Loading
Medullary thyroid cancer comes from the calcitonin-making C cells, not the thyroid hormone cells, so radioactive iodine does not work. Surgery is the only cure, a quarter of cases run in families through the RET gene, and the RET-selective drug selpercatinib has transformed treatment of advanced disease.
Medullary thyroid cancer arises from the parafollicular C cells and secretes calcitonin, which serves as its tumour marker. Germline RET mutations cause the hereditary forms (MEN2A, MEN2B and familial medullary thyroid cancer), and children who inherit them have the thyroid removed before cancer develops, timed by the mutation's risk level; most sporadic tumours carry a somatic RET M918T mutation, and a minority RAS mutations. Total thyroidectomy with central neck dissection is the only curative treatment, and calcitonin doubling time guides follow-up. For progressive advanced disease, vandetanib (2011) and cabozantinib (2012) were the first approved kinase inhibitors; selpercatinib, a RET-selective inhibitor, beat them in the LIBRETTO-531 trial and is now the standard for RET-mutant disease, with pralsetinib as an alternative. Phaeochromocytoma must be excluded before any thyroid surgery in MEN2.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Site decides cause and behaviour: HPV drives oropharyngeal cancer, EBV drives nasopharyngeal cancer, tobacco drives oral and laryngeal cancer; all drain into the neck node levels that surgeons and radiotherapists map.
Same organ: Acinic cell carcinoma of the salivary glands, Carcinoma ex pleomorphic adenoma, Multiple endocrine neoplasia type 1 (MEN1), Multiple endocrine neoplasia type 2 (MEN2A and MEN2B), Hyperparathyroidism-jaw tumour syndrome (CDC73-related parathyroid carcinoma), Oropharyngeal cancer (tonsil and base of tongue), Laryngeal and hypopharyngeal cancer, Oral cavity cancer (mouth and tongue), Head and neck squamous cell carcinoma, Nasopharyngeal carcinoma, Salivary gland cancers, Papillary thyroid cancer, Follicular thyroid cancer, Anaplastic thyroid cancer, Thyroid cancer, Nasal cavity and paranasal sinus cancers (including esthesioneuroblastoma), NUT carcinoma (midline carcinoma with NUTM1 rearrangement), Parathyroid carcinoma, Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4), HPV-positive oropharyngeal cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), Recurrent or metastatic head and neck squamous cell carcinoma, Hypopharyngeal cancer, Adenoid cystic carcinoma, Salivary duct carcinoma, Mucoepidermoid carcinoma, Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Lip cancer, Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA), Recurrent and metastatic nasopharyngeal carcinoma, Esthesioneuroblastoma (olfactory neuroblastoma), Sinonasal undifferentiated carcinoma (SNUC) and SWI/SNF-deficient sinonasal carcinoma
Nothing recorded yet.
Nothing recorded yet.
Also on OnCo: Symptoms and red flags · Early detection roadmap.
Prophylactic total thyroidectomy in childhood, timed by the RET codon risk category (before age one in MEN2B).
Total thyroidectomy with central compartment dissection, lateral dissection when nodes are involved; no radioactive iodine; levothyroxine replacement only.
Selpercatinib first line (LIBRETTO-531 beat cabozantinib and vandetanib); pralsetinib as an alternative.
Cabozantinib or vandetanib; external radiotherapy for local control; somatostatin analogues for diarrhoea from calcitonin.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
Selpercatinib is the first-line standard for advanced RET-mutant medullary thyroid cancer; RET testing at diagnosis is essential.
The medullary thyroid cancer page's approach to hereditary carriers and to surgery without radioactive iodine follows this guideline.
Cabozantinib is an option for progressive medullary thyroid cancer, now mainly for RET-negative disease or after selpercatinib.
Vandetanib is an approved option for progressive medullary thyroid cancer, used less since selpercatinib for RET-mutant disease.
Query for this cancer: (TITLE:"Medullary thyroid cancer" OR ABSTRACT:"Medullary thyroid cancer" OR TITLE:"Medullary thyroid carcinoma" OR ABSTRACT:"Medullary thyroid carcinoma" OR TITLE:"MTC" OR ABSTRACT:"MTC") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Medullary thyroid cancer, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Fainting, near-fainting, or an irregular or racing heartbeat; several kinase inhibitors prolong the QT interval and the labels require ECG and electrolyte monitoring.
Sudden severe abdominal pain, a hard or very tender abdomen, or abdominal pain with vomiting and fever. Boxed warning for gastrointestinal perforation on bevacizumab.
Tablets: take on an empty stomach (no food 2 hours before or 1 hour after). Avoid grapefruit.
Take on an empty stomach.
Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.
Reduce to 40 mg daily in moderate impairment; avoid in severe.
See all on the product pages:CabozantinibPralsetinibSelpercatinibVandetanib·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Medullary thyroid cancer, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.