HEALTH PROFESSIONAL · SOURCE READING

Metastatic papillary and follicular thyroid cancer

Source: Thyroid Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: May 9, 2025 · Captured 2026-09-09.

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Context: Papillary and Follicular Thyroid Cancer / Treatment Options for Papillary and Follicular Thyroid Cancer

Total thyroidectomy is still recommended as the initial treatment for metastatic papillary or follicular thyroid cancer. RAI is the second treatment and is given to ablate the remnant thyroid and treat the metastatic disease. If a thyroidectomy is not done, then RAI is not a treatment option for the patient. The most common sites of distant metastases are the lungs and bones. Treatment of distant metastases is usually not curative but may produce significant palliation. Genomic testing to identify actionable variants like RET and NTRK gene fusions should be considered for patients with advanced progressive disease. Treatment options for iodine-sensitive and iodine-resistant metastatic papillary and follicular thyroid cancer are described below.

Treatment options for iodine-sensitive thyroid cancer

Treatment options for iodine-sensitive thyroid cancer include:

RAI therapy. Metastases that demonstrate uptake of this isotope may be ablated by therapeutic doses of 131I.

Thyroid-suppression therapy.

Treatment options for iodine-resistant thyroid cancer

Treatment options for iodine-resistant thyroid cancer include:

Thyroid-suppression therapy.

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