Follicular Thyroid Cancer: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Follicular Thyroid Cancer?
An endocrinologist, a doctor who treats hormone and gland problems, and a thyroid surgeon usually care for follicular thyroid cancer. An oncologist, a cancer doctor, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is follicular thyroid cancer?
The thyroid gland is in the front part of the neck. It makes hormones that help regulate your metabolism, heart rate, blood pressure, and body temperature. Follicular cells in the thyroid use iodine from the blood to make these hormones.
Follicular thyroid cancer is a cancer of the thyroid gland. It is also called follicular carcinoma. It makes up about 1 out of 10 thyroid cancers.
These cancers usually do not spread to lymph nodes, but they can spread to other parts of the body, such as the lungs or bones. Lymph nodes are small glands that help fight infection.
The outlook for follicular cancer is not quite as good as that of papillary cancer, although it is still very good in most cases. Follicular carcinoma is more likely to come back and spread.
Symptoms
Symptoms vary depending on the type of thyroid cancer, but may include:
- A lump in the thyroid, called a nodule.
- Neck swelling.
- Enlargement of the thyroid gland.
- Hoarseness or a changing voice.
- Difficulty swallowing.
- Cough.
Most thyroid nodules are benign, which means not cancer. Only a small percentage are cancer.
Causes and who gets it
Thyroid cancer can occur in people of any age. Radiation to the thyroid increases the risk of developing thyroid cancer. This can come from radiation therapy to the neck, especially in childhood, or from nuclear plant disasters.
Risk factors are a family history of thyroid cancer and a chronic goiter, which is an enlarged thyroid.
Follicular thyroid cancer is more common in countries where people do not get enough iodine in their diet.
How doctors diagnose it
Your provider will do a physical exam. This may reveal a lump in your thyroid or swollen lymph nodes in your neck. Tests may include:
- A thyroid biopsy.
- A thyroid scan.
- Blood tests of thyroid function.
- An ultrasound of the thyroid and the lymph nodes of the neck.
- A CT scan of the neck.
- A PET scan.
A biopsy takes a small sample of tissue to check under a microscope.
Most often, a needle biopsy alone cannot show that a thyroid tumor is a follicular cancer. In that case the result may say "follicular neoplasm." Most follicular neoplasms turn out not to be cancer. To be sure, the next step is usually surgery to remove the half of the thyroid that has the tumor.
Treatment
Surgery is most often the initial treatment. Follicular thyroid cancer is usually treated in much the same way as papillary thyroid cancer.
If the tumor turns out to be a follicular cancer, a second operation is usually done to remove the rest of the thyroid. If there are signs before surgery that the cancer has spread, a total thyroidectomy, removal of the whole thyroid, will be done. Some nearby lymph nodes in the neck might also be removed and checked for cancer.
People who have had a thyroidectomy will need to take daily thyroid hormone therapy. The pills replace the thyroid hormone your body needs to function normally.
A radioiodine scan is usually done after surgery to look for areas in the body still taking up iodine. Cancer that has spread and takes up iodine can be treated with radioactive iodine. It is taken by mouth. If the cancer does not take up iodine, external beam radiation may help treat the tumor or prevent it from growing back in the neck.
If the cancer comes back, it might be found by blood tests or by imaging tests such as ultrasound or radioiodine scans.
Possible complications include a hoarse voice after surgery. A low calcium level can happen if the parathyroid glands are accidentally removed.
When to see a doctor
Contact your provider if you notice a lump in your neck. Hoarseness, a changing voice, or trouble swallowing can also be signs, so mention them to your provider. Most thyroid nodules are benign, which means they are not cancer.
Call 911 or go to the emergency room if you have trouble breathing or choking.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can examine a neck lump, order an ultrasound and blood tests, and refer you to a thyroid specialist. They can also help coordinate follow-up care after treatment.
Common questions
Is follicular thyroid cancer serious?
It can be, but the outlook is very good in most cases. Follicular carcinoma is more likely to come back and spread.
Is follicular thyroid cancer the same as papillary thyroid cancer?
No, they are two different types of thyroid cancer. Follicular cancer is usually treated in much the same way as papillary cancer.
Can follicular thyroid cancer spread?
Yes, it can spread to other parts of the body, such as the lungs or bones. It usually does not spread to lymph nodes.
Will I need thyroid hormone pills after surgery?
Yes, if your thyroid is removed, you will need daily thyroid hormone therapy. The pills replace the thyroid hormone your body needs.
Sources
- American Cancer Society - What Is Thyroid Cancer? Types of Thyroid Cancer
- American Cancer Society - Treatment of Thyroid Cancer, by Type and Stage
- MedlinePlus - Thyroid cancer
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
