Thyroid Cancer

Thyroid [THAHY-roid] cancer is cancer that occurs in the thyroid gland, a butterfly-shaped gland located in the neck between the Adam’s apple and the collarbone. The thyroid gland plays an important role in regulating the hormones that control metabolism (energy production). There are 2 types of cells in the thyroid gland referred to as follicular [fuh-LIK-yuh-ler] or C cells. When these cells have abnormalities and grow out of control, they can cluster and form a mass called a tumor or carcinoma. There are 4 types of thyroid cancer.

Papillary [PAP-uh-ler-ee]. This is the most common type of thyroid cancer and has good outcomes when caught in the early stages.

Follicular. A more aggressive kind of thyroid cancer, follicular cancer only occurs in about 10 out of every 100 of thyroid cancers.

Medullary [MED-uhl-er-ee]. This type of thyroid cancer is rare and spreads more quickly.

Anaplastic [an-uh-PLAS-tik]. Thyroid cancer that occurs as anaplastic is very rare and extremely hard to treat.

Most thyroid lumps are not tumors but nodules [NOJ-ools] that have developed on the thyroid and contribute to a condition called hyperthyroidism [hahy-per-THAHY-roi-diz-uhm]. Thyroid cancer is more common in women and more likely to occur in people under the age of 50. It is rare in children and adolescents. 

Because the thyroid can’t be felt from the neck, the symptoms of thyroid cancer can go undetected. Symptoms of thyroid cancer typically include:

• A lump or swelling in the neck
• A persistent cough not associated with an illness
• Changes to the voice
• Neck pain or swollen lymph nodes
• Trouble breathing or swallowing

See a doctor if your child experiences any of the symptoms of thyroid cancer. Lumps in the neck are often not thyroid cancer. However, since early detection is important for good outcomes related to cancer, it’s best to get tested as soon as possible.

There are a few known risk factors and suspected causes of thyroid cancer, such as:

• Sex. Women are 3 times as likely as men to develop thyroid cancer.
• Age. Thyroid cancer does not usually occur in children or adolescents, but unlike other cancers, it is also more likely to be diagnosed before 50.
• Hereditary factors. Some inherited conditions (conditions passed down through families) or gene mutations make it more likely that your child might develop thyroid cancer.
• Inherited risk. If an immediate family member has been diagnosed with thyroid cancer, your child is more likely to develop thyroid cancer as well.
• Exposure to radiation. Children who have been exposed to radiation in the past are more likely to develop thyroid cancer.
• Low in iodine. Eating a diet low in iodine can increase your child’s risk of developing thyroid cancer.

There is also some evidence that being of Asian descent increases your child’s risk of thyroid cancer.

If your doctor suspects your child may have thyroid cancer, your child will undergo testing to confirm the diagnosis and develop a treatment plan. The tests recommended for your child will depend on their age, overall health, family and medical history, and their preference. Diagnosis and testing generally include a:

• Discussion of family and medical history
• Physical exam
• Thyroid radioiodine [rey-dee-oh-AHY-uh-dahyn] scan
• Thyroid biopsy [BY-op-see]
• Other imaging tests

Your child’s doctor may also recommend a blood test to check hormone levels for other sources of thyroid problems or genetic testing to confirm the diagnosis. If it’s suspected that the cancer has spread beyond the thyroid, your child may undergo additional imaging tests like x-rays, MRI or CT scans, or PET scans to determine the extent of the cancer.

Thyroid cancer has the following 4 stages of diagnosis and the stages each have sub-stages depending on the type of cells involved.

1. Stage T1. The tumor is 2 cm or less in size and has not extended beyond the thyroid.
2. Stage T2. The tumor is between 2 and 4 cm in size. and has not extended beyond the thyroid.
3. Stage T3. The tumor is more than 4 cm in size and has begun to grow into the surrounding tissues.
4. Stage T4. The tumor can be any size but has grown beyond the thyroid and surrounding tissues towards the spine or other blood vessels.

Treatments for thyroid cancer will depend on the stage of cancer, the area affected, and your child’s overall health, age, and other conditions. There are generally 3 goals of cancer treatment:

1. Remove the growth.
2. Kill or stop current cancer from progressing.
3. Prevent cancer from returning.

Your child’s doctor will work as part of a treatment team that may include a surgeon, an endocrinologist [en-doh-kruh-NOL-uh-jist], and an oncologist [on-CALL-oh-jist] to develop a treatment plan that’s right for your child. That plan will likely include one or both of the following types of treatments.

• Local. The focus of these types of treatments is to remove the growth and kill cancer. This would include surgery to remove the thyroid or part of the thyroid. It may also include radioactive iodine treatment to kill any remaining cancer.
• Systemic. These treatments target the spread of cancer and prevention of its return and include things like radiation, chemotherapy [KEE-moh-THER-uh-PEE], and targeted therapy.

If your child’s thyroid does need to be removed because of thyroid cancer, they’ll be prescribed medicine. This medicine provides the hormone to regulate metabolism that they’ll be missing when their thyroid is gone. This medicine also suppresses the pituitary [pi-TOO-i-ter-ee] gland to prevent thyroid growths from recurring. 

Preventing cancer involves reducing basic risk factors. For those with genetic or inherited risk factors, this may be impossible. Doctors recommend the following steps to reduce some risks associated with developing thyroid cancer and to develop a healthy lifestyle that reduces the risk of cancer generally:

• Eat a healthy diet.
• Maintain a healthy weight.
• Exercise and stay active.
• Avoid exposure to radiation.
• Eat a diet that contains iodine (often included in table salt).

If detected early, certain types of thyroid cancers have a 5-year survival rate of nearly 100 percent so talk with your doctor if you have inherited risk factors or other conditions to see if additional screening or tests are recommended. 

Thyroid [THAHY-roid] cancer is cancer that occurs in the thyroid gland, a butterfly-shaped gland located in the neck between the Adam’s apple and the collarbone. Thyroid cancer is more common in women and more likely to occur in people under the age of 50.