyroid cancer is different from the more common thyroid problems, an overactive thyroid (hipertiroid) or an underactive thyroid (hipotiroid). With thyroid cancer, thyroid blood tests such as TSH are usually normal, even when a cancer is present (American Thyroid Association). For overactive and underactive thyroid, see our guide to tiroid (thyroid problems).
Kanser tiroid dalam kalangan wanita Malaysia
The Malaysia National Cancer Registry Report 2017-2021, published by the Ministry of Health's Institut Kanser Negara, shows how thyroid cancer affects Malaysian women:
- 8th most common cancer in women. Thyroid cancer made up 3.6% of cancers in women, after breast, colorectal, lung, womb (corpus uteri), ovary, cervix and lymphoma.
- About 3 times more common in women. Between 2017 and 2021, 3,258 women and 1,035 men were diagnosed.
- It affects younger women. 1,639 of the 3,258 women, about half, were aged 20 to 49 when they were diagnosed.
- Higher in Malay women. The incidence rate was highest in Malay women (4.8 per 100,000), compared with 4.3 in Other Bumiputera, 3.8 in Indian and 2.6 in Chinese women.
- Often found early. A stage was recorded for 42.2% of women with thyroid cancer. Among them, 48.0% were stage 1 and 21.2% stage 2, while 19.8% were stage 4.
GLOBOCAN 2024 estimates from the International Agency for Research on Cancer estimate 844 new cases of thyroid cancer in Malaysia in 2024, men and women together, and 61 deaths. For the most common cancer in Malaysian women, see our guide to kanser payudara (breast cancer).
Tanda kanser tiroid (thyroid cancer symptoms)
The NHS lists these as the main symptoms of thyroid cancer:
- a lump in the front, lower part of your neck; it usually feels hard, slowly gets bigger and is not painful;
- a hoarse voice (suara serak);
- difficulty swallowing or breathing;
- pain in the front of your neck, or a feeling like something is pressing against your neck.
Less common symptoms include a red face (flushing), softer poos or diarrhoea, weight loss and a cough (NHS). Some people notice a lump in the mirror, or when buttoning a collar or fastening a necklace. Rarely, there may be pain in the neck, jaw or ear, or a "tickle in the throat" (American Thyroid Association).
However, most thyroid cancers do not cause any symptoms, and many are found by chance during a check-up or a scan done for another reason (Cleveland Clinic). These symptoms are very common and can be caused by many different conditions. Having them does not mean you have thyroid cancer, but get them checked, because finding cancer early may make it easier to treat (NHS). If your throat is sore, see our guide to sakit tekak (sore throat).
Benjolan tiroid: kebanyakannya bukan kanser
A thyroid lump is called a thyroid nodule (nodul tiroid). Nodules are very common: by age 60, about half of all people have a thyroid nodule that can be found by examination or a scan, and over 90% of them are not cancer (American Thyroid Association). Only a small number of thyroid nodules are diagnosed as cancer (National Cancer Institute).
Most nodules do not cause symptoms or need treatment, but some become large enough to make it hard to swallow or breathe (National Cancer Institute). A doctor will usually check a nodule with an ultrasound scan and, if needed, a fine-needle biopsy (see below). Not every neck lump comes from the thyroid. For other causes of neck lumps, see our guide to benjolan di leher (neck lumps).
Jenis kanser tiroid
Thyroid cancer is grouped by the type of cell it grows from. The type matters, because it affects how fast the cancer grows and how it is treated.
| Type | How common | What to know |
|---|---|---|
| Papillary | Most common; about 70% to 80% (American Thyroid Association) | Grows slowly and often spreads to lymph nodes in the neck, but responds very well to treatment (Cleveland Clinic). Usually affects women of childbearing age (MedlinePlus) |
| Follicular | About 10% to 15% (American Thyroid Association) | Can spread through the blood to the lungs and bones (American Thyroid Association) |
| Oncocytic | About 3% to 5% (Cleveland Clinic) | More likely to spread than papillary or follicular types, and harder to treat (Cleveland Clinic) |
| Medullary | About 2% (American Thyroid Association) | Starts in the C cells, which make the hormone calcitonin. About 25% runs in families, linked to a change in the RET gene (American Thyroid Association; National Cancer Institute) |
| Anaplastic | Less than 2% (American Thyroid Association) | Rare and aggressive. It grows and spreads quickly and is the hardest type to treat (Cleveland Clinic; MedlinePlus) |
Papillary and follicular cancers are called differentiated thyroid cancers. They can be treated and can usually be cured (National Cancer Institute).
Punca dan faktor risiko kanser tiroid
It is not always clear what causes thyroid cancer (NHS). Anyone can get it, but it is more common in women. The NHS says women are more likely to get it in their early 40s, and men in their 70s. You might be more likely to get thyroid cancer if (NHS; Cleveland Clinic; National Cancer Institute):
- you are overweight or have obesity;
- you have a thyroid condition such as a swollen thyroid (goitre), Hashimoto's disease or thyroid nodules;
- a close family member has had thyroid cancer;
- you had radiation to the head or neck, or radiotherapy, especially as a child;
- you have had certain cancers before, such as breast cancer, oesophageal cancer, testicular cancer or non-Hodgkin lymphoma;
- you have an inherited condition such as multiple endocrine neoplasia type 2 (MEN2), which is linked to medullary thyroid cancer;
- you are of Asian background.
Routine X-rays, such as dental X-rays, chest X-rays and mammograms, are not linked with a high risk of thyroid cancer (American Thyroid Association).
Can thyroid cancer be prevented?
You cannot always prevent thyroid cancer, but the NHS suggests trying to lose weight if you are overweight and cutting down on alcohol, which can lower your chance of getting it and other cancers. If you have a family history of medullary thyroid cancer, a genetic test can show whether you carry the changed gene, and doctors may recommend regular scans or removing the thyroid to prevent cancer (Cleveland Clinic; National Cancer Institute).
Ujian untuk kanser tiroid
Your doctor will feel your neck and may arrange a blood test (NHS). If they think you need more tests, you may be referred to a specialist. Tests may include (NHS; National Cancer Institute; MedlinePlus):
| Test | What it is for |
|---|---|
| Blood tests | To check how your thyroid is working (TSH and thyroid hormones). Calcitonin may be checked if medullary thyroid cancer is possible. Blood tests generally cannot find thyroid cancer on their own (American Thyroid Association) |
| Ultrasound scan of the neck | To look at the size of the lump, whether it is solid or filled with fluid, and the lymph nodes in the neck |
| Fine-needle aspiration biopsy | A thin needle takes a small sample of cells from the lump to check for cancer |
| Laryngoscopy | A thin tube with a camera checks whether your vocal cords are moving normally |
| CT, MRI or PET scan | To find out the size of the cancer and whether it has spread (the stage) |
A fine-needle biopsy may sound frightening, but the needle is very small and you can usually go home or back to work afterwards (American Thyroid Association). Up to 80% of thyroid biopsies show a benign (non-cancer) result. Sometimes the result is unclear, and part of the thyroid may need to be removed to find out for sure (American Thyroid Association).
Waiting for results can be worrying. The NHS says it usually takes about 2 weeks to get results, and a longer wait does not mean anything is wrong. You may want to bring someone with you for support when you get your results.
Kanser tiroid tahap 1 hingga tahap 4
Many readers search for "kanser tiroid tahap 4". The stage describes how big the cancer is and how far it has spread. Thyroid cancer stages range from 1 to 4: the higher the number, the bigger the tumour or the more it has spread (Cleveland Clinic). Staging depends on the type of thyroid cancer and your age (National Cancer Institute):
| Type and age | Stages used | What the highest stage means |
|---|---|---|
| Papillary or follicular, younger than 55 | Stage 1 and 2 only | Stage 2 means the cancer has spread to other parts of the body, such as the lungs or bones. Stage 1 can include spread to nearby tissues and lymph nodes |
| Papillary or follicular, 55 and older | Stage 1 to 4 | Stage 4A: the cancer has grown into tissue in front of the spine or around major blood vessels. Stage 4B: it has spread to other parts of the body |
| Medullary, any age | Stage 1 to 4 | Stage 4 includes spread into structures in the neck or to other parts of the body, such as the lungs or liver |
| Anaplastic, any age | Always stage 4 (4A, 4B or 4C) | Because it grows quickly, anaplastic thyroid cancer is always treated as stage 4 |
Source: National Cancer Institute. Your outlook depends on your age, the type and stage of the cancer, whether it was completely removed by surgery, and your general health (National Cancer Institute).
Survival rates
In the United States, the 5-year relative survival for thyroid cancer is about 98%, which means people with thyroid cancer are nearly as likely to be alive 5 years later as people without it (SEER; Cleveland Clinic). By how far the cancer has spread when it is found, US data show (SEER):
- cancer only in the thyroid: 99.9%;
- spread to nearby lymph nodes: 98.1%;
- spread to distant parts of the body: 48.3%.
These figures include all types of thyroid cancer together. Cleveland Clinic notes that survival is still excellent for papillary and follicular cancers even when they have spread, while it is lower for advanced medullary cancer and anaplastic cancer. Survival rates are based on large groups of people and cannot tell you what will happen to you. Ask your specialist how they apply to your situation.
Rawatan kanser tiroid
Thyroid cancer is often treatable (NHS). The treatment depends on the size and type of the cancer, whether it has spread, and your general health. Your specialist team will explain the benefits and side effects and make a treatment plan with you (NHS).
Surgery
Surgery is the most common treatment (NHS). You may have:
- all of your thyroid removed (total thyroidectomy); or
- part of your thyroid removed (lobectomy), for example if the cancer is small, in one side of the thyroid and has not spread to the lymph nodes (American Thyroid Association).
Lymph nodes in the neck may also be removed if the cancer has spread, or might have spread, to them (NHS). Thyroid cancer is often cured by surgery alone, especially if it is small. For very small papillary cancers less than 1 cm across (microcarcinoma), recent studies suggest some people can be safely watched without surgery (American Thyroid Association).
Radioactive iodine (RAI) treatment
Radioactive iodine (I-131) is taken as a tablet or a drink. It is absorbed mainly by thyroid cells, so it can destroy cancer cells left after surgery, help stop the cancer coming back, or treat cancer that has come back or spread (NHS; Cleveland Clinic). Before treatment, your doctor may ask you to follow a low-iodine diet (American Thyroid Association). Afterwards, you will need to follow radiation safety instructions, such as keeping a distance from children and pregnant women, usually for a few days to 2 weeks (American Thyroid Association).
Hormone tablets
If your thyroid has been removed, you will need thyroid hormone tablets to replace the hormones it used to make. They also help stop the cancer coming back (NHS).
Other treatments
- Targeted medicines aim to slow or stop the cancer growing, and may be used if other treatments are not an option or the cancer has spread (NHS).
- Radiotherapy using a machine may be used if the cancer cannot be removed by surgery, or has come back or spread (NHS).
- Chemotherapy is not usually used for thyroid cancer, but may be offered if the cancer has come back or spread (NHS).
If advanced thyroid cancer cannot be cured, the aim of treatment is to control the cancer and its symptoms and help you live longer, and a palliative care team can help you and your family (NHS).
Selepas rawatan: hormon, kesan sampingan dan kehamilan
Taking thyroid hormone for life
If your whole thyroid is removed, you will take thyroid hormone tablets every day for the rest of your life (MedlinePlus). If only part of your thyroid is removed, you may not need them (American Thyroid Association). You will have regular blood tests to check the dose.
Possible side effects
- Hoarse voice after surgery, from injury to the voice box (MedlinePlus).
- Low calcium levels, if the small parathyroid glands next to the thyroid are accidentally removed during surgery (MedlinePlus).
- Dry mouth, dry eyes, sore throat or loss of taste after radioactive iodine (American Thyroid Association).
Regular check-ups
You will have regular check-ups after treatment to make sure the cancer has not come back (NHS). Thyroid cancer can return, but this is uncommon: Cleveland Clinic says only about 2 in 10 papillary thyroid cancers come back. Contact your doctor if you notice new swelling in your neck or swollen lymph nodes. You do not need to wait for your next check-up if you have symptoms or side effects that worry you (NHS).
Pregnancy and breastfeeding
Thyroid cancer is the second most common cancer diagnosed during pregnancy, after breast cancer (Cleveland Clinic). If it is found while you are pregnant, your doctor may wait until after the birth to start treatment. If treatment cannot wait, surgery can usually be done safely, and tests or treatments that use radiation are delayed until you have finished breastfeeding (Cleveland Clinic).
The American Thyroid Association advises that:
- radioactive iodine must never be given during pregnancy or breastfeeding;
- breastfeeding must be stopped completely at least 6 weeks before radioactive iodine treatment, and should not be restarted for that baby afterwards; breastfeeding is safe after future pregnancies;
- pregnancy should be delayed until at least 6 to 12 months after radioactive iodine treatment.
If you are pregnant or planning a pregnancy, tell your specialist before any treatment. If you think you might be pregnant, see our guide to tanda-tanda mengandung (early pregnancy signs).
Emotional support
Being told you have thyroid cancer can feel overwhelming, even when the outlook is good. It can help to bring someone with you to appointments, and to ask your care team any questions you have (NHS). A cancer support group can also help you feel less alone (MedlinePlus).
Bila perlu jumpa doktor
See a doctor at a klinik kesihatan or your GP if you have (NHS):
- a lump in your neck;
- a hoarse voice that is not getting better;
- difficulty swallowing that is not getting better;
- pain in the front of your neck, or a feeling like something is pressing on your neck.
Get urgent medical help if you are having difficulty breathing or are more short of breath than usual (NHS). See our guide to sesak nafas (shortness of breath). If you have a goitre or another thyroid condition, see a doctor if your usual symptoms change, get worse or do not feel normal for you (NHS).
Frequently asked questions (FAQ)
Apa tanda awal kanser tiroid (what are the early signs of thyroid cancer)?
The most common first sign is a painless lump in the front, lower part of the neck that usually feels hard and slowly gets bigger (NHS). Other signs include a hoarse voice, difficulty swallowing or breathing, and pain in the front of the neck. Many thyroid cancers cause no symptoms at all and are found by chance during a check-up or a scan done for another reason (Cleveland Clinic). See a doctor if you have a neck lump, or a hoarse voice or swallowing problem that is not getting better.
Benjolan tiroid semestinya kanser ke (is a thyroid lump always cancer)?
No. Thyroid lumps (nodules) are very common, and fewer than 1 in 10 turn out to be cancer (American Thyroid Association). By age 60, about half of all people have a thyroid nodule that can be found on examination or a scan (American Thyroid Association). A doctor usually checks a nodule with an ultrasound scan and, if needed, a fine-needle biopsy to find out whether it is cancer.
Kanser tiroid boleh sembuh ke (is thyroid cancer curable)?
Most thyroid cancers can be cured with treatment, especially when the cancer has not spread to distant parts of the body (Cleveland Clinic). Papillary and follicular thyroid cancers, which are the most common types, can usually be cured (National Cancer Institute). In the United States, the 5-year relative survival for thyroid cancer is about 98%, which means people with thyroid cancer are nearly as likely to be alive 5 years later as people without it (SEER; Cleveland Clinic). Rarer types, such as anaplastic thyroid cancer, are much harder to treat.
Apa maksud kanser tiroid tahap 4 (what does stage 4 thyroid cancer mean)?
Stage 4 means the cancer has grown into important structures in the neck or spread to other parts of the body, such as the lungs or bones (National Cancer Institute). Staging depends on the type of thyroid cancer and your age. For papillary and follicular thyroid cancer in people younger than 55, there are only stages 1 and 2, even if the cancer has spread. Anaplastic thyroid cancer is always stage 4. Your specialist can explain what your stage means for your treatment and outlook.
Kenapa kanser tiroid lebih kerap pada wanita (why is thyroid cancer more common in women)?
Women are about 3 times more likely than men to get thyroid cancer (Cleveland Clinic). In Malaysia, 3,258 women and 1,035 men were diagnosed between 2017 and 2021, and thyroid cancer was the 8th most common cancer in women (Malaysia National Cancer Registry Report 2017-2021). Other risk factors include radiation to the head and neck in childhood, a family history of thyroid cancer, having a goitre or thyroid nodules, and being overweight (NHS).
Boleh hidup tanpa tiroid (can you live without a thyroid)?
Yes. If your whole thyroid is removed, you will take thyroid hormone tablets every day for the rest of your life to replace the hormones your thyroid used to make (MedlinePlus). The tablets also help stop the cancer coming back. If only part of the thyroid is removed, you may not need hormone tablets (American Thyroid Association). You will have regular blood tests and check-ups to make sure the dose is right.
Boleh mengandung selepas kanser tiroid (can I get pregnant after thyroid cancer)?
Talk to your specialist about timing. The American Thyroid Association advises delaying pregnancy until at least 6 to 12 months after radioactive iodine (I-131) treatment, and radioactive iodine must never be given during pregnancy or breastfeeding. If thyroid cancer is found while you are pregnant, treatment can often wait until after the birth, and surgery can usually be done safely if it cannot wait (Cleveland Clinic).
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. If you have a lump in your neck or other symptoms that worry you, see a doctor.
References
- Symptoms of thyroid cancer — NHS
- Causes of thyroid cancer — NHS
- Tests and next steps for thyroid cancer — NHS
- Treatment for thyroid cancer — NHS
- Thyroid cancer — Cleveland Clinic
- Thyroid cancer — MedlinePlus, U.S. National Library of Medicine
- Thyroid cancer treatment (PDQ), patient version — National Cancer Institute
- Cancer stat facts: thyroid cancer — SEER, National Cancer Institute
- Thyroid cancer (papillary and follicular) — American Thyroid Association
- Thyroid nodules — American Thyroid Association
- Radioactive iodine — American Thyroid Association
- Malaysia National Cancer Registry Report 2017-2021 — Institut Kanser Negara, Kementerian Kesihatan Malaysia
- GLOBOCAN 2024: Malaysia fact sheet — Global Cancer Observatory, International Agency for Research on Cancer
