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Thyroid Tumors

  • 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.

    • ThyroidThyroid cancer is often detected by the primary care physician during a routine exam.
      The cancer cells can spread (metastasize) to other parts of the body.
      Most children with thyroid cancer respond very well to treatment.

    How Children’s Hospital Boston approaches thyroid cancer

    The Thyroid Program at Children’s, 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

    We understand how overwhelming a diagnosis of thyroid cancer can be. Right now, you probably have a lot of questions. What is it? What is the best treatment? What do we do next?

    We’ve tried to provide some answers to those questions in the following pages, and our experts can explain your child’s condition fully when you meet with us.

    Types of thyroid cancer

    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 canceralso develops in the cells that produce thyroid hormone. Although its pattern of growth is somewhat different than 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 preventative 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.

    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

    The first step in treating your child is forming an accurate and complete diagnosis. Some children with thyroid cancer do experience symptoms—such as a lump in the neck. Others are diagnosed before presenting any symptoms, which is why it is 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 triage them to best individualized treatment (or to observation without treatment if their evaluation is reassuring).

    Because medullary thyroid cancer can sometimes occurs as part of a genetic disease, genetic testing is typically offered when medullary thyroid cancer is diagnosed. 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.

    After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Then we will meet with you and your family to discuss the results and outline the best treatment options.

    Resources for your family
    Our For Patients and Families website offers a wealth of general information and resources.

  • We know how difficult a diagnosis of thyroid cancer can be, both for your child and for your whole family. That's why our physicians are focused on family-centered care: From your first visit, you'll work with a team of professionals who are committed to supporting all of your family's physical and psychosocial needs. We'll work with you to create a care plan that's best for your child. 

    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.

    Coping and support

    We understand that you may have a lot of questions when your child is diagnosed with thyroid cancer. How will it affect my child long term? What do we do next? We've tried to provide some answers to those questions in the following pages, but there are also a number of other resources to help you and your family.
     
    Patient education: From the first visit through follow-up care, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have — How can I prevent complications or recognize them if they occur? How often will my child require follow-up? They will also reach out to you by phone, continuing the care and support you received while at Children's.
     
    Parent to parent: Want to talk with someone whose child has been treated for thalassemia? We can put you in touch with other families who have been through the same experience that you and your child are facing, and share with you their experience at Children's.
     
    Faith-based support: If you are in need of spiritual support, we will help connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
     
    Social work and mental health professionals: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.

    On our For Patients and Families site, you can read all you need to know about:

    • getting to Children's
    • accommodations
    • navigating the hospital experience
    • resources that are available for your family

    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

    We’re known for our science-driven approach. In fact, we’re home to the world's most extensive pediatric hospital research enterprise; and we partner with elite health care and biotech organizations around the globe. But as specialists in innovative, family-centered care, our physicians never forget that your child is precious, and not just a patient.

    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. For more information on our endocrinology research, click here.

    Children speak: What’s it like to be a medical research subject? (video)

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