KidsMD Health Topics

Pediatric Thyroid Cancer

  • Overview

    You probably haven’t spent too much time thinking about your child’s thyroid: A small, butterfly-shaped gland located at the base of the neck, it’s easy to overlook. But the thyroid actually plays a critical role in your child’s development—it produces hormones that control growth and metabolism. Thyroid cancer—when the cells in the gland become abnormal and grow out of control—is unusual in children, but, unfortunately, it does occur, and the cancer cells can spread, or metastasize, to other parts of the body.

    The Thyroid Program at Children’s Hospital Boston, one of the only centers in the United States devoted exclusively to the care of children with thyroid diseases, is distinguished by our expertise in thyroid sonography, fine needle aspiration and radioiodine therapy.   We are committed to offering the best multispecialty, long-term care to children with thyroid cancer. You may not have spent a lot of time thinking about the thyroid, but we have, and at Children’s your child will be in good hands.

    Reviewed by Stephen A. Huang, MD,
    © Children’s Hospital Boston, 2010

    »
    Boston Children's Hospital 
    300 Longwood Avenue
    Boston MA 02115
     617-355-7476

  • In-Depth

    There are three main types of thyroid cancer:

    • Papillary thyroid cancer, the most common type, develops in the cells that produce thyroid hormone. It is most often treated with surgery, followed by radioiodine therapy and a type of hormone treatment called TSH suppression.
    • Follicular thyroid cancer also develops in the cells that produce thyroid hormone. Although its pattern of growth is somewhat different from papillary thyroid cancer’s, it is generally treated in a similar fashion.
    • Medullary thyroid cancer, the least common type, develops in cells that do not produce thyroid hormone. Surgery is the primary therapy for this type of cancer. Certain families are predisposed to develop this type of cancer and can be offered genetic testing to guide preventive care.
    • Anaplastic thyroid cancer is an extremely rare type of thyroid cancer that occurs almost exclusively in adults. Surgery is the primary therapy, followed by radiation therapy and sometimes chemotherapy.

    Causes

    Doctors have discovered that unusually high exposure to radiation can cause children to develop thyroid cancer—this is one reason that radiation is no longer used to treat benign conditions. And in rare cases, thyroid cancers can be familial. But the vast majority of children who develop thyroid cancer—about 90 percent—have no known risk factors for the disease whatsoever.

     

    Early detection and prevention

    As with other cancers, the outcome of thyroid cancer is best when it is diagnosed and treated in its early stages. Our thyroid program is designed to rapidly evaluate patients with thyroid masses in order to deliver individualized treatment.

                 Because medullary thyroid cancer sometimes occurs as part of a genetic[h1]  disease, we typically offer genetic testing. If this testing shows that your child carries a genetic risk, your child’s physician will monitor your child and, in some cases, may suggest a prophylactic removal of your child’s thyroid.

     

    When to seek medical advice

    Often, a child’s thyroid cancer is detected by his primary care physician during the course of a routine well-child exam. But please don’t hesitate to contact your child’s doctor if you notice a lump in your child’s throat or if anyone in your family is diagnosed with medullary thyroid cancer.

     

    Long-term outlook

    Thyroid cancer is unquestionably serious, and your child’s prognosis will of course depend on the type of cancer, when it is diagnosed, and how it is treated.  [h3] Fortunately, most children with thyroid cancer do respond very well to treatment.


     [h1]Majority of medullary thyroid cancer in adults is sporadic rather than genetic.  In children, the incidence of genetic vs. sporadic medullary thyroid cancer is unknown but likely varies dramatically from one part of the world to another (so would not generalize).

     [h3]Most everyone says this (not controversial, so removed specific reference to me).

    FAQ

    Q: Will my child be OK?

    A: Thyroid cancer is unquestionably serious, and your child’s prognosis will of course depend on the type of cancer, when it is diagnosed and how it is treated. Fortunately, most children with thyroid cancer do respond very well to treatment.      

    Q: What are the symptoms of thyroid cancer?

    A: Symptoms may include a lump in the neck, swollen lymph nodes, hoarseness or trouble with breathing or swallowing, but most children with thyroid cancer feel absolutely well at the time of diagnosis.

    Q: Was my child’s cancer caused by exposure to radiation?

    A: High radiation doses (such as those used to treat certain childhood cancers) may increase a child’s risk of developing thyroid cancer. Such exposures are fortunately very rare. In comparison, the radiation exposure from common radiology test (such as X-rays, CT imaging, or dental films) are very low and are not thought to increase a child’s risk of developing thyroid cancer.

    Questions to ask your doctor

    After your child is diagnosed with thyroid cancer, you may feel overwhelmed with information. It can be easy to lose track of the questions that occur to you.

    Lots of parents find it helpful to jot down questions as they arise—that way, when you talk to your child’s doctors, you can be sure that all of your concerns are addressed.

    Here are some questions to get you started:

    • What type of thyroid cancer does my child have?
    • Has my child’s thyroid cancer spread?
    • Can it be treated with surgery?
    • How long will my child need to be in the hospital?
    • What are the possible short and long-term complications of treatment? How will they be addressed?
    • What is the likelihood of cure?
    • What services are available to help my child and my family cope?
    CarePages

    Keep family and friends up to date during your child’s treatment by creating a free Children’s CarePage.

  • Tests

    Some children with thyroid cancer do experience symptoms—such as a lump in the neck.

    Others are diagnosed before they have any symptoms, which is why it’s so important to take your child for regular check-ups. In order to diagnose thyroid cancer, your child’s physician will take a complete medical history and conduct a physical examination. Your child’s physician may also perform other diagnostic procedures, including:

    • blood tests, to see if the thyroid is functioning properly
    • an ultrasound (also called sonography) to confirm the presence of a thyroid mass

    Like other cancers, the outcome of thyroid cancer is best when it is diagnosed and treated in its early stages. Our thyroid program is designed to rapidly evaluate patients with thyroid masses in order to quickly get them individualized treatment (or to observation without treatment if their evaluation is reassuring). Children’s Thyroid Program is distinguished by our expertise in ultrasound-guided fine needle aspiration—a very safe, minimally-invasive procedure that has eliminated the need for complicated surgery in most patients.

  • Your child's care will, of course, vary, depending on the type of thyroid cancer with which your child has been diagnosed. Some potential components of treatment include:

    • Surgery: Your child's physician will remove as much of the cancer as possible. If necessary, surgeons will remove the entire thyroid, in a procedure called “near-total thyroidectomy.”
    • Radioactive iodine therapy: Your child's doctors may recommend a course of radioactive medication to destroy cancer cells that may be left after surgery.
    • Hormone therapy: This is given to patients with thyroid cancer to replace normal hormones and to slow the growth of cancer cells.
    Integrative therapies

    Our patient-centered approach means that we want your child to not only get better, but also feel good along the way. Throughout the hospital, you¹ll find clinicians trained in therapies that can make your child feel more comfortable, learn to shift focus away from pain and enjoy some peaceful moments during what may be an anxious time. Read about how acupuncture, guided meditation, guided imagery, massage, Reiki and therapeutic touch could help your child.

  • Research & Innovation

    Along with Dana-Farber Cancer institute, Children’s Hospital Boston is conducting numerous research studies that will help clinicians better understand and treat thyroid cancer. Learn more about our endocrinology research.

    Clinical trials

    Children’s doctors and scientists have made many breakthrough discoveries about diseases like polio and leukemia; our ongoing innovative research continues to push the boundaries of the way pediatric medicine is practiced.

    It’s possible that your child will be eligible to participate in one of Children’s current clinical trials. These studies are useful for a multitude of reasons: Some trials are designed to evaluate the effectiveness of a particular drug, treatment or therapy on a specific disease; others help doctors to better understand how and why certain conditions occur. At any given time, Children’s has hundreds of clinical trials underway.

    If your child’s physician recommends participation in one of Children’s clinical trials, that likely means that your child’s physician believes that the plan outlined in that trial represents the absolute best, latest care your child can possibly receive.

    And participation in any clinical trial is completely voluntary: We will take care to fully explain all elements of the treatment plan prior to the start of the trial, and you may remove your child from the medical study at any time.

    To search for a cancer trial at Dana Farber/Children’s Hospital Cancer Center, go to: Dana-Farber, Pediatric Oncology Clinical Trials.

    To search the NIH’s list of clinical trials taking place around the world, go to: http://www.clinicaltrials.gov/ct2/search

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