Thyroid cancer is a relatively common endocrine malignancy, often diagnosed in its early stages. The disease originates in the thyroid gland, a butterfly-shaped organ located at the base of the neck. While the vast majority of cases are highly treatable with an excellent prognosis, the disease can prove fatal in rare instances. These tragic outcomes are often highlighted when they affect public figures, offering a stark reminder of the disease’s most aggressive forms.
Documented Cases of Mortality
The late Chief Justice of the United States, William Rehnquist, is a prominent example who died from a virulent form of the disease. He was diagnosed with thyroid cancer in October 2004 and died less than a year later in September 2005 at the age of 80. The aggressive nature of his treatment, which included a tracheotomy, chemotherapy, and radiation, suggested he was battling the fastest-growing subtype of thyroid cancer.
Opera singer and mezzo-soprano Joanna Simon, the sister of Carly Simon, also died from the disease in October 2022 at the age of 85. Her passing highlighted that thyroid cancer can still be deadly, particularly in older patients or those with a later-stage diagnosis.
Types of Thyroid Cancer That Cause Death
Fatal cases are almost always attributed to the rare, undifferentiated, or highly metastatic forms. The most lethal of these is Anaplastic Thyroid Carcinoma (ATC), which accounts for less than two percent of all thyroid cancer diagnoses but is responsible for up to 40 percent of all thyroid cancer deaths. ATC is characterized by its uncontrolled and rapid growth, often presenting as an enlarging mass in the neck.
This aggressive growth frequently leads to local invasion of adjacent structures like the trachea and esophagus. Airway obstruction and suffocation are common for ATC patients, often necessitating procedures like a tracheotomy. The median survival time is only a few months, reflecting its extreme resistance to conventional treatments.
Medullary Thyroid Carcinoma (MTC) originates from the parafollicular C-cells of the thyroid, rather than the more common follicular cells. While generally having a better prognosis than ATC, advanced MTC that has spread to distant sites also carries a poor outlook. Unlike the common forms, MTC does not respond to radioactive iodine therapy because its cells do not absorb iodine.
Contextualizing the High Survival Rate
The celebrity fatalities are exceptions to the positive prognosis for most thyroid cancer patients. Papillary and follicular carcinomas, collectively known as differentiated thyroid cancers, make up over 95 percent of all cases. For these common forms, the overall five-year relative survival rate in the United States is approximately 98.4 percent.
The excellent prognosis is heavily influenced by the cancer stage at the time of diagnosis. For cancer localized entirely within the thyroid gland, the five-year survival rate exceeds 99.5 percent. Even when the cancer has spread to nearby lymph nodes, classified as regional disease, the five-year survival remains exceptionally high, around 98 to 99 percent for differentiated subtypes.
Standard treatment involves surgical removal of the thyroid gland, known as a total thyroidectomy or a lobectomy. Following surgery, high-risk patients often receive radioactive iodine (RAI) therapy, which targets and destroys any remaining thyroid tissue or microscopic cancer cells. This combination of surgery and targeted treatment contributes directly to the high success rates.
Even for differentiated thyroid cancer that has spread to distant organs, the five-year survival rate remains high, at 74 percent for papillary and 67 percent for follicular carcinoma. The rarity and virulence of Anaplastic Thyroid Carcinoma make the disease fatal in isolated cases, but these outcomes should not overshadow the highly favorable statistics for the vast majority of individuals diagnosed.