Guidelines Thyroid Cancer in Children
GENERAL DESCRIPTION:
There are three major types of thyroid cancer. The first is papillary thyroid cancer (PTC), the second is follicular thyroid cancer (FTC), and the third is differentiated thyroid cancer (DTC). Papillary thyroid cancer (PTC) is the most common in children and adults and it represents 85%-90% of cases. Follicular thyroid cancer (FTC) is usually found as a solitary thyroid nodule. It has a low risk to spread into lymph nodes in the neck but because it the cancer may invade the blood vessels it possibly can spread to the lungs and bones. The last major type is differentiated thyroid cancer (DTC) which by definition includes both papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC). Differentiated thyroid cancer (DTC) is different in adults and children. In adults, the cancer has a high risk of metastasis however most patients still live a very normal and happy life. Children have much better outcomes than adults have with this cancer. After being diagnosed, approximately 40 to 60% of children develop lymph nodes and only 15% of the time will the lymph nodes spread into cancer in the lungs. If you wish to learn more about the topic of thyroid cancer, you may continue onto these sites:
http://www.endocrineweb.com/conditions/thyroid-cancer/thyroid-cancer
http://www.thyroid.org/cancer-of-the-thyroid-gland/
Spanish Translation
Hay tres tipos principales de cáncer de tiroides. La primera es el cáncer papilar de la tiroides (PTC), el segundo es el cáncer folicular de la tiroides (FTC) y el tercero es el cáncer diferenciado de tiroides (DTC). Cáncer papilar de la tiroides (PTC) es la más común en niños y adultos y representa el 85% - 90% de los casos. Cáncer folicular de la tiroides (FTC) se encuentra generalmente como un nódulo tiroideo solitario. Tiene un bajo riesgo de propagación a los ganglios linfáticos en el cuello, pero debido a el cáncer puede invadir los vasos sanguíneos posiblemente puede propagarse a los pulmones y los huesos. El último tipo importante es cáncer diferenciado de tiroides (DTC) que por definición incluye cáncer papilar de la tiroides (PTC) y cáncer de tiroides folicular (FTC). Cáncer diferenciado de tiroides (DTC) es diferente en niños y adultos. En adultos, el cáncer tiene un alto riesgo de metástasis sin embargo más pacientes todavía viven una vida muy normal y feliz. Los niños tienen mucho mejores resultados que los adultos tienen con este cáncer. Después de ser diagnosticado, aproximadamente 40 a 60% de los niños desarrollan ganglios linfáticos y sólo el 15% del tiempo se extenderá los ganglios linfáticos en cáncer en los pulmones. Si usted desea aprender más sobre el tema del cáncer de tiroides, puede continuar en estos sitios:
TYPES OF THYROID CANCER IN CHILDREN:
Papillary: This form of thyroid cancer occurs in cells that produce thyroid hormones containing iodine. This type, the most common form of thyroid cancer in children, grows very slowly. This form can spread to the lymph nodes via lymphatics in the neck and occasionally spreads to more distant sites.
Follicular:
This type of thyroid cancer also develops in cells that produce thyroid hormones containing iodine. The disease afflicts a slightly older age group and is less common in children. This type of thyroid cancer is more likely to spread to the neck via blood vessels, causing the cancer to spread to other parts of the body, making the disease more difficult to control.
Medullary:
This rare form of thyroid cancer develops in cells that produce calcitonin, a hormone that does not contain iodine. This cancer tends to spread to other parts of the body and constitutes about 5-10 percent of all thyroid malignancies. Medullary thyroid carcinoma (MTC) in the pediatric population is usually associated with specific inherited genetic conditions, such as multiple endocrine neoplasia type 2 (MEN2)
Anaplastic:
This is the fastest growing of the thyroid cancers, with abnormal cells that grow and spread rapidly, especially locally in the neck. This form of cancer is not seen in children.
Symptoms:
Symptoms of this disease vary. Your child may have a lump in the neck, persistent swollen lymph nodes, a tight or full feeling in the neck, trouble with breathing or swallowing, or hoarseness.
Diagnosis:
If any of these symptoms occur, consult your child’s physician for an evaluation. The evaluation should consist of a head and neck examination to determine if unusual lumps are present. A blood test may be ordered to determine how the thyroid is functioning. Ultrasonography uses sound waves and a computer to create an image of the thyroid gland and neck contents such as lymph nodes. Other tests that may be warranted include a radioactive iodine scan, which provides information about the thyroid shape and function, identifying areas in the thyroid that do not absorb iodine in the normal way, or a fine needle biopsy of any abnormal lump in the thyroid or neck. Sometimes it is necessary to remove a part of the tumor or one of the lobes of the thyroid gland, known as a thyroid lobectomy, for analysis to help establish a diagnosis and plan for management.
TREATMENTS FOR THYROID CANCER:
If the tumor is found to be malignant, then surgery is recommended. Surgery may consist of a lobectomy, subtotal thyroidectomy (removal of at least one lobe and up to near-total removal of the thyroid gland), or a total thyroidectomy. In children with papillary or follicular thyroid cancer, total or near-total thyroidectomy is currently the standard of practice, as children typically have more extensive disease at presentation, have higher rates of spread, and it reduces the risk of recurrence. In children, there is an increased need for repeat surgery when less than a total thyroidectomy is performed. Lymph nodes in the neck may need to be removed as part of the treatment for thyroid cancer if there is suspicion of spread of cancer to the lymph nodes.
Surgery may be followed by radioactive iodine therapy, to destroy cancer cells that are left after surgery. Thyroid hormone therapy may need to be administered throughout your child’s life to replace normal hormones and slow the growth of any residual cancer cells.
If cancer has spread to other parts of the body, chemotherapy (treatment by chemical substances or drugs) may be given. This therapy interferes with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells and shrink tumors. Radiation treatment may also be required for treatment of some forms of thyroid cancer.
In general, treatment outcomes for this type of cancer in children tend to be excellent. The best outcomes are seen in teenage girls, papillary type cancer, and tumors localized to the thyroid gland.
There are three major types of thyroid cancer. The first is papillary thyroid cancer (PTC), the second is follicular thyroid cancer (FTC), and the third is differentiated thyroid cancer (DTC). Papillary thyroid cancer (PTC) is the most common in children and adults and it represents 85%-90% of cases. Follicular thyroid cancer (FTC) is usually found as a solitary thyroid nodule. It has a low risk to spread into lymph nodes in the neck but because it the cancer may invade the blood vessels it possibly can spread to the lungs and bones. The last major type is differentiated thyroid cancer (DTC) which by definition includes both papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC). Differentiated thyroid cancer (DTC) is different in adults and children. In adults, the cancer has a high risk of metastasis however most patients still live a very normal and happy life. Children have much better outcomes than adults have with this cancer. After being diagnosed, approximately 40 to 60% of children develop lymph nodes and only 15% of the time will the lymph nodes spread into cancer in the lungs. If you wish to learn more about the topic of thyroid cancer, you may continue onto these sites:
http://www.endocrineweb.com/conditions/thyroid-cancer/thyroid-cancer
http://www.thyroid.org/cancer-of-the-thyroid-gland/
Spanish Translation
Hay tres tipos principales de cáncer de tiroides. La primera es el cáncer papilar de la tiroides (PTC), el segundo es el cáncer folicular de la tiroides (FTC) y el tercero es el cáncer diferenciado de tiroides (DTC). Cáncer papilar de la tiroides (PTC) es la más común en niños y adultos y representa el 85% - 90% de los casos. Cáncer folicular de la tiroides (FTC) se encuentra generalmente como un nódulo tiroideo solitario. Tiene un bajo riesgo de propagación a los ganglios linfáticos en el cuello, pero debido a el cáncer puede invadir los vasos sanguíneos posiblemente puede propagarse a los pulmones y los huesos. El último tipo importante es cáncer diferenciado de tiroides (DTC) que por definición incluye cáncer papilar de la tiroides (PTC) y cáncer de tiroides folicular (FTC). Cáncer diferenciado de tiroides (DTC) es diferente en niños y adultos. En adultos, el cáncer tiene un alto riesgo de metástasis sin embargo más pacientes todavía viven una vida muy normal y feliz. Los niños tienen mucho mejores resultados que los adultos tienen con este cáncer. Después de ser diagnosticado, aproximadamente 40 a 60% de los niños desarrollan ganglios linfáticos y sólo el 15% del tiempo se extenderá los ganglios linfáticos en cáncer en los pulmones. Si usted desea aprender más sobre el tema del cáncer de tiroides, puede continuar en estos sitios:
TYPES OF THYROID CANCER IN CHILDREN:
Papillary: This form of thyroid cancer occurs in cells that produce thyroid hormones containing iodine. This type, the most common form of thyroid cancer in children, grows very slowly. This form can spread to the lymph nodes via lymphatics in the neck and occasionally spreads to more distant sites.
Follicular:
This type of thyroid cancer also develops in cells that produce thyroid hormones containing iodine. The disease afflicts a slightly older age group and is less common in children. This type of thyroid cancer is more likely to spread to the neck via blood vessels, causing the cancer to spread to other parts of the body, making the disease more difficult to control.
Medullary:
This rare form of thyroid cancer develops in cells that produce calcitonin, a hormone that does not contain iodine. This cancer tends to spread to other parts of the body and constitutes about 5-10 percent of all thyroid malignancies. Medullary thyroid carcinoma (MTC) in the pediatric population is usually associated with specific inherited genetic conditions, such as multiple endocrine neoplasia type 2 (MEN2)
Anaplastic:
This is the fastest growing of the thyroid cancers, with abnormal cells that grow and spread rapidly, especially locally in the neck. This form of cancer is not seen in children.
Symptoms:
Symptoms of this disease vary. Your child may have a lump in the neck, persistent swollen lymph nodes, a tight or full feeling in the neck, trouble with breathing or swallowing, or hoarseness.
Diagnosis:
If any of these symptoms occur, consult your child’s physician for an evaluation. The evaluation should consist of a head and neck examination to determine if unusual lumps are present. A blood test may be ordered to determine how the thyroid is functioning. Ultrasonography uses sound waves and a computer to create an image of the thyroid gland and neck contents such as lymph nodes. Other tests that may be warranted include a radioactive iodine scan, which provides information about the thyroid shape and function, identifying areas in the thyroid that do not absorb iodine in the normal way, or a fine needle biopsy of any abnormal lump in the thyroid or neck. Sometimes it is necessary to remove a part of the tumor or one of the lobes of the thyroid gland, known as a thyroid lobectomy, for analysis to help establish a diagnosis and plan for management.
TREATMENTS FOR THYROID CANCER:
If the tumor is found to be malignant, then surgery is recommended. Surgery may consist of a lobectomy, subtotal thyroidectomy (removal of at least one lobe and up to near-total removal of the thyroid gland), or a total thyroidectomy. In children with papillary or follicular thyroid cancer, total or near-total thyroidectomy is currently the standard of practice, as children typically have more extensive disease at presentation, have higher rates of spread, and it reduces the risk of recurrence. In children, there is an increased need for repeat surgery when less than a total thyroidectomy is performed. Lymph nodes in the neck may need to be removed as part of the treatment for thyroid cancer if there is suspicion of spread of cancer to the lymph nodes.
Surgery may be followed by radioactive iodine therapy, to destroy cancer cells that are left after surgery. Thyroid hormone therapy may need to be administered throughout your child’s life to replace normal hormones and slow the growth of any residual cancer cells.
If cancer has spread to other parts of the body, chemotherapy (treatment by chemical substances or drugs) may be given. This therapy interferes with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells and shrink tumors. Radiation treatment may also be required for treatment of some forms of thyroid cancer.
In general, treatment outcomes for this type of cancer in children tend to be excellent. The best outcomes are seen in teenage girls, papillary type cancer, and tumors localized to the thyroid gland.
