What The Fault in Our Stars Can Teach Us About Thyroid and Bone Cancer

On screen

The Fault in Our Stars follows two teenagers who meet at a cancer support group. Hazel Grace Lancaster lives with thyroid cancer that has spread to her lungs, and Augustus "Gus" Waters is a survivor of osteosarcoma, a form of bone cancer. The film handles both diagnoses with tenderness, and the two very different cancers give us a chance to explain each one clearly.

The reality

Thyroid cancer. According to the National Cancer Institute, there are four main types of thyroid cancer: papillary, follicular, medullary, and anaplastic. Papillary is the most common type, and the four types differ in how aggressive they are. NCI notes that thyroid cancer found at an early stage can often be treated successfully.

Hazel's cancer is described as having spread from the thyroid to her lungs. When a cancer spreads from where it started to another part of the body, it is called metastatic. Importantly, a cancer is still named for where it began — so thyroid cancer that has reached the lungs is still thyroid cancer, not a new lung cancer.

Bone cancer (osteosarcoma). NCI explains that bone cancer is rare and includes several types. Some bone cancers, including osteosarcoma and Ewing sarcoma, are seen most often in children and young adults. Gus's osteosarcoma fits that pattern — it is among the bone cancers that most often affect younger people, which is part of why the diagnosis resonates in a story about teenagers.

What the story gets right — and what to remember

The film reflects real facts on both fronts: thyroid cancer can spread beyond the thyroid, and osteosarcoma is a bone cancer that particularly affects children and young adults. Where fiction and reality part ways is in the details of any individual case. Every person's cancer, treatment, and course is different, and a movie is written to move an audience, not to describe anyone's medical situation.

Nothing here is medical advice. These characters' experiences should not be read as a guide to any real diagnosis; those conversations belong with a person and their healthcare team.

Awareness, screening & prevention

Here it's worth being honest about the limits of what NCI states. For thyroid cancer, NCI notes it does not have PDQ evidence-based information about prevention, and it maintains dedicated screening information rather than a general public screening recommendation. For bone cancer, NCI is equally clear that it does not have PDQ evidence-based information about prevention or about screening. The most useful takeaways from NCI are therefore about recognition and understanding: knowing that thyroid cancer has several types that vary in aggressiveness, that early-stage thyroid cancer can often be treated successfully, and that certain bone cancers concentrate in children and young adults.

Turning a story into something useful

A film that reached a generation of young readers and viewers put two less-discussed cancers — thyroid and bone — into everyday conversation. Learning the real facts (that a cancer keeps the name of where it started, that thyroid cancer has different types, that osteosarcoma often affects young people) turns an emotional story into lasting understanding. Sharing that knowledge and supporting free cancer education helps keep clear information available to families who need it.

Questions to ask a healthcare team

• What does it mean when a cancer spreads but keeps the name of where it started?
• What are the main types of thyroid cancer, and how do they differ?
• Which bone cancers are most common in children and young adults?
• Where can I find reliable, plain-language information about these cancers?