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Together is a new resource for anyone affected by pediatric cancer - patients and their parents, family members, and friends.
Learn MoreDifferentiated thyroid cancers (DTCs) are a type of thyroid cancer. The thyroid gland lies just below the throat in the front of the neck. The thyroid makes hormones that control body functions.
DTCs are the most common type of thyroid cancer in children.
There are 2 types of DTCs:
About 90% of thyroid cancer cases in children are papillary thyroid cancer.
The thyroid gland lies at the base of the throat in the front of the neck. It has 2 lobes, 1 on the right and the other on the left. The thyroid gland has follicular cells that make hormones. Small parathyroid glands lie behind the thyroid.
Papillary thyroid cancer often appears as nodules in the thyroid gland. The nodules may be in one or both lobes. By the time of diagnosis, this cancer has often spread outside of the thyroid to nearby lymph nodes in the neck.
Follicular thyroid cancer starts in the follicular cells of the thyroid gland. This cancer usually stays in the neck area, but it can sometimes spread to the lungs and bones.
The thyroid gland uses iodine from the diet to make hormones. DTCs take up iodine. This feature is important for screening and treatment with radioactive iodine.
Despite the tendency for DTC to spread in children, this type of cancer has an excellent outcome with a greater than 95% survival rate.
Surgery to remove the cancer is the main treatment. Patients with intermediate and high-risk DTC may receive treatment with 131I radioactive iodine (RAI).
Signs and symptoms of DTC include:
Thyroid cancer does not always cause symptoms. The doctor may find it during a regular physical exam.
DTC occurs most often in older children and teens. Teens are 10 times more likely to develop thyroid cancer than younger children. These cancers are more common in females than males.
Families may have genetic disorders that increase their cancer risk. Parents may pass down these conditions to their children. Changes in the child's genes may also increase their cancer risk.
Patients with DTC often have a change (mutation) in the RET gene, so it does not work properly. A child may inherit this mutation from either parent. Or your child may be the first person in your family with this gene change.
Your child's care team may suggest genetic counseling and genetic testing if your child has one of these gene changes.
Genetic syndromes (disorders) linked to DTCs include:
Exposure to high doses of radiation can increase a person's risk for cancer. There is a higher risk of cancer from ionizing radiation when:
Learn more about radiation safety.
Doctors use several types of tests to diagnose medullary thyroid cancer. Tests may include:
The cancer stage depends on the nodule's features and if cancer has spread to other parts of the body. The stages are:
The stage helps doctors classify patients into risk groups after surgery. In general, children with DTC have a good prognosis. However, some patients are at higher risk for more disease.
| Risk group | Spread of disease |
|---|---|
| Low Risk | Cancer is only in the thyroid gland with little or no spread to lymph nodes. |
| Intermediate Risk | Some cancer has spread to nearby lymph nodes. |
| High Risk | Cancer has spread to nearby lymph nodes, tissues outside the thyroid, or other parts of the body such as the lungs. |
A team of specialists will evaluate, treat, and monitor your child's cancer. The team will balance the need for care and treatment with possible harm from treatment side effects. The team will monitor your child because:
DTC has a greater than 95% survival rate in pediatric patients.
Recurrence is more likely in children under 10 years of age and patients whose cancer has spread to the lymph nodes before diagnosis. Even with the risk of recurrence, their chance of survival is good.
Factors that influence prognosis include:
Your child's doctor is the best source of information about your child's case.
After treatment, your child will need lifelong monitoring and follow-up care from a team of specialists. This care is important because:
The care team will recommend the frequency and type of tests for monitoring, which depends on individual patient needs.
Follow-up care may include:
Recurrence of thyroid cancer can happen many years after treatment. Regular monitoring provides early detection of thyroid cancer that develops later.
Care team members with Psychology, Child Life, Social Work, and other areas can help your child cope and improve their quality of life. They can assist with concerns, including:
Adjusting to a thyroid cancer diagnosis can be challenging for families. Although the prognosis is generally good, the disease requires lifelong management with medication and monitoring. Your child may need more support as they go from adolescence to young adulthood and gain independence. Adjustment challenges may also be greater for patients who have thyroid cancer as second cancer.
Doctors recommend that patients receiving radioactive iodine therapy be followed for possible long-term and late effects of treatment. These can include:
All cancer survivors should live a healthy lifestyle and get regular physical checkups and screenings by a health care provider familiar with cancer survivorship issues to stay well.
Your care team may prepare a survivorship care plan. This plan is a complete record of your child's treatment, medical concerns, and health screenings they need.
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Together does not endorse any organization mentioned in this article.
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Reviewed: December 2022