The American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) system is used for staging thyroid cancer. Initial management of patients should generally include laboratory measurements for general thyroid function with T3, T4, TSH (thyroid hormones), and sometimes blood levels of thyroglobulin. Other tests may include blood levels of calcium and, for patients with medullary thyroid cancer, calcitonin. An ultrasound of the neck is generally performed as initial imaging. Neck computerized tomography (CT) is sometimes obtained to evaluate regional anatomy including lymph nodes.
Unlike the staging of many other cancer disease sites, thyroid cancer staging includes age. In general, patients who are less than 45 years old fare much better than older patients. In fact, all patients younger than 45 are considered to have stage I disease unless they have metastasis (distant spread) which is considered stage II. At the other end of the spectrum, all patients with the anaplastic type of thyroid cancer are considered to have stage IV disease because of their near universally dismal outcomes with current treatment regimens.