Team approach to treating thyroid cancer and disorders

Our Thyroid Center brings together all the experts your child needs. A board composed of doctors from several medical specialties meets and reviews each child’s case. This team develops a comprehensive treatment plan that addresses your child’s complete medical needs.

Team members may include:

• Endocrinologists

• Pediatric surgeons

• Ear, nose and throat (ENT) surgeons

• Anesthesiologists

• Radiologists

• Surgical pathologists and lab pathologists

• Genetic specialists

• Oncologists

• Child life specialists

• Social workers

Advanced diagnostic tests for thyroid disease

We use the latest tests to diagnose thyroid problems in children. Depending on your child’s symptoms and the suspected cause, your child may need:

Diagnostics

• Thyroid hormone levels – too high – hyperthyroidism; too low hypothyroidism

• Thyroid biopsies – our interventional radiology doctors perform either a fine needle aspirate biopsy or a core biopsy

Imaging tests for thyroid disorders

Imaging tests help detect problems such as thyroid nodules, thyroid tumors and thyroid cancer. Our radiologists have expertise in reading thyroid imaging scans and identifying (mapping) lymph nodes affected by thyroid cancers.

We offer the latest imaging tests for thyroid disorders including:

• Ultrasounds

• Nuclear medicine scans

For children with larger tumors or tumors that may involve nearby tissues, our specialist may recommend:

• CT scans

• MRI

Thyroid biopsies

Examining cells from thyroid tissue is the best way to definitively diagnose or rule out thyroid cancer. Our interventional radiology doctors perform a fine needle aspirate biopsy to retrieve thyroid tissue. This process involves inserting a thin, hollow needle through numbed skin to reach the thyroid gland.

Although this procedure is quick, children usually can’t sit still for it (most adults can). For this reason, our skilled pediatric anesthesiologists provide medical sedation. This allows our doctors to get the tissue samples they need without greatly distressing your child.

Pathologists who specialize in thyroid disorders examine these tissue samples for signs of cancer and other diseases. Getting accurate, fast results helps our team quickly develop an effective treatment plan.

Advanced thyroid surgeries and treatments

Children who receive care at our Thyroid Center typically need a combination of surgical and nonsurgical treatments. Our team of experts works together to develop the most effective treatment plan for your child’s unique needs.

We offer:

Thyroid surgeries (thyroidectomies)

Our pediatric surgeons and ENT surgeons perform a high volume of pediatric thyroid surgeries called thyroidectomies. Our deep experience helps ensure successful results for your child.

Depending on the diagnosis, your child may undergo:

• Partial thyroidectomy, also called hemithyroidectomy or thyroid lobectomy, to remove half of the thyroid gland.

• Total thyroidectomy to remove the entire thyroid gland.

• Lymph node removal (lymphadenectomy) to treat cancer that spreads to nearby lymph nodes or lymph nodes that look abnormal.

Thyroid hormone replacement therapy

Thyroid hormones regulate metabolic processes that help your child grow and develop. Children who have their thyroid glands completely removed must take lab-made thyroid hormones for the rest of their life. Some children who get partial thyroidectomies also need these hormones.

Our endocrinologists closely monitor the levels of thyroid hormones in your child’s blood and make medication adjustments as needed. It’s especially important that thyroid hormone levels stay within a certain range if a child has a history of thyroid cancer. Maintaining safe thyroid hormone levels can lower the risk of cancer recurrence (cancer that comes back after treatments).

Postsurgical treatments for thyroid cancer

In some instances, thyroid cancer can spread to lymph nodes or other parts of the body. Should cancer spread, your child may need cancer treatments after a thyroidectomy. Your child’s endocrinologist or surgeons will coordinate treatment.

Possible treatments include:

• Radioactive iodine therapy: This oral medication destroys any remaining thyroid tissue and thyroid cancer cells. It also helps children who have overactive thyroid glands (hyperthyroidism) that make too much thyroid hormone.

• Tyrosine kinase inhibitors (TKIs): We’re among a select few pediatric centers in the country with the expertise to offer TKIs for children with advanced thyroid cancer or medullary thyroid cancer that spreads. TKIs are a type of oral targeted therapy that finds and destroys lingering cancer cells in some children. A pediatric oncologist also provides care for children receiving TKI therapy.

Dedicated services for children at risk for thyroid cancer

Children with MEN syndromes are more likely to develop medullary thyroid cancer. To prevent your child from developing this difficult-to-treat cancer, our surgeons perform preventive (prophylactic) surgery to remove the thyroid gland before the cancer develops.

The timing of the surgery depends on the type of MEN syndrome and other factors unique to each child. We closely monitor your child’s health to ensure treatment happens at the appropriate time. Some children need surgery during their first year of life, while others don’t need surgery until their teen years.

Genetic tests for thyroid disorders

Children who have extensive family histories of thyroid cancer or a diagnosis that suggests an inherited condition, may see our genetic specialists. These experts perform blood tests to check for gene changes (mutations) that increase a child’s risk of thyroid cancer. Children who have thyroid cancer risk factors receive advanced care and close monitoring through our Cancer Susceptibility Program.

Continuing thyroid care into adulthood

Children with thyroid cancer or MEN syndromes and those who need thyroid hormone replacement therapy require lifelong monitoring and care. We follow these children as they grow and provide services that protect your child’s health and help them enjoy a happy childhood. When the time is right, we ease the transition to adult care.