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Thyroid Late Effects

Sometimes certain treatments for childhood cancer can affect the thyroid gland.

This damage is usually very easy to treat.

Signs and symptoms may not show up for years after treatment.

Learn More About the Endocrine System

How the thyroid gland works

The thyroid gland is located in the lower part of the neck in front of the trachea, also known as the windpipe.

The gland produces 2 hormones: triiodothyronine (T3) and thyroxine (T4). These hormones play an important role in:

  • Growth
  • Metabolism
  • Energy level
  • Mental development
  • Body temperature

The pituitary gland makes thyroid stimulating hormone (TSH). It releases TSH in response to the levels of T3 and T4 in the blood.

If the levels are low, the pituitary gland makes more TSH to increase the production of thyroid hormones. If T3 and T4 levels are high, the pituitary makes less TSH to signal the thyroid gland to slow down production.

The thyroid gland makes thyroxine, a hormone that plays an important role in growth and mental development. Thyroxine, T4, also helps regulate the body’s temperature and metabolism.

The thyroid gland makes thyroxine, a hormone that plays an important role in growth and mental development. Thyroxine, T4, also helps regulate the body’s temperature and metabolism.

Causes of thyroid problems

What problems can occur

Problems that may occur:

  • Hypothyroidism – An underactive thyroid
  • Hyperthyroidism – An overactive thyroid
  • Thyroid nodules – Benign growths on the thyroid
  • Thyroid cancer – Malignant growths on the thyroid

What survivors can do

Know your risks and monitor your health

Ask your oncologist about your risks of developing late effects.

Inform your primary health care provider about your risks. Share a copy of your Survivorship Care Plan, which includes a treatment summary. The summary includes details about your cancer treatment and information about health problems that may occur because of treatment.

Regular check-ups

Survivors should have yearly check-ups with a health care provider.

The check-up should include evaluation of growth in children and teens, examination of the thyroid gland, and a blood test to measure the levels of TSH and T4.

During periods of rapid growth, health care providers may recommend more frequent monitoring of thyroid levels.

If problems with thyroid levels are identified, health care providers may refer survivors to an endocrinologist. If a lump is detected on the thyroid, survivors may be referred to a surgeon or other specialist.

Pregnancy-related concerns

Female survivors at risk for thyroid problems who are planning to become pregnant should have their thyroid function checked before attempting pregnancy.

Expectant mothers with thyroid disease have a higher chance of having babies with developmental problems.

It is also important to monitor thyroid levels periodically during pregnancy.


Reviewed: November 2019