Children can suffer from a variety of thyroid issues, but can they develop thyroid cancer? Sadly, the truth is yes, although the good news is it is far from common. Top endocrinologist Dr Mark Vanderpump completes his series on thyroid problems in children and adolescents with this guide to paediatric thyroid cancer.
Thyroid cancer in children – rare, but dangerous
5 Quick facts:
- Thyroid cancer is thankfully rare in children. However, children who have had radiotherapy to their head or neck are at a higher risk than others.
- Thyroid cancer symptoms include nodules on the thyroid, enlarged lymph nodes, pain in the neck and changes in the voice. More rarely, they can cause swelling in the neck (goitres).
- After the Chernobyl nuclear incident in 1986, the surrounding area (such as Belarus), affected by high doses of radiation, saw an increased incidence of thyroid cancer in children less than ten years old at the time of the incident. Over 30 years later, the frequency is now falling but remains above average.
- Thyroid nodules are more likely to be cancerous in children than adults. This means that even if tests, such as fine-needle aspiration cytology suggest they are benign, surgery still may be recommended to remove the nodules.
- Thyroid cancer is more aggressive in children aged ten or under, and recurrence rates are also a little higher.
Thyroid Cancer Treatment
Treating thyroid cancer in children is similar to adult treatment:
- A total thyroidectomy (surgical removal) is the first step.
- Targeting a low serum TSH (thyroid stimulating hormone) level using thyroid hormone replacement with levothyroxine is recommended for all patients.
- Radioiodine treatment – this is especially recommended in children under ten, and in patients who show signs that the cancer has spread to the lymph nodes in the neck.
- It is essential for the child to have regular follow-ups for the rest of their life, with their doctors measuring thyroglobulin levels in the blood – the presence of this protein indicates that there is still some thyroid material left in the patient, which could be cancerous.
The prognosis for children with thyroid cancer is excellent with mortality rates at less than 10%.