Although the prevalence of thyroid nodule is approximately 1% to 5% in the general adult population, 6% to 10% of older persons may have solitary nodules. Between 2% and 10% of thyroid nodules are noted to be carcinomatous. Approximately 1200 persons die of thyroid carcinoma each year in the United States alone; the incidence is much higher in women than in men. With early diagnosis and treatment, patients with thyroid cancers are living longer than ever before. In terminally ill older patients with nonresectable tumors and distant metastasis, all attention must be given to adequate pain control and maintenance of quality of life.