Pediatric Thyroid Cancer
The thyroid is a butterfly shaped gland located at the base of the throat. It has two lobes separated in the middle by a strip of tissue (the isthmus). The thyroid itself secretes three main
hormones: (1) Thyroxine contains iodine, needed for growth and metabolism; (2) Triiodothyronine, similar in function to Thyroxine, effects body size, tissues growth, and function: and (3) Calcitonin, which decreases the concentration of calcium in the blood and increases calcium in the bones. All three of these hormones have an important role in your child’s growth.Thyroid cancer is the third most common tumor malignancy in children. It occurs six times more often in females than males and shares several characteristics with adult thyroid cancer patients. Surgery is the preferred treatment for this cancer and although the procedure is often uncomplicated, one of the risks of thyroid surgery involves vocal cord paralysis. Consequently,an otolaryngologist—head and neck surgeon should be consulted.
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.
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 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 multiple endocrine neoplasia type 2 (MEN2), an
inherited genetic form of the cancer.
Anaplastic: This is the fastest growing of the thyroid cancers, with extremely abnormal cells that
grow and spread rapidly, especially locally in the head and neck region. This form of cancer
usually is found in older patients.
The symptoms of this disease vary. Your child may have a lump in the neck, continuous swollen
lymph nodes, a tight or full feeling in the neck, and/or trouble with breathing or swallowing,
hoarseness.
If any of these symptoms occur, consult your child’s physician for a diagnosis. The diagnosis could consist of a head and neck examination to determine if unusual lumps are present; a blood test to indicate how the thyroid is functioning; a sonography, which uses high-frequency sound waves and a computer to create an image of the thyroid gland; a radioactive iodine scan, which provides information about the thyroid shape and function, identifying areas in the thyroid that do no absorb iodine in the normal way; fine needle biopsy, removal for study of a small part of the tumor; and surgery, where a procedure known as a thyroid lobectomy, necessitates removal of the lobe of the thyroid gland that contains the tumor, for analysis.
If the tumor is found to be malignant then surgery is used to remove as much of the tumor as possible either by lobectomy or subtotal thyroidectomy (removal of at least one thyroid lobe and up to a near-total removal of the thyroid gland). If necessary, the otolaryngologist— head and neck surgeon may remove the entire thyroid, in a procedure called a total thyroidectomy. Surgery may be followed by radioactive iodine therapy which destroys cancer cells that are left after surgery and help prevent the disease from returning Thyroid hormone therapy may need to be administered throughout your child’s life when he/she has had surgery to remove the thyroid followed by radioactive iodine treatment to replace normal hormones and slow the growth of cancer cells. If cancer has spread to other parts of the body, chemotherapy, the treatment of disease by means of 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. In general, treatment outcomes for this type of cancer in children tend to be excellent. The best outcome is achieved with teenage girls, papillary type cancer, and a tumor localized to the thyroid gland
Source: National Cancer Institute “Population-based Outcomes for Pediatric Thyroid Carcinoma,” by Nina L. Shapiro MD, and Neil Bhattacharyya MD, Laryngoscope. 2005 Feb;115(2):337-40.
Read MoreThyroid cancer markers
The term thyroid cancer markers or ‘tumor marker’’ was originally used to indicate a protein in the blood able to signal the presence or suspicion of a tumor. Presently, the utility of thyroid cancer markers has been expanded to include the following criteria:
(a) to identify subjects at risk of developing a specific tumor type;
(b) to perform early diagnosis of a primary tumor or its metastasis;
(c) to contribute to histotyping of the tumor;
(d) to contribute to prognosis;
(e) to monitor progression of the tumor, primary or metastatic;
(f) to monitor response to therapy;
(g) to contribute to understanding of tumor pathogenesis;
(h) to suggest diagnostic or therapeutic interventions related to the tumor marker itself or to tumor marker-related molecular events (Van Veelen et al., 2009).
In the specific case of thyroid cancer markers, the biochemical evaluation of the thyroid cancer patient has advanced from simple serum thyroglobulin (Tg) and calcitonin (CTN) determinations to genomic and proteomic analyses (Giordano, 2008; Krause et al., 2009). For several decades,
many controversies existed regarding the management of thyroid nodules highlighting the need for strong and reliable TTMthat would be useful in routine clinical practice. This article will extend the findings of our previous reviews on thyroid cancer markers to focus on these two systems biology techniques (Carpi et al., 2006a; Mechanick and Carpi, 2008).
Laboratory and clinical research provide a large number of biomarkers useful or potentially useful for the management of patients with a thyroid tumor. The application settings for the use of thyroid cancer markers vary from preoperative selection of thyroid nodules for surgery to postoperative follow-up including monitoring of metastatic disease. The latter application suffers from the lack of evidence-based recommendations and consists primarily of consensus statements that vary over time. However, Tg remains a consistent and essential tool. On the other hand, the
former application is more grounded in data. Preoperative screening algorithms affect a larger number of patients (those with thyroid nodules compared to those with thyroid cancer) and can effectively reduce surgical excisions of benign nodules. Unfortunately, many of these techniques are too complicated or costly to be routinely used in clinical laboratories or are as yet poorly standardized. Nevertheless, the thyroid cancer markers determinations on preoperative percutaneous biopsy specimens are becoming more feasible. For example, the use of LNAB, which yields more tissue than FNAB, and the recently standardized galectin-3 immunodetection method, which confers accurate information regarding cancer risk, represents two emergent technologies that can optimize the preoperative selection of thyroid nodules.
Read MoreThyroid Nodules
I. What is it?
Thyroid nodules, also called as goiter, are one of the disorders of the thyroid gland, where the endocrine gland is enlarged. The enlargement of this organ is said to be diffused, where it could be that the whole gland is enlarged or only its nodules. In addition, thyroid nodules are small lumps, growing in the thyroid gland area. Thyroid nodules can be very small in size although they grow bigger in centimeters. They appear in the thyroid glands either singly or in groups with different sizes. Until now, the cause of the occurrence of these nodules is yet to be determined.
II. Its symptoms
Although thyroid nodule is a common condition, most of its occurrence does not show any symptoms. Usually, thyroid nodules can be determined through a routine physical examination or just by noticing a lump in the neck area. It should be known that if the nodule is made up of thyroid cells, then the patient may be suffering from hyperthyroidism. In some cases where the nodule is large enough, difficulty in swallowing may be experienced or difficulty in breathing can be felt as the enlarged nodule may press on the windpipe.
According to Medline Plus, about 90 to 95 percent of the nodules is not cancerous and only five percent of it can lead to cancer. However, all nodules in the thyroid should be examined thoroughly.
Read MoreThyroid Hair Loss
Thyroid Hair Loss
There are a lot of reasons why an individual may experience hair loss. Hormonal imbalances or problems, stress or being in a major surgery are just a few of the many reasons why an individual experiences hair loss. Hair loss may happen for so many reasons but it is commonly associated to thyroid problems such as hyperthyroidism and hypothyroidism. Losing one’s hair is one of the most common symptoms for both thyroid disorders; hypothyroidism and hyperthyroidism. The thyroid gland produces thyroid hormones. If the thyroid gland is underactive or overactive, the thyroid hormones become imbalanced. It could either be the body is getting more thyroid hormones or inadequate thyroid hormones. When this happens, one’s hair may fall out. However, hair loss caused by thyroid problems may be treated.
Read MoreThyroid Symptoms in Women
If a woman’s thyroid gland no longer produces enough amounts of thyroid hormones needed by the body, then she will be suffering from Hypothyroidism. If a woman’s thyroid gland produces more thyroid hormones than what the body needs, she may have Hyperthyroidism. Before she can be given any medication, she has to undergo a series of tests to be able to determine the right thyroid symptom she is suffering from. Identifying the signs and symptoms of thyroid disorder leads doctors to provide the right diagnosis and treatment. Hypothyroidism has been classified into two categories. It can either be early or late onset. Early symptoms would be fatigue, goiter, increased sensitivity to cold temperature and gaining unwanted weight, to name a few. Women are more likely to have thyroid problems than men. Some thyroid problems may show symptoms even if it is still in its early stage. Some thyroid problems no matter how severe, shows no symptoms at all. The later the symptoms show, the dangerous it can be. In cases like this, it is best to consult professional help. Thyroid problems, if left undiagnosed and untreated put one’s life at risk. Don’t allow to be left undiagnosed. Visit your doctor.